Obstructive Disease

Question Answer
Inability of the lung to maintain normal function. (Bad pH and high CO2) Respiratory Failure
What term is applied to patients with long term chronic obstructive pulmonary disease, who show persistent airway obstruction normally manifested by decreased expiratory flow rates? COPD
With COPD, it is harder for the patient to get air ______. Out
What is a general cause of COPD? Smoking
As a result of air trapping, a patient will have an increased anteroposterior diameter which is referred to a _____ ______. Barrel chest
*Physical appearances of COPD Barrel chest, clubbing of the digits, cyanosis, decreased and adventitious breath sounds, hypereesonant chest, ventilation pattern
*PFT's for COPD Increased FRC,Increased RV,Increased RV/TLC Ratio, Decreased expiratory flow studies
*PFT's for COPD Frequent and increased in pulmonary compliance,Increased airway resistance
*General X-Ray findings for COPD Increased Anteroposterior Diamter (barrel chest),Flattened hemidiaphragms,Hyperinflation
One of the first notable symptoms in COPD is _______. Dyspnea (shortness of breath)
ABG's of COPD patients with CO2 retention Ventilation/perfusion inequalities develop,Hypoxemia becomes worse,Stimulation of peripheral receptors (Hypoxic drive) results in hyperventilation
Right sided heart failure, or an enlargement of the right ventricle due to high blood pressure in the lungs Cor Pulmonale
_____ _____ causes the right side of the heart to work harder Pulmonary hypertension
How can you manage COPD? Symptomatic treatment of the presenting problem (drugs, aerosol therapy),Exercise,Oxygen therapy,Treatment for congestive heart failure,Proper education support
*Types of COPD (CBABE),Cystic Fibrosis,Bronchitis,Asthma,Brochiectasis,Emphysema
What is Emphysema? Characterized by enlargement of air spaces distal to terminal bronchioles, with loss of elastic fibers and destruction of alveolar septal wall.
What can cause Emphysema? Smoking,Environmental conditions,Occupational hazards (dust fumes, etc),Heredity
*What are the different types of Emphysema? Centrilobular (most common, smoking)Panlobular (non smoking, aging)Bullous (air leak, bleb and bullae formation)
What are some clinical manifestations of Emphysema? Shortness of breath, Nonproductive cough,Frequent respiratory infections, Cyanosis, Barrel chest, Hyper-resonant chest, Polycythemia, Use of accessory muscles, Clubbing of digits, Anorexia, Muscle Atrophy,*Lengthened E time due to recoil damage
X-Ray findings for Emphysema
Acute inflammation of tracheobronchial tree with production of excessive mucus Bronchitis
What are some manifestations and causes of Bronchitis? Mucosal Edema and increased sputum,Causes: Infection, allergic, chemicals
Normally a self limiting process without serious complications or residual effects Acute Bronchitis
Chronic cough with excessive sputum production of unknown etiology for 3 months a year for 2 or more years. Chronic Bronchitis
What causes chronic bronchitis? Frequent acute episodes of bronchitis from smoking, air pollution, or chronic infections (cystic Fibrosis)
Chest X Ray findings in Chronic Bronchitis Early in disease X-ray changes are not significant. If the disease has moved to periphery, hyperinflation with a flattened hemidiapragm may be noticed.
PFT's in Chronic Bronchitis Early stages- may be normal except slight decrease in expiratory flow rates. Later- pulmonary function results are consistent with Emphysema
What are some treatments for chronic bronchitis? Removal of irritants, aerosol or bronchodilator therapy, antibiotic, treatment faulty consistent with COPD
Permanent abnormal dilation and distortion of bronchi and/or bronchioles Bronchiectasis
Classifications of Bronchiectasis Cylindrical (tubular)- walls are dilated with regular outlines, Fusiform (cystic)-walls have large, irregularly shaped distortions, Saccular – complete destruction of bronchial walls.
Clinical manifestations of Bronchiectasis Chronic loose cough, often exacerbated by change in postition,Clubbing of digits,Recurrent infections
*Bronchiectasis have increased sputum production of a characteristic three-layer nature upon standing. Top layer (thin, frothy),Middle layer (turbid, mucopurient),Bottom Layer (opaque, mucopurulent to purulent)
Bad breath Halitosis
Blood streaked sputum Hemoptysis
Chest X-ray findings Bronchiectasis Usually normal unless disease is advanced, may show multiple cysts with associated fluid level
PFT's for Bronchiectasis are consistent with ______. COPD

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