Term
| what are the classifications of obstructive pulmonary disease? |
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Definition
| asthma, obstructive airway disease (chronic bronchitis and emphysema), and other obstructive pulmonary disease: bronchiectasis, bronchiolitis, CF, peripheral airways disease, BOOP (restrictive, treat w/steroids) |
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Term
| what is acute bronchitis? |
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Definition
| acute inflammation of the airway, usually occurring in the winter and can be viral - though simalero says to still administer antibx if the pt is coughing up yellow |
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Term
| what are "blue bloaters"? common associations? |
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Definition
| COPD pts, who often have tattoos and a yellow "V sign" (from cigarettes) |
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Term
| what is chronic bronchitis? |
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Definition
| a response to chronic bronchial irritation (usually cigarette smoke), where excessive mucus secretion is manifested by chronic or recurrent productive cough (present most days for a min of 3 mos/year for at least 2 successive years) - this can cause airway remodeling |
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Term
| what is the major symptom associated with chronic bronchitis? primary cause/other causes? |
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Definition
| major symptom: chronic productive cough. primary cause: coal dust and cigarette smoking. other: air pollution, infections, occupational irritants. |
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Term
| what are other characteristics of chronic bronchitis? |
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Definition
| mucus gland hypertrophy/hyperplasia, increased sputum production, hypercapnea, frequent, polycythemia, and possible cor pulmonale |
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Term
| what is acute exacerbation of chronic bronchitis characterized by? what needs to be administered to the pt? |
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Definition
| worsening cough, increased sputum production, and changes in sputum color/viscosity/amount. this may be associated w/worsening respiratory status or constitutional symptoms. *often acute exacerbations are due to a bacterial infection, and thus antibx should be administered |
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Term
| can kartagener's predispose pts for bronchiectasis? |
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Definition
| yes b/c it is ciliopathic, (also associated w/situs inversus) |
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Term
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Definition
| emphysema pts w/pursed lip breathing (keeps alveoli open) |
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Term
| what gene deficiency will cause panlobar emphysema? |
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Definition
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Term
| what is the major symptom of emphysema? primary cause? other causes? |
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Definition
| major symptom: dyspnea, primary cause: cigarette smoke. other causes: air pollution, infection, inherited enzyme deficiency, occupational irritants |
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Term
| what are other characteristics of emphysema? |
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Definition
| irreversible, loss of elastic recoil in the lungs, increased total lung capacity (though not properly functional), prolonged expiratory time in relation to inspiratory time, and normocapnea |
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Term
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Definition
| an *obstructive* pulmonary disease that is: reversible (in most pts), inflammatory, and characterized by increased airway reponsiveness |
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Term
| what are the major symptoms of asthma? (*exam question*) |
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Definition
| cough (productive/nonproductive), dyspnea, wheezing, and hyponocapnea |
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Term
| what are factors that precipitate symptoms in asthmatics? (*exam question*) |
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Definition
| allergens, drugs, emotions, exercise, infections, occupational irritants, smoking/pollutants, and strong odors |
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Term
| what characterizes breathing during an asthma attack? |
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Definition
| decreased performance on PFTs, prolonged expiratory time in relation to inspiratory time, and tachypnea |
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Term
| what is the pathology of advanced chronic asthma? |
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Definition
| hyperinflation, increased number of mucus glands, thick tenacious mucus, mucus plugs, muscular hypertrophy, thickened BM, and peribronchial eosinophilic infiltration |
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Term
| what 2 things will commonly be seen histologically in sputum from an asthma pt? |
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Definition
| curschmann's spirals (mucus) and charcot leyden crystals (eosinophils) |
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Term
| what are the two phases of asthma? |
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Definition
| early (immediate) response and late (delayed) response |
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Term
| what is the major problem with early response asthma? tx? |
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Definition
| major problem: bronchospasm tx: albuterol (rapid bronchodilator) |
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Term
| what is the major problem with late response asthma? tx? |
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Definition
| major problem: inflammation (typically more severe than early response) tx: advair/xolair, long acting bronchodilators |
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Term
| what are the characteristics of early asthmatic response? |
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Definition
| early asthmatic response occurs in all pts w/asthma and is caused by release of mediators from mast cells (histamine). it generally occurs 5-10 min after exposure and lasts 1.5-2 hrs. |
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Term
| what treatment does early asthmatic response respond to? |
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Definition
| bronchodilators (*beta-agonists*, fast acting), cromoyln sodium (prophylactic), and corticosteroids (partial chronic effect) |
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Term
| what are the characteristics of late asthmatic response? |
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Definition
| the late asthmatic response occurs in 50-90% of pts and is due to chemotactic factors recruiting eosinophils, platelets, and neutrophils. the late asthmatic response occurs 3-8 hrs after exposure and lasts a widely varying amount of time |
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Term
| what treatment does late asthmatic response respond to? |
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Definition
| cromolyn sodium and corticosteroids, (*poorly to bronchodilators*) |
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Term
| what are the triggers for asthma? |
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Definition
| viral respiratory infections, exercise, endocrine factors (pregnancy), ASA/beta blockers, weather changes/cold air, allergens, emotional expression (anger/laughing), food additives (sulfites), environmental changes, and exposure to irritants/occupational chemicals |
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Term
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Definition
| asthma, aspirin sensitivity, and nasal/ethmoidal polyposis |
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