Term
|
Definition
| a well perfused emphysema pt who struggles to breath |
|
|
Term
| What % of caloric energy does a 'pink puffer' extend on breathing? |
|
Definition
|
|
Term
| Why do emphysema pt's present with a pursed lip expression? |
|
Definition
| Must maintain larger reserve volume to help prevent alveolar collapse |
|
|
Term
|
Definition
Using arms to facilitate breathing by broadening the chest
hands are placed on the knees and shoulders brought slightly forward |
|
|
Term
| What are two signs of 'pink puffer' emphysema pts? |
|
Definition
|
|
Term
| Do 'pink puffer' pts have low pCO2? |
|
Definition
| If low, not by much. They can get O2, it just comes a large exertive cost |
|
|
Term
| What is chronic bronchitis? |
|
Definition
| persistent, productive cough on most days for at least 3 consecutive months in 2 consecutive years |
|
|
Term
| What are s/sx of chronic bronchitis? |
|
Definition
wheezing
crackles
tachycardia
polycythemia |
|
|
Term
| In chronic bronchitis is it a dry cough? |
|
Definition
|
|
Term
| What is the prevalence of chronic bronchitis? |
|
Definition
| 9.8 million pt's in the US |
|
|
Term
| Why does polycythemia present with chronic bronchitis? |
|
Definition
| The body senses low pO2 and makes more RBC's to try and increase O2 supply to the tissues |
|
|
Term
| Are the airways inflamed in chronic bronchitis? |
|
Definition
|
|
Term
| What kind of cellular change is seen in the airway mucous glands when chronic bronchitis is present? |
|
Definition
| hypertrophy --> airway obstruction |
|
|
Term
| What are two sounds often heard with chronic bronchitis? |
|
Definition
| crackling and course lung sounds |
|
|
Term
| With chronic bronchitis, can coughing clear the airway of excess mucous? |
|
Definition
|
|
Term
| What is the #1 cause of chronic bronchitis? |
|
Definition
|
|
Term
| What are secondary causes of chronic bronchitis? |
|
Definition
| air pollution and infections |
|
|
Term
| What is a 'blue bloater'? |
|
Definition
| A stereotypical chronic bronchitis pt, they are blue because they can't clear enough CO2 |
|
|
Term
| What lung dz presents with obese, edematous pts? |
|
Definition
chronic bronchitis
Due to poor O2/CO2 exchange, pt reduces activity --> obesity |
|
|
Term
| Why does right sided heart failure appear in chronic bronchitis pts? |
|
Definition
| The lungs sense that there is not much O2 present, so it constricts attemping to divert blood to a well perfused area of the lung, that doesn't exist. Therefore the entire lung constricts --> increased blood flow resistance --> edema and right sided heart failure |
|
|
Term
| Why are chronic bronchitis pts happy and cyanotic? |
|
Definition
| CO2 buildup --> CO2 narcosis and poor O2 perfusion |
|
|
Term
| Do chronic bronchitis pts struggle to breath? |
|
Definition
| As long as they have enough O2 to avoid triggering peripheral chemoreceptors, then no. |
|
|
Term
| What are associated s/sx of chronic bronchitis? |
|
Definition
decreased VA's at night
decreased color vision
transient visual obscurations
7% have swollen optic nerve heads
82% have decreased retinal fxn w/ abnormal VEP
increased risk of increased pCO2 and decreased blood pH |
|
|
Term
| What causes decreased VA's and decreased color vision in chronic bronchitis pt? |
|
Definition
| poor O2 perfusion in the retina |
|
|
Term
| What is the goal of chronic bronchitis and emphysema? |
|
Definition
| manage s/sx, avoid causative agent (smoking) |
|
|
Term
| How is chronic bronchitis treated? |
|
Definition
treated similar to asthma
not curable however |
|
|
Term
| What are the 5 "A's" of smoking cessation? |
|
Definition
Ask
Advise
Assess
Assist
Arrange |
|
|
Term
| If a smoker wants to quit, what steps should be taken? |
|
Definition
set a quit date, ideally within two weeks
remove tobacco products from the home
Call a stop smoking support line |
|
|
Term
| What are drug tx classes for chronic bronchitis and emphysema? |
|
Definition
| bronchodilators and anti-inflammatory drugs |
|
|
Term
| What are the two types of bronchodilators for chronic bronchitis and emphysema tx? |
|
Definition
short acting Beta 2 agonists
long acting Beta 2 agonists |
|
|
Term
|
Definition
| bronchodilator that is more toxic, causes seizures and arrythmias |
|
|
Term
| What is a controversial tx of chronic bronchitis and emphysema? |
|
Definition
glucocorticoids
May be useful during exacerbations
May decrease number of exacerbations |
|
|
Term
| Is oxygen therapy used in tx of chronic bronchitis and emphysema? |
|
Definition
| yes, show to prolong survival. Used primarily for chronic bronchitis |
|
|
Term
| Are AB's used to tx chronic bronchitis and emphysema? |
|
Definition
yes, decreases frequency and severity of exacerbations
reduces mortality |
|
|
Term
| Why are glucocorticoids controversial for chronic bronchitis tx? |
|
Definition
| They compromise lung immune system and may lead to increased infection |
|
|
Term
| What is a bronchial valve? |
|
Definition
| umbrella shaped device that is placed in the bronchioles to block airflow to diseased lung regions. NOT used yet, experimental |
|
|
Term
| What are phoshodiesterase inhibitors? |
|
Definition
| PDE-4 enzyme inhibitor, limits inflammation of airway smooth muscle and airway nerves |
|
|
Term
| Do steroid/statin combos show promise for chronic bronchitis tx? |
|
Definition
| yes, may have anti-inflammatory effect |
|
|
Term
| What vaccine has been shown to reduce morbidity and mortality in chronic bronchitis and emphysema pts? |
|
Definition
|
|
Term
| What are surgical tx's for emphysema? |
|
Definition
bullectomy --> reduce compression of surrounding tissue
volume reduction surgery --> remove part of lung to prevent pressure and collapse of less diseased parts --> more space in thoracic cavity for diaphragm |
|
|
Term
|
Definition
| a well perfused emphysema pt who struggles to breath |
|
|
Term
| What % of caloric energy does a 'pink puffer' extend on breathing? |
|
Definition
|
|
Term
| Why do emphysema pt's present with a pursed lip expression? |
|
Definition
| Must maintain larger reserve volume to help prevent alveolar collapse |
|
|
Term
|
Definition
Using arms to facilitate breathing by broadening the chest
hands are placed on the knees and shoulders brought slightly forward |
|
|
Term
| What are two signs of 'pink puffer' emphysema pts? |
|
Definition
|
|
Term
| Do 'pink puffer' pts have low pCO2? |
|
Definition
| If low, not by much. They can get O2, it just comes a large exertive cost |
|
|
Term
| What is chronic bronchitis? |
|
Definition
| persistent, productive cough on most days for at least 3 consecutive months in 2 consecutive years |
|
|
Term
| What are s/sx of chronic bronchitis? |
|
Definition
wheezing
crackles
tachycardia
polycythemia |
|
|
Term
| In chronic bronchitis is it a dry cough? |
|
Definition
|
|
Term
| What is the prevalence of chronic bronchitis? |
|
Definition
| 9.8 million pt's in the US |
|
|
Term
| Why does polycythemia present with chronic bronchitis? |
|
Definition
| The body senses low pO2 and makes more RBC's to try and increase O2 supply to the tissues |
|
|
Term
| Are the airways inflamed in chronic bronchitis? |
|
Definition
|
|
Term
| What kind of cellular change is seen in the airway mucous glands when chronic bronchitis is present? |
|
Definition
| hypertrophy --> airway obstruction |
|
|
Term
| What are two sounds often heard with chronic bronchitis? |
|
Definition
| crackling and course lung sounds |
|
|
Term
| With chronic bronchitis, can coughing clear the airway of excess mucous? |
|
Definition
|
|
Term
| What is the #1 cause of chronic bronchitis? |
|
Definition
|
|
Term
| What are secondary causes of chronic bronchitis? |
|
Definition
| air pollution and infections |
|
|
Term
| What is a 'blue bloater'? |
|
Definition
| A stereotypical chronic bronchitis pt, they are blue because they can't clear enough CO2 |
|
|
Term
| What lung dz presents with obese, edematous pts? |
|
Definition
chronic bronchitis
Due to poor O2/CO2 exchange, pt reduces activity --> obesity |
|
|
Term
| Why does right sided heart failure appear in chronic bronchitis pts? |
|
Definition
| The lungs sense that there is not much O2 present, so it constricts attemping to divert blood to a well perfused area of the lung, that doesn't exist. Therefore the entire lung constricts --> increased blood flow resistance --> edema and right sided heart failure |
|
|
Term
| Why are chronic bronchitis pts happy and cyanotic? |
|
Definition
| CO2 buildup --> CO2 narcosis and poor O2 perfusion |
|
|
Term
| Do chronic bronchitis pts struggle to breath? |
|
Definition
| As long as they have enough O2 to avoid triggering peripheral chemoreceptors, then no. |
|
|
Term
| What are associated s/sx of chronic bronchitis? |
|
Definition
decreased VA's at night
decreased color vision
transient visual obscurations
7% have swollen optic nerve heads
82% have decreased retinal fxn w/ abnormal VEP
increased risk of increased pCO2 and decreased blood pH |
|
|
Term
| What causes decreased VA's and decreased color vision in chronic bronchitis pt? |
|
Definition
| poor O2 perfusion in the retina |
|
|
Term
| What is the goal of chronic bronchitis and emphysema? |
|
Definition
| manage s/sx, avoid causative agent (smoking) |
|
|
Term
| How is chronic bronchitis treated? |
|
Definition
treated similar to asthma
not curable however |
|
|
Term
| What are the 5 "A's" of smoking cessation? |
|
Definition
Ask
Advise
Assess
Assist
Arrange |
|
|
Term
| If a smoker wants to quit, what steps should be taken? |
|
Definition
set a quit date, ideally within two weeks
remove tobacco products from the home
Call a stop smoking support line |
|
|
Term
| What are drug tx classes for chronic bronchitis and emphysema? |
|
Definition
| bronchodilators and anti-inflammatory drugs |
|
|
Term
| What are the two types of bronchodilators for chronic bronchitis and emphysema tx? |
|
Definition
short acting Beta 2 agonists
long acting Beta 2 agonists |
|
|
Term
|
Definition
| bronchodilator that is more toxic, causes seizures and arrythmias |
|
|
Term
| What is a controversial tx of chronic bronchitis and emphysema? |
|
Definition
glucocorticoids
May be useful during exacerbations
May decrease number of exacerbations |
|
|
Term
| Is oxygen therapy used in tx of chronic bronchitis and emphysema? |
|
Definition
| yes, show to prolong survival. Used primarily for chronic bronchitis |
|
|
Term
| Are AB's used to tx chronic bronchitis and emphysema? |
|
Definition
yes, decreases frequency and severity of exacerbations
reduces mortality |
|
|
Term
| Why are glucocorticoids controversial for chronic bronchitis tx? |
|
Definition
| They compromise lung immune system and may lead to increased infection |
|
|
Term
| What is a bronchial valve? |
|
Definition
| umbrella shaped device that is placed in the bronchioles to block airflow to diseased lung regions. NOT used yet, experimental |
|
|
Term
| What are phoshodiesterase inhibitors? |
|
Definition
| PDE-4 enzyme inhibitor, limits inflammation of airway smooth muscle and airway nerves |
|
|
Term
| Do steroid/statin combos show promise for chronic bronchitis tx? |
|
Definition
| yes, may have anti-inflammatory effect |
|
|
Term
| What vaccine has been shown to reduce morbidity and mortality in chronic bronchitis and emphysema pts? |
|
Definition
|
|
Term
| What are surgical tx's for emphysema? |
|
Definition
bullectomy --> reduce compression of surrounding tissue
volume reduction surgery --> remove part of lung to prevent pressure and collapse of less diseased parts --> more space in thoracic cavity for diaphragm |
|
|
