Term
| REDUCTION IN THE AIRWAY DIAMETER brought about by contraction of smooth muscle, vascular congestion, edema of the bronchial wall and thick, tenacious sputum |
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Definition
| WHAT IS THE PATHOPHYSIOLOGIC HALLMARK OF ASTHMA? |
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Term
BRONCHIAL HYPER-REACTIVITY ADN BRONCHOSPASM
INCREASED SECRETIONS & INCREASED VISCOSITY
BRONCHIAL REMODELING |
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Definition
| AIRWAY INFLAMMATION RESULTS IN WHAT? |
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Term
Allergies
Genetic
Other (air pollution, psychogenic, unknown) |
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Definition
| What are the causes of inflammation in asthma? |
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Term
|
Definition
| WHAT ARE THE TWO MAIN TYPES OF ASTHMA? |
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Term
|
Definition
| What is the single largest risk factor for the development of asthma? |
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Term
No personal or family history of allergy
Negative skin tests
Normal serum IgE levels |
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Definition
| Describe idiosyncratic asthma |
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Term
Cough (chronic and dry, often nocturnal)
Intermittent wheezing
Shortness of breath
Disturbed sleep from cough
Poor exercise tolerance
Chest tightness |
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Definition
| What are the clinical manifestations of asthma? |
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Term
| ALL THAT WEEZES IS NOT ASTHMA AND ALL ASTHMA DOESN'T WEEZE |
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Definition
| WHAT IS THE CLASSIC APHORISM IN THE DIAGNOSIS OF ASTHMA? |
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Term
Symptoms improved with test dose of bronchodilating medication
Demonstration of sensitivity to stimuli (allergens, cold air, etc)
Elevated IgE levels in sputum and serum
Elevated blood eosinophil count |
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Definition
| How would you diagnose asthma? Would would the laboratory find? |
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Term
| Airway remodeling in response to the chronic inflammation, resulting in gradual decline in pulmonary function |
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Definition
| What is the key long term complication of asthma? |
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Term
| Anti-inflammatory approach with multiple agent protocols |
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Definition
| What is critical in treatment of asthma? |
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Term
| Beta-2 agonists (bronchodilators) |
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Definition
| How do you treat an acute episode of asthma? |
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Term
| RELAX SMOOTH MUSCLE (BRONCHIOLES, VASCULATURE, UTERUS) |
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Definition
| WHAT DO BETA 2 SYMPATHETIC RECEPTORS DO? |
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Term
Bronchodilation
Adverse effects due to receptor cross reactivity:
Tachycardia
Hyperglycemia
Hypertension |
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Definition
| What is the utility of Beta-2 agonists? What are the adverse effects? |
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|
Term
Short-acting
LABA: long-acting beta agonists |
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Definition
| What are the two basic types of beta-2 agonists? |
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Term
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Definition
| How long does a short-acting beta agonist last? |
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Term
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Definition
| How long does a long-acting beta agonist last? |
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Term
| It's a parasympathetic blocker "long-acting muscarinic antagonists", causes an increase in airway diameter |
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Definition
| What is LAMA and what does it do? |
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Term
LABA inhaler
LAMA inhaler
Glucocorticoid inhaler
Leukotriene modulators |
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Definition
| What would treatment look like to prevent asthmatic attacks? |
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Term
Epinephrine subcutaneous injection
Beta-2 inhalers
Glucocorticoids:
Oral (1 mg/kg/day) as effective as parenteral
Takes 6-12 hrs for any effect
Reduces hospitalizations |
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Definition
| What would treatment look like in an emergency asthma situation? |
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Term
|
Definition
| Inflammation of the lungs due to infectious organisms |
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Term
|
Definition
| What are the causative agents of pneumonia? |
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Term
Cough (often productive)
Fever, chills
Dyspnea |
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Definition
| What are the most common symptoms of pneumonia? |
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Term
| Symptoms plus a chest xray and laboratory tests |
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Definition
| How do you diagnose pneumonia? |
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Term
Community acquired pneumonia (CAP)
Hospital-acquired pneumonia (HAP) |
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Definition
| What two basic types of pneumonia are there? |
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Term
| Community acquired pneumonia can be caused by bacteria, viruses, or fungi, while hospital acquired pneumonia usually is just bacteria |
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Definition
| What is the difference in community acquired pneumonia and hospital acquired pneumonia? |
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Term
| Antibiotics and supportive care, if it was community acquired hospitalization may be required |
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Definition
| How do you treat pneumonia? |
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Term
| Stabilization in 3-5 days, full recovery in 4-12 weeks depending on age |
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Definition
| What does pneumonia prognosis look like? |
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Term
Pleural empyema
Lung abscess
Pleural effusion |
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Definition
| What are the potential complications of pneumonia? |
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Term
| COPD (chronic obstructive pulmonary disease) |
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Definition
A chronic and gradually progressive pulmonary disorder
Hallmarks are airflow obstruction and gradual alveolar dilation and destruction |
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Term
CHRONIC BRONCHITIS
EMPHYSEMA |
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Definition
| WHAT ARE THE TWO CLINICAL FORMS OF COPD? |
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|
Term
Chronic bronchitis = Airway obstruction > alveolar loss
Emphysema = Alveolar loss > airway obstruction |
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Definition
| What is the difference in chronic bronchitis and emphysema? |
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Term
| Bronchial damage and inflammation |
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Definition
| What is the underlying cause of the airway obstruction of chronic bronchitis? |
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Term
|
Definition
| WHAT PREDOMINATES WITH CHRONIC BRONCHITIS SYMPTOMS? |
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|
Term
Progressive shortness of breath with exertion (dyspnea)
Chronic cough but less significant |
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Definition
| What are the symptoms of emphysema? |
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Term
|
Definition
| What are the three hallmarks of COPD treatment? |
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Term
Mulit-faceted smoking cessation programs: education, support groups, medications, behavioral modification counseling
Success rates low: 15-20 percent are able to quit long term |
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Definition
| What is the best way to quit smoking and what are the success rates? |
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Term
| Prevent new damage and improve airways |
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Definition
| What are the improvement treatment strategies of COPD? |
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Term
Airway support
Supplemental oxygen |
|
Definition
| What is the supportive treatment strategy of COPD? |
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Term
|
Definition
| Malignancy arising from the respiratory epithelium |
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Term
| Greater than breast cancer, prostate cancer, colorectal cancer, and pancreatic cancer |
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Definition
| What does the death toll look like from lung cancer? |
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|
Term
Squamous carcinoma (30%)
Small cell carcinoma (15%)
Large cell carcinoma (10%)
Adenocarcinoma (35%)
Others (10%) |
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Definition
| What are the four main types of lung cancer? |
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Term
SMALL CELL LUNG CANCER (SCLC)
NON-SMALL CELL LUNG CANCER (NSCLC) |
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Definition
| FROM A CLINICAL PERSPECTIVE, WHAT ARE THE TWO TYPES OF LUNG CANCER? |
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Term
| Small cell carcinoma is much more aggressive, death without treatment happens in a matter of 6-17 weeks and with treatment is only around 10-16 months |
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Definition
| What does small cell carcinoma look like in comparison to non-small cell? |
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Term
|
Definition
| What is the main cause of lung cancer? |
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Term
Weight loss
Cough
Hemoptysis (bloody sputum)
Chest or vertebral pain |
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Definition
| What are lung cancer symptoms? |
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Term
| Direct visualization with biopsy and imaging |
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Definition
| How do you diagnose lung cancer? |
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|
Term
Combination chemotherapy
Sometimes also radiation therapy |
|
Definition
| How do you treat small cell carcinoma? |
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Term
|
Definition
| How do you treat non-small cell carcinoma? |
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Term
|
Definition
Infection caused by Mycobacterium tuberculosis
Slow growing aerobic bacterium
“Acid-fast bacillus”
Initially either a pulmonary (aerosol acquired) or gastrointestinal (ingestion of infected milk) disease |
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Term
| IN LATE STAGES IN CAN INFECT AND AFFECT EVERY ORGAN SYSTEM |
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Definition
| WHAT IS UNIQUE ABOUT THE PRESENTATION OF TUBERCULOSIS? |
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Term
|
Definition
| WHAT PERCENTAGE OF HUMANITY HAS BEEN INFECTED WITH TUBERCULOSIS? |
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Term
|
Definition
| WHAT IS THE KEY PATHOLOGIC FEATURE OF TUBERCULOSIS? |
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|
Term
|
Definition
| WHAT ARE THE TWO TYPES OF TUBERCULOSIS INFECTION? |
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|
Term
| 90-95% because the immune system keeps it at bay |
|
Definition
| In what percentage of patients is the tuberculosis infection latent and why? |
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|
Term
| None with a positive skin test |
|
Definition
| What are the symptoms of latent tuberculosis? |
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|
Term
| No, the TB bacilli are not present in their expired air |
|
Definition
| Are people with latent tuberculosis contagious? |
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|
Term
Intermittent fever (“night sweats”)
Weight loss
Cough, hemoptysis
Fatigue, malaise |
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Definition
| What are the symptoms of progressive tuberculosis? |
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|
Term
| Yes, TB bacilli will be present in expired air |
|
Definition
| Are those with progressive tuberculosis contagious? |
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|
Term
100% cure rate if treatment is completed and no drug resistance is encountered
Without treatment most die |
|
Definition
| What is the prognosis of tuberculosis? |
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|
Term
Infants, elderly, and immunocompromised individuals
Very lethal |
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Definition
| Widespread (milliary) tuberculosis is most common in what population and what is the mortality rate like? |
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|
Term
History and physical
Sputum evaluation (acid-fast stain & culture)
Skin testing
Chest x-ray
Lab testing (interferon gamma release assays) |
|
Definition
| How do you diagnose tuberculosis? |
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|
Term
Three or four drugs based on sensitivity studies for first 2-3 months
Two or three drugs for an additional 4-7 |
|
Definition
| How do you treat sensitive tuberculosis strains? |
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|
Term
| Up to 20 months of second and third line agents |
|
Definition
| How do you treat resistant tuberculosis strains? |
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|
Term
|
Definition
| What are the two forms of sleep apnea? |
|
|
Term
|
Definition
Pharyngeal collapse during sleep resulting in apnea
Results in hypoxia
Associated with significant long term complications |
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|
Term
|
Definition
| What are the main risk factors in Obstructive Sleep apnea? |
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|
Term
Fatigue
Daytime sleeping
Reduced cognition
Depression |
|
Definition
| What are the symptoms of obstructive sleep apnea? |
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|
Term
Accidents
Cardiovascular disease
Cerebral vascular accidents |
|
Definition
| What are the long term risks of obstructive sleep apnea? |
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|
Term
Weight loss
Airway control devices
Continuous positive airway pressure (CPAP)
Sleep apnea oral appliances |
|
Definition
| How do you treat obstructive sleep apnea? |
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|
Term
|
Definition
| What is normal pulmonary blood pressure? |
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|
Term
Idiopathic pulmonary hypertension
Secondary pulmonary hypertension |
|
Definition
| What are the two types of pulmonary hypertension? |
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|
Term
Drugs (esp. appetite suppressors), toxins
HIV
Left sided heart failure
COPD
Chronic high altitude exposure
Sarcoidosis
Obstructive sleep apnea |
|
Definition
| What are some of the causes of Secondary Pulmonary Hypertension? |
|
|
Term
|
Definition
| WHAT IS THE MAJOR SYMPTOM OF PULMONARY HYPERTENSION? |
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