Clin Med- Pulmonology
Terms
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- Definition of Acute Asthma
- -reversible airflow obstruction associated w/ a state of inc. responsiveness of the tracheobronchial tree to many different stimuli
- Extrinsic Asthma
- -allergic or atopic
- Intrinsic Asthma
- -no obvious extrinsic cause
- pathophysiology of asthma
-
-bronchospasm
-edema
-mucous production
-inc'd airway resistance
-hypoxemia, hypercarbia
-dec'd max expiratory flow rates - definition of pleural effusion
- -Abnormal accumulation of fluid in the pleural space
- Exudative effusion
-
-abnormality of the pleura
-parapneumonia, malignancy, PE
-unilateral
-most commonly associated with bacterial pneumonia - Transudative effusion
-
-Imbalance of oncotic or hydrostatic pressure
-CHF, cirrhosis
-bilateral
-serous in appearance
- - Pleural fluid/Serum Protein ratio of effusions
-
-transudative: <0.5
-exudative: >0.5 - Pleural fluid/serum LDH ration of effusions
-
-transudative: <0.6
-exudative: >0.6 - Absolute LDH of effusions
-
-transudative: NL
-exudative: > 2/3 - definition of PTX
- -accumulation of air in the normally airless pleural space, between the lung and chest wall
- Primary Spontaneous PTX
-
-NL young, healthy people w/o lung disease
-young, tall, thin, males - Secondary Spontaneous PTX
-
-Occurs as complication of underlying pulmonary disease - COPD- most common cause
- Necrotizing pulmonary Infx - Catemenial PTX
-
-uncommon
-recurs at menstrual period
- thought secondary to pleural and diaphragmatic endometriosis - Traumatic PTX
- -penetrating and nonpenetrating trauma
- Iatrogenic PTX
-
-most common
-Usually due to complications of CVP line access, thoracenthesis pleural Bx, mech - Tension PTX
-
-compromises ventilation by shifting mediastinal structures, impairing venous retain & cardiac output
- often occurs as complication of mech. vent. or other secondary PTX
- not common with primary PTX - T/F: Pneumonia is the 6th leading cause of death in the US
- true
- 90% of bacterial cases are due to...
- -pneumococcal pneumonia
- Which pneumonia will you find a rust-colored sputum?
- -strep pneumonia (pneumococcal)
- Which pneumonia will you find patchy alveolar infiltrates on CXR?
- -Haemophilis influenza
- Which pneumonia is necrotizing lobar pneumonia with bulging minor fissure on CXR?
- -Klebsiella
- Which pneumonia is contracted through the airborne transmission heat exchange systems, resp. therapy devices, water sprays and NOT human to human contact?
- -Leigonnella
- What is the most common type of pneumonia?
- -viral
- definition of acute bronchitis
- -Inflammation of the bronchial mucosa due to infection
- What is the most common cause of acute bronchitis?
- -virus
- Name three bacterial causing factors of acute bronchitis
-
-Haemophilus influenza,
-Streptococcus pneumoniae,
-Moraxella catarrhalis - inspiration
- -contraction of diaphragm (primary respiratory muscle) increases intrathoracic volume
- exhalation
- -passive process as diaphragm relaxes and elastic recoil restores resting volume
- What is the primary factor that chemoreceptors notice?
- -pCO2
- generalized hypoxia over time results in...
- -pulmonary HTN
- FVC
- -forced vital capacity
- FEV1
- -forced expiratory volume in the first second of exhalation
- FEV1/FVC
- -adjusts FEV1 to individual’s actual FVC
- DLco2
- -diffusion capacity of CO2, measurement of overall alveolar function
- NL pO2
- >60 (corresponds to 90% saturation)
- NL pCO2
- 40
- definition of COPD
-
-characterized by permanent obstruction of airflow
-smoking is the major cause - T/F: COPD is the 20th leading cause of death in the US
- False: 4th
- COPD pathophys
-
-Mucous hypersecretion
-Ciliary dysfunction
-Airflow limitation
-Pulmonary hyperinflation
-Gas exchange abnormalities - definition of emphysema
- -permanent enlargement of alveolar ducts and sacs with destruction of their walls
- definition of chronic bronchitis
- -excessive secretion of mucous causing cough for at least 3 months in at least 2 consecutive years
- Etiology of emphysema
-
-smoking causes inflammation
-surfactant deficiency - Vt
- -500
- IRV
- -3100
- ERV
- -1200
- RV
- -1200
- TLC
-
-6000
TLC = Vt + IRV + ERV + RV
or TLC = VC + RV - VC
-
-4800
VC= Vt + IRV + ERV
-should be 80% of TLC - IC
-
-3600
IC = Vt + IRV - FRC
-
-2400
FRC = ERV + RV