Fa davis : Obstructive Pulmonary Disorders

Chronic bronchitis

-Clubbing of fingers -Hypoxia -Excessive mucus Chronic bronchitis occurs when air cannot get out of the lungs. Those with chronic bronchitis are known as "blue bloaters" due to cyanosis due to hypoxia. Hypoxia may lead to clubbing of the fingers. Excess mucus is produced in bronchitis.

Emphysema

- Pink puffer - Hyperresonance - Air cannot exit lungs Individuals with emphysema are sometimes referred to as "pink puffers" because it causes carbon dioxide retention and pursed-lip breathing. Emphysema results from air not exiting the lungs, leading to hyperresonance of the lung tissues. The chest volume is increased, not decreased. Clubbing of the fingers is associated with cyanosis and is usually not present with emphysema.

Obstructive sleep apnea

*Symptoms include loud snoring and unrestful sleep *Diagnosis requires a sleep study *Obesity is a risk factor *Diagnosed with polysomnography Obstructive sleep apnea results in the upper airway closing intermittently during sleep. It involves recurrent episodes of sleep apnea of 2 to 3 minutes in duration. Symptoms include loud snoring, choking during sleep, unrestful sleep, and sleepiness during the day. Obesity is a risk factor. Polysomnography, or a sleep study, is used for diagnosis.

Asthma

- FEV1 is commonly reduced in asthma - Bronchodilators may improve FEV1 in patient with asthma - Spirometry is used to evaluate pulmonary function in asthma In asthma, reduced FVC may occur and the use of bronchodilators will improve FEV1 values. Spirometry is the technique used to measure lung function in asthma and is not an invasive procedure. Pulmonary function tests are normally reduced in asthma.

Chronic obstructive pulmonary disease

- Smoking is a major cause - Alpha 1-antitrypsin deficiency (AAT) increases risk - Signs and symptoms include clubbing of the fingers, cyanosis, and pursed-lip breathing -Pulmonary function tests are key to diagnosis Three components comprise COPD: airway hyperreactivity, emphysema, and chronic bronchitis. Emphysema causes excess air in the alveoli. Chronic bronchitis causes inflammation, edema, and excess mucus in the airways. Patients may present with clubbing of the fingers, cyanosis, barrel-chested appearance, increased anterior-posterior chest diameter, and pursed-lip breathing. Smoking is a significant factor in the development of this condition. Deficiency in the enzyme alpha 1-antitrypsin is the only currently identified genetic risk factor for developing COPD. Pulmonary function tests are key to diagnosing COPD.

Asthma

- Treated with maintenance medications and rescue medications -Allergy is a common etiology -Symptoms include dyspnea, wheezing, and chest tightness Asthma is a hyperactive airway disease often caused by allergy. Signs and symptoms include dyspnea, wheezing, chest tightness, and coughing, especially at night or with exercise. Categories of asthma include mild intermittent, mild persistent, moderate persistent, and severe persistent. Treatment involves a combination of maintenance and rescue medications for acute episodes. In asthma, FEV1 is reduced.

Bronchiectasis

-Results from untreated infection -Components of the bronchiole wall are replaced with fibrous tissue - Hemoptysis is caused by inflamed airway mucosa This uncommon disease results from untreated infections that damage the bronchioles. Fibrotic changes due to inflammation result in bronchiole dilatation. Hemoptysis is present in 50 to 70% of patients with bronchiectasis.

Which of the following are associated with chronic obstructive pulmonary disease? Select all that apply. A. Chronic bronchitis B. Hyperactive airways C. Bronchiectasis D. Emphysema E. Pleural effusion

A. Chronic bronchitis B. Hyperactive airways D. Emphysema

Which of the following are associated with chronic bronchitis? Select all that apply. A. Cyanosis B. Air trapping C. Blue bloater D. Hyperresonance E. Problems getting air into the lungs

A. Cyanosis C. Blue bloater E. Problems getting air into the lungs

Bronchiole dilation resulting from chronic infections is present in ____________. A. bronchiectasis B. asthma C. chronic obstructive pulmonary disease D. obstructive sleep apnea

A. bronchiectasis

Which of the following are obstructive lung diseases? Select all that apply. A. Pulmonary fibrosis B. Asthma C. Obstructive sleep apnea D. Pneumothorax E. Chronic obstructive pulmonary disease

B. Asthma C. Obstructive sleep apnea E. Chronic obstructive pulmonary disease

The upper airways closing during sleep is known as ____________. A. chronic obstructive pulmonary disease B. obstructive sleep apnea C. bronchiectasis D. pneumothorax

B. obstructive sleep apnea