COPD Flashcards

1
Q

primary function of resp system:

A

gas exchange

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2
Q

structures involved in the generation of rhythmic resp mvmts and reflexes

A

medulla, pons (resp centre)

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3
Q

electrical impulses generated by resp centre carried by ___ nerves to _____

A

phrenic; diaphragm

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4
Q

contraction of diaphragm and other muscles increase _____ pressure and allow air to be sucked in, reaching ___

A

intrathoracic; alveoli

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5
Q

large pulmonary BV and conducting airways located in _____

A

pleural cavity

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6
Q

what are cilia?

A

hair like structures that move superficial liquid lining layer from deep within lungs toward the pharynx to enter GI tract (lung defense mechanism)

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7
Q

alveolar cells secrete _____ that maintain stability of pulmonary tissue by reducing surface tension

A

surfactant

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8
Q

fx of lungs?

A

regulate pH, make arachidonic acid–>prostaglandins and leukotrienes, convert angiotensin 1–>2,

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9
Q

how does malnutrition affect pulmonary system?

A

adverse affect on lung structure, elasticity, function, muscle mass/strength/endurance, lung immunity, control of breathing

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10
Q

pulmonary system disorders categorized as primary:

A

TB, bronchial asthma, cancer of lung

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11
Q

pulmonary system disorders categorized as secondary:

A

associated with cardiovascular disease, obesity, HIV, sickle cell disease, scoliosis

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12
Q

chronic conditions of pulm system?

A

cystic fibrosis and COPD

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13
Q

symptoms and signs of pulmonary disease:

A

cough, dyspnea, fatigue, early satiety, anorexia, wt loss

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14
Q

____ tests used to diagnose/monitor status of lung disease by measuring ability of resp system to exchange O2 and CO2

A

pulmonary function

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15
Q

this device uses light waves to measure oxygen saturation of arterial blood, placed on end of finger

A

pulse oximeter

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16
Q

third most common cause of death in the world

A

COPD

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17
Q

risk factors for COPD?

A

smoke from cigarettes, biomass fuel for cooking and heating in developing countries, air pollution, occupational smoke/dust, genetic factors

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18
Q

COPD encompasses :

A

chronic bronchitis, emphysema

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19
Q

pt with primary emphysema suffer from greater ____

A

dyspnea and cachexia

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20
Q

pt with bronchitis have ____

A

hypoxia, hypercapnia, pulmonary hypertension, right heart failure

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21
Q

condition characterized by destruction of lung parenchyma with lack of elastic recoil

A

emphysema

22
Q

_____deficiency present in 1-2% of COPD pt

A

alpha 1 antitrypsin

23
Q

allergies, smoking, congestive heart failure, pulmonary embolism, pneumonia, systemic infections are reason for _____% of COPD exacerbation

A

20-40

24
Q

how does osteoporosis make COPD worse?

A

altering configuration of chest wall

25
Q

mainstay of treatment for COPD pt

A

inhaled bronchodilators given by metered dose inhalers (in severe dyspnea, administered in nebulized form)

26
Q

if resp failure, need ___

A

mechanical ventilation

27
Q

breathing with normal lungs expends 36 to 72 kcals/day, but increases ____ x in COPD

A

10

28
Q

two main goals in managing hypermetabolism seen in stable COPD:

A

prevention of wt loss and prevention of loss of LBM

29
Q

inverse relationship between dietary ______ and COPD risk

A

iron and calcium

30
Q

increased BP which leads to enlargement and failure of right ventricle of heart, can mask wasting cuz fluid retention

A

cor pulmonale

31
Q

these have opposite effect, important indicators

A

leptin (satiety) vs. adiponectin (enhance appetite)

32
Q

promotes inflammation and insulin resistance by production of IL6 and TNF-alpha

A

resistin

33
Q

diet supplementation of _____ shown delay and reduce risk of upper resp infections and asthma, lowering incidence of bronchiolitis during first year of life

A

DHA, Arachidonic Acid

34
Q

___ and ___ help with inflammation

A

PUFAs, aspirin

35
Q

protein requirements:

A

1.2-1.7g/kg

36
Q

fluid requirements:

A

35ml/kg up to 60 years, then 30ml/kg

37
Q

ppl in advanced COPD are in state of ____

A

pulmonary cachexia (myostatin influence)

38
Q

energy requirements during healing;

A

30kcal/kg

39
Q

risk increases over age of ____

A

40

40
Q

inflammatory cells and mediators involved in asthma vs COPD:

A

eosinophilic vs. neutrophilic

41
Q

pathophysiological changes in COPD lead to

A

airflow limitation, gas trapping, gas exchange abnormalities, mucus hypersecretion, pulmonary hypertension, exacerbations, systemic features

42
Q

max volume of air exhaled in first second of forced expiration

A

FEV1 (forced expiratory volume in first second)

43
Q

what is max amount of air which can be exhaled from lungs on rapid complete exhalation?

A

FVC (forced vital capacity)

44
Q

consequence of air trapping during expiration:

A

hyperinflation

45
Q

signs of hypoxemia:

A

cyanosis, clubbing, polycythemia

46
Q

if not treat hypoxemia what happens?

A

pulmonary artery hypertension, right sided heart failure

47
Q

treatments for COPD:

A

pulmonary rehab programs, oxygen therapy, meds (bronchodilators, glucocorticosteroids, mucolytic agents, antibiotics), surgery

48
Q

protein ____% energy, fat ___%, and CHO ___%

A

15-20; 30-45; 40-55

49
Q

smokers need ___ supplement

A

Vit C (16-32 mg/day)

50
Q

why early satiety?

A

hyperinflation of lungs cause flattening of diaphragm and pressure on abdominal cavity while eating; drinking too much fluids before meals

51
Q

malnutrition classified as:

A

<20 BMI or <90% IBW

52
Q

chronic bronchitis more common in ____ pt, emphysema more common in ____ pt

A

overweight; malnourished