3 classifications of obstructive pulmonary disorders (3)
1) In wall of lumen
2) Increasing pressure around the outside of the airway lumen
3) Airway lumen
Airway obstruction that is reversible (not completely in some patients)
Asthma
Airway inflammation
Increased airway responsiveness to a variety of stimuli
Asthma
Most common chronic disease of children
Asthma
Immunohistopathologic features of asthma include ______ and mast cell activation
edema
Inflammatory cell infiltration by _______, ______, and lymphocytes in asthma
neutrophils; eosinophils
Inflammation of the airway in asthma includes acute ________
bronchospasm
Mucosal edema, mucous plug formation in ______
asthma
In asthma there is ______ remodeling: thickening of basement membrane
airway wall
Wheezing manifestation of ______
asthma
Tightness of chest manifestation of ______
asthma
Dyspnea manifestation of______
asthma
Cough (dry or productive) manifestation of ______
asthma
Increased sputum production (thick, tenacious, scant, and viscid) in ______
asthma
Hyperinflated chest manifestation of _______
asthma
Decreased breath sounds manifestation of _____
asthma
Clinical manifestations of severe asthma attack include Use of accessory muscles of respiration
_______ retractions
intercostal
Clinical manifestations of severe asthma attack include distant breath sounds with ________ wheezing
inspiratory
Clinical manifestations of severe asthma attack include _____ and ______
orthopnea; agitation
Clinical manifestations of severe asthma attack include tachypnea, which is > ______bpm, and tachycardia >______bpm,
30; 120
Clinical manifestations of severe asthma attack include ______ paradoxus
pulsus
________ is NOT a good indication of airflow in severe asthma attack
wheezing
PEFR < ______L/min in severe asthma attack
80
You can diagnose asthma through radiographic finding, which includes ______ with flattening of the _____-
hyperinflation; diaphragm
You can diagnose asthma through _______ examination
sputum
Charcot-Leyden crystals
Eosinophils
Curschmann spirals are types of ______ examination in _____
sputum; asthma
You can diagnose asthma through ______ function tests
pulmonary
Forced expiratory volumes ______ while diagnosing asthma
decrease
Determines index of airway function when diagnosing asthma
Peak expiratory flow rate (PEFR)
Ratio of FEV1/FVC before and after administration of short-acting bronchodilator
Peak expiratory flow rate (PEFR)
Obstruction indicated by FEV1/FVC
75%
_____ testing used for young patients with extrinsic asthma
skin
When diagnosing asthma, _______ is normal during mild attack
ABG (arterial blood gas)
Respiratory ____ and hypoxemia as bronchospasm increases in intensity used to test for ______ when diagnosing ______
alkalosis; ABG; asthma
_____elevation: sign that patient is getting worse when diagnosing asthma
PaCO2
Elevated _____ and eosinophils helps identify CBC when diagnosing ____
WBC’S; asthma
_______ provocation testing used to diagnose asthma; test with _______or methacholine
Bronchial; histamine
1) Avoid triggers
2) Environmental control
3) Preventive therapy
Stop smoking, etc
4) Desensitization (allergen specific immunotherapy)
all types of treatment for ______
asthma
O2 therapy, small-volume nebulizers, B2 agonists, types of medications for ______
asthma
corticosteroids, leukotriene modifiers, mast cell inhibitors types of medications for _____
asthma
Epinephrine, subcutaneous terbutaline, aminophylline are meds to treat _______
status asthmaticus (severe attack unresponsive to routine therapy)
intravenous corticosteroids (mainstay of therapy); oxygen therapy with or without mechanical ventilation are meds to treat _____
status asthmaticus (severe attack unresponsive to routine therapy)
Acute inflammation of the trachea and bronchi leads to acute ______
bronchitis
Viral or nonviral
Heat
Smoke inhalation
causes of ______
acute bronchitis
Inhalation of irritant chemicals
Allergic reactions
causes of _____
acute bronchitis
Swelling of bronchial mucosa in children, associated with obstruction, respiratory distress, and wheezing
a sign of ______ bronchitis
asthmatic
In _______airways become inflamed and narrowed from capillary dilation
acute bronchitis
In _________ there is
Swelling from fluid exudation and
Infiltration with inflammatory cells
acute bronchitis
Increased mucus production
Loss of ciliary function
Loss of portions of the ciliated epithelium
leads to __________
acute bronchitis
Usually mild and self limiting
Cough (productive or nonproductive)
signs of ________
acute bronchitis
Low-grade fever
Substernal chest discomfort
signs of _______
acute bronchitis
Sore throat
Postnasal drip
Fatigue
signs of ______
acute bronchitis
What is the primary cause of acute bronchitis?
recent onset of cough
_________ used to distinguish acute bronchitis from pneumonia
Chest x-ray
Usually no treatment needed for viral
acute bronchitis
Antibiotic therapy (bacterial)
Codeine-containing medications (for cough)
used to treat ________
acute bronchitis
Increase fluid intake
Avoid smoke
Use a vaporizer in bedroom
used to treat _________
acute bronchitis
Cigarette smoking (90%)
Repeated airway infections
causes of _______
chronic bronchitis
Genetic predisposition
Inhalation of physical or chemical irritants
causes of ______
chronic bronchitis