COPD, Emphysema, Chronic Bronchitis, questions and answers 100% correct

COPD, Emphysema, Chronic Bronchitis, questions and answers 100% correct COPD -Preventable disease characterized by airflow obstruction that is not fully reversible. -Airlflow limitation is usually progressive and associated with abnormal inflammatory response of the lungs to noxious gases. -Is the third leading cause of death in the US. -Is a combination of Chronic Bronchitis and Emphysema. Emphysema -Destruction of lung parenchyma that leads to gas exchange abrnomalities and air trapping. -Obstructive pulmonary disease. Panlobular emphysema -Found in the lower regions of the lungs. -Abnormal weakening and enlargement of all air spaces distal to the terminal bronchioles. -Decreased alveolar-capillary surface area. -Associated with alpha 1-antitrypsin. Centrilobular emphysema -Involves respiratory bronchioles proximal to acinus. -Respiratory bronchial walls enlarged and destroyed. -A rim of parenchyma remains unaffected. -Most common form of emphysema. -Strongly associated with cigaretter smoking and Chronic Bronchitis. -Causes hyperinflation. Emphysema structural changes -Permanent enlargement and destruction of the airspaces distal to terminal bronchioles. -Destruction of pulmonary capillaries. -Weakening of the distal airways. -Bronchospasms. -Hyperinflation. Causes of emphysema -Cigarette smoking. -Genetic predisposition (SERPINA1 gene zz associated with low antitrypsin levels). -Occupational exposure (cotton, wood, grain). -Atmospheric pollutants (sulfur dioxide, ozone, nitrogen oxides). Chronic bronchitis -Inflammation of the bronchi marked by excessive airway secretions that cause narrowing of the airways. -Obstructive type pulmonary disease. -Presence of cough for at least 3 months in each of two consecutive years Chronic bronchitis chain of events -Chronic inflammation and swelling of peripheral airways. -Hyperinflation of alveoli. -Excessive mucus production and accumulation. -Partial or total mucus plugging. -Smooth muscle constriction of bronchial airways (bronchospasms). Causes of chronic bronchitis -Cigarette smoking, -Atmospheric pollutants (sulfur dioxide, ozone, nitrogen oxides). -Repeated infections. -Gastroesophageal Reflux Disease (GERD). Clinical manifestations of emphysema -Thin, underweight. -Barrel chest (classic sign). -Pursed lip breathing. -Hyperventilation, often at rest. -Use of accessory muscles. -Reddish skin. Clinical manifestations of chronic bronchitis -Stocky, overweight. -Hypoventilation (diminished respiratory drive). -Cyanosis. -Cough (classic sign) -Copious amounts of purulent sputum. Chest xray of emphysema patient -Translucent lung field (hyperinflation). -Depressed or flattened diaphragms. -Normal or small vertical heart. -Presence of blebs or bullae. -Long narrow heart. Pink puffer -This type of COPD patient has decreased DLCO. Blue bloater -This type of COPD patient has normal DLCO. Treatment -Patient and family education. -Smoking cessation. -Avoid inhaled irritants. -Avoidance of infection. -Bronchodilators. -Noninvasive positive pressure ventilation. -Mechanical ventilation only if needed (pH < 7.25). -Antibiotics. -Lung volume reduction. -Alpha 1 antitrypsin therapy. NIPPV -Has gained popularity. -Improves pH, PaCO2, and PaO2. -Reduces hospital length of stay. Prolastin -Injected to treat Type 1 emphysema. COPD diagnosed by spirometry -According to GOLD. -Defined by FEV1/FVC < 70%. -Post bronchodilator < 80%. -If FEV1 < 40%, ABG should be performed. COPD management goals -Relieve symptoms. -Reduce mortality. -Prevent disease progression. -Prevent and treat exacerbations. -Prevent or minimize side effects of treatment.