Managing Chronic Disease Exam questions and
answers
True or False? Palliative care is the same as curative care.
False.
What are the 5 goals of palliative care?
Slow progression of the disease
Improve quality of life
Maintain functionality
Treat symptoms
Prevent exacerbations
When we treat chronic conditions we are providing a type of what care?
Palliative
When is a patient transferred to hospice care?
When a provider determines a patient has 6 months or less to live
Hospice care falls under the umbrella of what type of care?
Palliative
True or false? All curative care is resumed during hospice care?
False
What is chronic illness?
A permanent deviation from normal health
What is an exacerbation?
An acute decompensation, or episode of worsening symptoms
If there is stiffening of the lung tissue and/or a decrease in surfactant as we would see with pulmonary
fibrosis or acute respiratory distress syndrome (ARDS), this would increase or decrease compliance?
Decrease
If there is a loss of elasticity in the alveoli, as we would see in emphysema, would this increase or
decrease compliance?
Increase
Which chronic obstructive pulmonary disease is the only condition that increases compliance?
Emphysema
, What is compliance?
The ease in which the chest wall, lungs, and alveoli can be distended during inflation
How is compliance helpful when thinking about exhalation?
Increased compliance leads to adequate exhalation
What are 3 things that can cause a decrease in compliance?
Pulmonary Edema
Pulmonary Fibrosis or Scarring
Reduced surfactant
How does pulmonary edema decrease in compliance? (2)
Fluid accumulation outside of the alveolus can create pressures that resist alveolar expansion
Severe pulmonary edema can cause fluid to seep into the alveolus, diluting surfactant
What can cause reduced surfactant? (2)
Prematurity - surfactant is only present in adequate amounts at 38 weeks gestation.
In adults, caused by injury to type 2 cells during severe lung infections or ARDS
How does pulmonary fibrosis or scarring decrease lung compliance?
With severe inflammation (pneumonia, ADRS...) or for idiopathic reasons, collagen accumulates in the
lung interstitium.
What 2 impacts will pulmonary edema & pulmonary fibrosis have on ventilation & gas exchange?
Diffusion of O2 & CO2 can only occur between the alveoli & capillary if the space between them is small.
Accumulation of edema between the alveoli & capillary will widen the space between them 🡪 decreasing
gas exchange.
Pulmonary fibrosis stiffens the alveoli, decreasing inflow of O2 into the alveoli.
Is COPD an obstructive or a restrictive lung disorder?
Obstructive
What is the difference between obstructive or restrictive?
Obstructive makes it hard to exhale and restrictive makes it hard to get air in
What are 3 examples of obstructive lung disorders?.
Chronic bronchitis
Emphysema
Asthma
What 2 symptoms do both obstructive and restrictive lung disease share?
Dyspnea
Cough
answers
True or False? Palliative care is the same as curative care.
False.
What are the 5 goals of palliative care?
Slow progression of the disease
Improve quality of life
Maintain functionality
Treat symptoms
Prevent exacerbations
When we treat chronic conditions we are providing a type of what care?
Palliative
When is a patient transferred to hospice care?
When a provider determines a patient has 6 months or less to live
Hospice care falls under the umbrella of what type of care?
Palliative
True or false? All curative care is resumed during hospice care?
False
What is chronic illness?
A permanent deviation from normal health
What is an exacerbation?
An acute decompensation, or episode of worsening symptoms
If there is stiffening of the lung tissue and/or a decrease in surfactant as we would see with pulmonary
fibrosis or acute respiratory distress syndrome (ARDS), this would increase or decrease compliance?
Decrease
If there is a loss of elasticity in the alveoli, as we would see in emphysema, would this increase or
decrease compliance?
Increase
Which chronic obstructive pulmonary disease is the only condition that increases compliance?
Emphysema
, What is compliance?
The ease in which the chest wall, lungs, and alveoli can be distended during inflation
How is compliance helpful when thinking about exhalation?
Increased compliance leads to adequate exhalation
What are 3 things that can cause a decrease in compliance?
Pulmonary Edema
Pulmonary Fibrosis or Scarring
Reduced surfactant
How does pulmonary edema decrease in compliance? (2)
Fluid accumulation outside of the alveolus can create pressures that resist alveolar expansion
Severe pulmonary edema can cause fluid to seep into the alveolus, diluting surfactant
What can cause reduced surfactant? (2)
Prematurity - surfactant is only present in adequate amounts at 38 weeks gestation.
In adults, caused by injury to type 2 cells during severe lung infections or ARDS
How does pulmonary fibrosis or scarring decrease lung compliance?
With severe inflammation (pneumonia, ADRS...) or for idiopathic reasons, collagen accumulates in the
lung interstitium.
What 2 impacts will pulmonary edema & pulmonary fibrosis have on ventilation & gas exchange?
Diffusion of O2 & CO2 can only occur between the alveoli & capillary if the space between them is small.
Accumulation of edema between the alveoli & capillary will widen the space between them 🡪 decreasing
gas exchange.
Pulmonary fibrosis stiffens the alveoli, decreasing inflow of O2 into the alveoli.
Is COPD an obstructive or a restrictive lung disorder?
Obstructive
What is the difference between obstructive or restrictive?
Obstructive makes it hard to exhale and restrictive makes it hard to get air in
What are 3 examples of obstructive lung disorders?.
Chronic bronchitis
Emphysema
Asthma
What 2 symptoms do both obstructive and restrictive lung disease share?
Dyspnea
Cough
