???
The common name used for emphysema patients
What is pink puffers?
On the PFT, decreased _____ flows are expected
(Bonus points if you know what volumes and capacities would be increased)
What is expiratory?
Bonus: increased RV, FRC, TLC
Name at least 2 vital signs a emphysema patient will present with
What is increased RR, HR, BP, CO, decreased sats
Name the two types of emphysema
What is Panlobular (Panacinar)and centrilobular (Centriacinar)?
Name at least 2 pathologic or structural changes with emphysema
What is Permanent enlargement and destruction of airspaces distal to the terminal bronchioles, destruction of the A-C membrane, weakening of the distal airways, air trapping and hyperinflation?
Name at least 3 findings on the CXR
What is radiolucent lung fields, depressed/ flattened diaphragms, long and narrow heart, increased retrosternal airspace, and occasionally emphysematous bullae?
Name what you would expect to find on palpation and percussion.
What is decreased tactile fremitus, decreased expansion, and a hyperresonant percussion note?
The most common form of emphysema and is strongly associated with cigarette smoking and chronic bronchitis is...
What is Centrilobular (Centriacinar)?
A patient with emphysema has diminished breath sounds and hyperresonance.
Name the most likely underlying physiologic cause
What is airtrapping?
On the ABG, mild to moderate is expected to be...
What is acute alveolar hyperventilation with hypoxemia (uncompensated respiratory alkalosis)?
Name at least 2 auscultation findings
What is prolonged expiration, diminished breath sounds, diminished heart sounds, and wheezes, crackles and rhonchi (if accompanied by CB)?
This type of emphysema is found with deficiency of the protease inhibitor alpha1-antitripsyn
What is Panlobular (Panacinar)?
A patient with emphysema uses pursed-lip breathing during expiration.
Name what PLB compensates for
What is airway collapse during expiration (stents open the airways)?
On the ABG, severe is expected to be ...
What is Chronic ventilatory failure with hypoxemia (compensated respiratory acidosis)?
Name at least 3 inspection findings for emphysema
What is PLB, tripod position, use of accessory muscles during inspiration and expiration, increased AP diameter, clubbing (late stage), thin/ underweight, minimal cough and mucus unless accompanied by CB, presence of Hoover sign?
Name the type of emphysema that is associated with bleb formation
What is Panlobular (Panacinar)?
A patient with emphysema presents with mild dyspnea.
ABG results:
pH 7.46 / PaCO₂ 33 / PaO₂ 65 / HCO₃ 24
Name the interpretation and what is the first step you would do for this patient
What is uncompensated respiratory alkalosis with moderate hypoxemia (acute alveolar hyperventilation with hypoxemia) - initiate oxygen therapy?
Name what the hematology would show an increase of in the late stage
(Bonus points if you can explain why)
What is hemoglobin and hematocrit?
Bonus: chronic hypoxemia = polycythemia
Explain the Hoover Sign
(Bonus points if you know what it represents)
What is inward movement of the lower lateral chest wall during each inspiration?
Bonus: severe hyperinflation
Explain the difference between the 2 types of emphysema (Panlobular vs Centrilobular)
Panlobular: Abnormal weakening of all alveoli distal to the terminal bronchioles, dilation and destruction of the entire acinus, found with deficiency of the protease inhibitor alpha1 antitripsyn
Centrilobular: Respiratory bronchioles enlarge, become confluent, then destroyed in the central (proximal) portion of the acinus.