Definitions
A preventable and treatable disease state
characterized by the presence of incompletely
reversible airflow obstruction
COPD
Inspection: Stocky, overweight, peripheral edema, distended neck veins, productive cough with
purulent sputum, digital clubbing and cyanotic nail beds
Palpation: Normal
Percussion: Normal
Auscultation: Crackles and Wheezes
ABG: Chronic ventilatory failure with hypoxemia
DLCO: normal
These findings are consistent with:
Chronic Bronchitis
The term for the type of ventilation reflective of a higher than normal CO2 in the arterial blood:
hypoventilation
XRAY shows blunted costrophrenic angles, which disease process is this consistent with
Pleural effusion
Decreased FEV1 and Decreased FEV1% confirm
Obstructive disease
A chronic productive cough for 3 months for 2
successive years; other causes have been
excluded
Chronic Bronchitis
Inspection: Thin, barrel chested, using accessory muscles, pursed lip breathing
Palpation: Decreased tactile fremitus, and decreased chest expansion
Percussion: Hyperresonance
Auscultation: Diminished breath sounds with prolonged expiration
ABG: Chronic ventilatory failure with hypoxemia
DLCO: decreased
These findings are consistent with
Emphysema
These are commonly cultured from the mucus in the tracheobronchial tree of a
patient with cystic fibrosis
Pseudomonas aeruginosa
Haemophilus influenzae
Staphylococcus aureus
A patient has chest radiograph findings of "Bat's wings" pattern fluffy infiltrates
Normal cardiac silhouette
Fluffy densities near the hilum this is consistent with
noncardiogenic pulmonary edema
Increased RV and Increased TLC are consistent with
obstruction and air trapping
Permanent enlargement of the airspaces distal
to the terminal bronchioles accompanied by
destruction of alveolar walls without obvious
fibrosis
emphysema
Inspection: HR 130, RR 28, accessory muscle use, pulsus paradoxus, cough with excessive
thick, white sputum
Palpation: Decreased tactile fremitus
Percussion: Hyperresonance
Auscultation: Expiratory wheezes
ABG: Acute alveolar hyperventilation with mild hypoxemia
PEFR: decreased
These findings are consistent with:
Asthma
A ph 7.35-7.45, CO2 >45, HCO3 >26 are consistent with what type of gas
Chronic ventilatory failure
Your pt has these findings on a CT scan
Air bronchograms
Consolidation
This is consistent with
Pneumonia
What causes abnormal volumes and capacities in obstructive diseases
Air trapping
A genetic disorder caused by mutations in pair of
genes located on chromosome 7; characterized
by dysfunction of the exocrine glands
CF
Inspection: Increased HR, RR, and BP, SpO2 88%, pursed lip breathing, barrel chested,
cyanotic, coughing up large amounts of foul sputum that settles into 3 layers of a 24-hr period
Palpation: Decreased tactile and vocal fremitus
Percussion: Hyperresonance
Auscultation: Crackles and Wheezing
These findings are consistent with:
Bronchiectasis
A PH >7.45, CO2 <35, HCO3 22-26 are consistent with what type of gas
Acute alveolar hyperventilation
bilateral "butterfly" pattern fluffy infiltrates
cardiomegaly
pleural effusion
cardiogenic pulmonary edema
Presence of a chronic cough
Chronic exposure to environmental smoke
Decreased FEV1 and FEV1% are used to confirm the diagnosis of what disease
COPD
A disease characterized by chronic dilation and
distortion of one or more bronchi
Bronchiectasis
A 7 year old female presents to the Emergency Room with shortness of breath, dyspnea, and
accessory muscle use. Your immediate evaluation reveals tachycardia, tachypnea, crackles, and
strong cough with small amounts of green sputum. SpO2 of 85% on Room Air. Patient history
includes an elevated sweat chloride test and chromosome 7 genetic mutation. The patient's
disease process is:
CF
Your patient has status asthmaticus. They have shallow, labored breathing, wheezing, accessory
muscle use, HR 120 bpm, and RR 8 bpm. Which of the following ABG’s would you expect?
Acute ventilatory failure with hypoxemia
This disease process features alveolar consolidation, alveolar capillary interstitial destruction, Ghon
complex nodules, granulomas, cavity formation, hemoptysis in bronchial secretions, and fibrosis with
permanent scarring:
TB
After the inhalation of a bronchodilator, what percentage change in peak expiratory flow (PEFR)
would be required to demonstrate reversible airflow limitation consistent with asthma?
>20%