NR601 Midterm
What are the 3 primary physiological changes of aging? - answer1. Reduced
physiological reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp
control, fluid/lyte balance, etc.).
3. Impaired immunological function (infection risk is greater, autoimmune dz's more
prevalent)
What is the preferred amount of exercise for elderly? - answer30min/day 5 days/wk of
moderate exercise.
If trying to lose wt: 60min/day.
What are PFTs? - answerGroup of tests that provide quantifiable measurement of lung
function, used to dx resp abnormalities or assess progression/resolution of lung dz.
What is FEV1? - answerForced Expiratory Volume in 1 second (80-120%)
What is FVC? - answerForced Vital Capacity (80-120%)
What is normal FEV1/FVC ratio? - answer<0.7 (70%)
What is GOLD 1 criteria? - answerMild
FEV1 >/= 80% predicted
What is GOLD 2 criteria? - answerModerate
FEV1 50-79% predicted
What is GOLD 3 criteria? - answerSevere
FEV1 30-49% predicted
What is GOLD 4 criteria? - answerVery severe
FEV1 <30% predicted
What are the signal symptoms of COPD? - answerDyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
What are characteristics of COPD? - answerCommon, preventable, treatable.
,Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory response in
airways and lungs to noxious particles/gases
Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance, small
airway dz.
Decreased elastic recoil of alveoli.
What are risk factors for COPD? - answerSmoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
What is seen on phys exam in COPD? - answerMay be normal in early states
As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at
bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance),
accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein
distention.
How is COPD diagnosed? - answerSpirometry is gold standard (pre and post
bronchodilator).
Irreversible airflow limitation is hallmark.
How is COPD treated? - answerBronchodilators: beta agonists (long/short),
anticholinergics (long/short), or combo.
What is the MOA of beta agonists? - answerStimulates beta-2-adrenergic receptors,
increasing cyclic AMP, resulting in relaxing airways.
What is the MOA of anticholinergics? - answerBlock the effect of acetylcholine on
muscarinic type 3 receptors, resulting in bronchodilation.
Why are long-acting beta agonists prescribed for COPD? - answerThey are for
moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of exacerbations,
improve QOL.
What are some non pulmonary diagnoses that result in COPD-type symptoms? -
answerCHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
, Obstructive sleep apnea
Aspergillosis
Chronic fatigue syndrome
What are signal symptoms of asthma? - answerWheezing
Shortness of breath
Cough (esp at night)
Chest tightness
What is chronic bronchitis? - answerDaily chronic cough w/increased sputum for at least
3 consecutive months in at least 2 consecutive years.
Usually worse on wakening.
May or may not be associated with COPD.
What is emphysema? - answerCharacterized by obstruction to airflow caused by
abnormal airspace enlargement distal to terminal bronchioles.
Chronic inflammation/remodeling, trapping air, hindering effective O2/CO2 exchange
(all due to inflammatory mediators infiltrating airways).
What are signal symptoms of ischemic heart dz? - answerChest pain
Chest tightness
Chest discomfort
What is ischemic heart dz? - answerImbalance between supply and demand for blood
flow to myocardium
What are signal symptoms of lung CA? - answerCough
Dyspnea
Wt loss
Anorexia
Hemoptysis
What is lung CA? - answerMalignant neoplasm originating in parenchyma of
lung/airways
What are signal symptoms of MI? - answerProlonged CP (>20min duration)
SOB
Confusion
Weakness
Worsening HF
What is an MI? - answerNecrosis of heart tissue caused by lack of blood and O2 supply
to the heart
What are the 3 primary physiological changes of aging? - answer1. Reduced
physiological reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp
control, fluid/lyte balance, etc.).
3. Impaired immunological function (infection risk is greater, autoimmune dz's more
prevalent)
What is the preferred amount of exercise for elderly? - answer30min/day 5 days/wk of
moderate exercise.
If trying to lose wt: 60min/day.
What are PFTs? - answerGroup of tests that provide quantifiable measurement of lung
function, used to dx resp abnormalities or assess progression/resolution of lung dz.
What is FEV1? - answerForced Expiratory Volume in 1 second (80-120%)
What is FVC? - answerForced Vital Capacity (80-120%)
What is normal FEV1/FVC ratio? - answer<0.7 (70%)
What is GOLD 1 criteria? - answerMild
FEV1 >/= 80% predicted
What is GOLD 2 criteria? - answerModerate
FEV1 50-79% predicted
What is GOLD 3 criteria? - answerSevere
FEV1 30-49% predicted
What is GOLD 4 criteria? - answerVery severe
FEV1 <30% predicted
What are the signal symptoms of COPD? - answerDyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
What are characteristics of COPD? - answerCommon, preventable, treatable.
,Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory response in
airways and lungs to noxious particles/gases
Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance, small
airway dz.
Decreased elastic recoil of alveoli.
What are risk factors for COPD? - answerSmoking (increasing w/number of pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
What is seen on phys exam in COPD? - answerMay be normal in early states
As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at
bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance),
accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein
distention.
How is COPD diagnosed? - answerSpirometry is gold standard (pre and post
bronchodilator).
Irreversible airflow limitation is hallmark.
How is COPD treated? - answerBronchodilators: beta agonists (long/short),
anticholinergics (long/short), or combo.
What is the MOA of beta agonists? - answerStimulates beta-2-adrenergic receptors,
increasing cyclic AMP, resulting in relaxing airways.
What is the MOA of anticholinergics? - answerBlock the effect of acetylcholine on
muscarinic type 3 receptors, resulting in bronchodilation.
Why are long-acting beta agonists prescribed for COPD? - answerThey are for
moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of exacerbations,
improve QOL.
What are some non pulmonary diagnoses that result in COPD-type symptoms? -
answerCHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
, Obstructive sleep apnea
Aspergillosis
Chronic fatigue syndrome
What are signal symptoms of asthma? - answerWheezing
Shortness of breath
Cough (esp at night)
Chest tightness
What is chronic bronchitis? - answerDaily chronic cough w/increased sputum for at least
3 consecutive months in at least 2 consecutive years.
Usually worse on wakening.
May or may not be associated with COPD.
What is emphysema? - answerCharacterized by obstruction to airflow caused by
abnormal airspace enlargement distal to terminal bronchioles.
Chronic inflammation/remodeling, trapping air, hindering effective O2/CO2 exchange
(all due to inflammatory mediators infiltrating airways).
What are signal symptoms of ischemic heart dz? - answerChest pain
Chest tightness
Chest discomfort
What is ischemic heart dz? - answerImbalance between supply and demand for blood
flow to myocardium
What are signal symptoms of lung CA? - answerCough
Dyspnea
Wt loss
Anorexia
Hemoptysis
What is lung CA? - answerMalignant neoplasm originating in parenchyma of
lung/airways
What are signal symptoms of MI? - answerProlonged CP (>20min duration)
SOB
Confusion
Weakness
Worsening HF
What is an MI? - answerNecrosis of heart tissue caused by lack of blood and O2 supply
to the heart
