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Matching: Types of obstructive lung disease (COPD):
|-?-emphysema||enlargement of air spaces & ↓ recoil resulting from destruction of alveolar walls; caused by smoking & α1-antitrypsin deficiency → ↓ elastic activity; findings: dyspnea, ↓ breath sounds, tachycardia, ↓ I/E ratio; "pink puffer"|
|-?-asthma||bronchial hyperresponsiveness causes reversible bronchoconstsriction; can be triggered by viral URIs, allergens, stress; findings: cough, wheezing, dyspnea, tachypnea, hypoxemia, ↓ I/E ratio, pulsus paradoxus|
|-?-chronic bronchitis||productive cough for > 3 consecutive months in 2 or more yrs; hypertrophy of mucus-secreting glands in the bronchioles (Reid index > 50%); leading cause is smoking; findings: wheezing, crackles, cyanosis|
|-?-bronchiectasis||chronic necrotizing infection of bronchi → dilated airways, purulent sputum, recurrent infections, hemoptysis; associated with bronchial obstruction, cystic fibrosis, poor ciliary motility|
|chronic bronchitis emphysema asthma bronchiectasis|
Restrictive lung disease
|I. Poor breathing mechanics (extrapulmonary)||a) poor muscular effort||two diseases?|
|b) poor apparatus||one disease?
|II. Interstitial lung diseases||Polypeptide||eight diseases?|
Lung - physical findings
|Abnormality||Breath Sounds||Resonace||Fremitus||Tracheal Deviation|
|Bronchial obstsruction||Absent over area||↓||-?-↓||Toward side of lesion|
|Pleural effusion||↓ over effusion||-?-Dulless||↓||--|
|Pneumonia (lobar)||-?-May have bronchial breath sounds over lesion||Dullness||↑||--|
|Pneumothorax||↓||Hyperresonant||Absent||-?-Away from side of lesion|
Lung cancer/bronchogenic carcinoma
Tumors that arise centrally:
-?-squamous cell carcinoma clear link to smoking; ectopic PTH-related peptide production
-?-small cell carcinoma clear link to smoking; associated with ectopic hormone production (ADH, ACTH); may lead to Lambert-Eaton syndrome
Features of carcinoid tumor: -?-can cause carcinoid syndrome (flushing, diarrhea, wheezing, salivation)
Features of metastases: -?-very common; brain (epilepsy), bone (pathologic fracture), and liver (jaundice, hepatomegaly)
|Lobar||Most frequently? -?-pneumococcus||Intra-alveolar exudates → consolidation; may involve -?-entire lung|
S. pyogenes and the other three?
|Acute inflammatory infiltrates from brochioles into adjacent alveoli; -?-patchy distribution involving ≥ 1 lobes|
|Interstitial (atypical) pneumonia||Two viruses?
Also mycoplasma, legionella and -?-chlamydia
|Diffuse patchy inflammation localized to interstitial areas at -?-alveolar walls; distribution involving ≥ 1 lobes|