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Obstructive Pulmonary Diseases - Coggle Diagram
Obstructive Pulmonary Diseases
Septic
Cystic Fibrosis
Pathology
Excessive thick sputum production and impairment of mucociliary blanket
Risk factors/causes
Genetic (autosomal recessive)
Signs/Symptoms
Productive cough, dyspnea, accessory muscle use, sputum production, inspiratory crackles and wheezes, nail clubbing, weight loss, decreased activity tolerance
Complications
Associated w/ GERD, pancreatic insufficiency
Hemoptysis, spontaneous PTX, osteoporosis, muscle wasting, chronic back pain, diabetes
Treatment
Antibiotics/antifungal (infection), airway clearance, nutrition, exercise, energy conservation, osteoporosis care, lung transplant (end stage)
Bronchiectasis
Pathology
Permanent dilation of bronchi from destruction of muscle and elastic properties of lung
Mucociliary blanket impairment, sputum production, bacterial colonization (due to pooling of secretions)
Risk factors/causes
Other disease (CF, COPD)
Chronic inflammation, poor defense mechanism to minimize tissue damage from infection
Categories
Cylindrical = uniform dilation
Varicose = local constrictions on top of cylindrical
Saccular/cystic = more severe (bullae)
Diagnostics
Dilation of bronchi on CT, obstructive PFT
Treatment
Manage underlying disease (antibiotics, steroids, bronchodilators)
Surgical resection or transplant
Supplemental O2, airway clearance, rehab, nutrition
Nonseptic
Asthma
Pathology
stimulant causes inflammation and hyperactivity/bronchoconstriction
Risk Factors
Female, genetics, atopy, smoking (or exposure), obesity, pollutants
Signs and Symptoms
wheezing, dyspnea, chest pain, facial distress, non-prod cough
Lung function relatively normal between episodes
Staging
Mild = symptoms 2x/wk, 70-90% FEV1
Moderate = symptoms 1x/day, 60-80% FEV1
Severe = symptoms despite medication, <60% FEV1, intolerance to exertion
Types
Non atopic (intrinsic)
Atopic (extrinsic) = associated w/ allergy
Exercise induced
Treatment
Minimize exacerbation, bronchodilators, exercise
Emphysema
Pathology
Enlargement of acini leads to air trapping and impaired gas exchange
Risk factors
SMOKING
Signs/Symptoms
DOE, diminished breath sounds, wheezing, barrel chest, flattened diaphragm, accessory muscle use, V/Q mismatch, cachexia, PH and RHF due to fluid backup in lungs
Treatment
Smoking cessation,
meds, supplemental O2, exercise/pulm rehab, surgery
Chronic Bronchitis
Pathology
Persistent cough w/ sputum >3 mo/yr for 2+ years
Loss of elastic recoil in lungs leads to airway obstruction and hyperinflation
Risk factors/causes
Smoking,
age, exposure to pollutants
Flu most common source of infection
Signs/Symptoms
Dyspnea, productive cough, wheezes, barrel chest, accessory muscle use
Diagnosis
Obstructive pattern PFT, culture (infection)
Treatment
Infection control (antibiotics), meds (bronchodilators, corticosteroids, expectorants, mucolytics), supplemental O2, exercise/pulmonary rehab, hydration (easier to cough up mucus), smoking cessation)
Bronchiolitis Obliterans
Pathology
Acute inflammation, destruction of bronchioles, hyperinflation, patchy atelectasis
Risk factors/causes
Infection, toxic fume exposure, CT disease, chronic bronchitis,
lung transplant rejection
Signs and Symptoms
DOE, cough, wheezes/crackles, fever
Staging
Acute = not pulm disorder
Simple
Complicated = age, FEV1<50%, repeated exacerbations, poor nutrition, comorbidities
End stage = bronchiectasis, purulent secretions, recurrent infection
Treatment
Decrease exposure, meds, supplemental O2
A1-Antitrypsin Deficiency
Pathology
Deficiency in enzyme synthesized by liver which removes bacteria from airway - leads to lung damage
Risk factors
Genetics, smoking
Signs/Symptoms
Usually start in 30s
SOB, cough w/ sputum, wheezes, hyperactive airways
Strong association w/ emphysema and liver disease
Treatment
Similar to emphysema
LAM
Pathology
Multi-system involvement, cyst formation
Risk factors
Genetic (unknown etiology)
Signs/Symptoms
Dyspnea, PTX, hemoptysis
Treatment
Avoid pregnancy (hormonal changes), avoid labor-intensive jobs (increases risk of PTX), hormone/gene therapy