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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
2 mins
Obstructive Lung Disease
- Blocked Airflow
- Increased residual volume
- V/Q Mismatch
- Decreased forced vital capacity (FVC)
- Decreased FEV1/FVC ratio
- Asthma
- Bronchiectasis
- Chronic bronchitis
- Emphysema
51 secs
COPD Overview (Chronic Obstructive Pulmonary Disease Overview)
- Causes
- Inhaled Toxins
- Smoking
- AAT Deficiency
- Assessment
- Emphysema
- Chronic Bronchitis
- Asthma
- Considerations
- Spirometry
- Slow Progression
2 mins
Emphysema
- Clinical Features
- Pink Puffer
- Exhale through Pursed Lips
- Barrel Chest
- Pathophysiology
- Obstructive Lung Disease
- Increased Lung Compliance
- Types
- Centriacinar
- Panacinar
2 mins
Chronic Bronchitis
- Pathophysiology
- Chronic Inflammation of Bronchi
- Signs and Symptoms
- Early-Onset Cyanosis
- Blue Bloaters
- Productive Cough
- Wheezing
- Chronic Obstructive Pulmonary Disease (COPD)
- Late-Onset Dyspnea
- Crackles
- Diagnosis
- Reid Index > 50%
2 mins
Chronic Bronchitis Assessment
- Clinical Findings
- Chronic Productive Cough
- > 3 Months for 2 Years
- Increased Mucus Production
- Dyspnea
- Cyanosis
- Wheezes
- Complications
- Right Side Heart Failure
- Jugular Venous Distention (JVD)
- Peripheral Edema
2 mins
Chronic Bronchitis Interventions
- Tripod Position
- Humidified Oxygen
- Pursed Lip Breathing
- Increase Fluid Intake
- ABGs
- Early Detection of Exacerbation
- Considerations
- Lowest O2 Therapy
- Assisted Ventilation
- Increased Infection Risk
2 mins
Bronchiectasis
- Obstructive Lung Disease
- Chronic Necrotizing Infection
- Permanent Airway Dilation
- Poor Ciliary Motility
- Kartagener's Syndrome
- Cystic Fibrosis
- Allergic Bronchopulmonary Aspergillosis
- Hemoptysis
- Increased Sputum
2 mins
Asthma
- Obstructive lung disease
- Bronchial Hyperresponsiveness
- History of Atopic Disease
- Beta2 agonists
- Corticosteroids
- Curschmann's spirals
- Hypertrophy of smooth muscle
- Reversible
- Charcot Leyden crystals
- Methacholine challenge
- Wheezing
- Cough
- Initially decreased PaCO2
- Pulsus paradoxus
2 mins
Asthma Assessment
- Assessment
- Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
- Shortness of Breath (SOB)
- Tachypnea and Tachycardia
- Wheezing
- Diaphoresis
- Accessory Muscles
- Decreased Pulmonary Function Tests
2 mins
Intermittent Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use ≤ 2 / Week
- No Interference With ADLs
- Nighttime Awakening < 2 / Month
- > 80 % of Predicted FEV1
1 min
Persistent Mild Asthma
- Diagnosis
- Symptoms (Brochoconstriction) and Rescue Inhaler Use > 2 Days / Week
- Nighttime Awakening 3-4 / Month
- Greater or equal to 80 % of Predicted FEV1
1 min
Persistent Moderate Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use Daily
- Nighttime Awakening > 1 / Week
- 60-80% Predicted FEV1
- FEV1/FVC Decreased 5%
2 mins
Persistent Severe Asthma
- Diagnosis
- Symptoms (Bronchoconstriction) and Rescue Inhaler Use: Multiple/ Day
- With Minimal Activity
- Nighttime Awakening: Nightly
- < 60% Predicted FEV1
- > 5% Decrease FEV1/FVC
2 mins
Stages of Asthma Treatments
- Mild Intermittent
- Short-acting Inhaled Beta-Agonist
- Mild Persistent
- Low-Dose Inhaled Corticosteroid
- Montelukast (Leukotriene Receptor Antagonist)
- Moderate Persistent
- Low to Medium-dose Inhaled Corticosteroid
- Zileuton
- Severe Persistent
- High-Dose Inhaled Corticosteroid
- Systemic Corticosteroids
- Omalizumab (Allergies)
2 mins
Asthma Implementation and Education
- Medication
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Implementation
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Education
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
2 mins
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