Pulmonology Faculty Therapy Exam Review

Comprehensive vocabulary flashcards covering asthma, COPD, various types of pneumonia, and pleurisy, based on the 4th-year faculty therapy exam lecture notes.

Bronchial Asthma

A chronic inflammatory disorder of the airways characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and airway inflammation.

Airway Remodelling

Structural changes in chronic severe asthma, such as subepithelial fibrosis and smooth muscle hypertrophy, leading to irreversible obstruction in $10$-$20\%$ of patients.

Occupational Asthma

Asthma triggered by chemicals, dust, or fumes in the workplace, accounting for $5$-$15\%$ of adult-onset cases.

Silent Chest

A life-threatening clinical sign during a severe asthma exacerbation where breath sounds and wheezing are absent due to minimal airflow.

Pulsus Paradoxus

A drop in systolic blood pressure of $> 10\,mmHg$ during inspiration, indicating severe asthma.

Spirometry Reversibility Criterion

An improvement in FEV1 of $\geq 12\%$ and $\geq 200\,mL$ after bronchodilator administration, used as a key diagnostic criterion for asthma.

FeNO (Fractional exhaled NO)

A diagnostic test elevated in eosinophilic asthma ($> 25\,ppb$).

AIR therapy

The use of an ICS/Formoterol combination (e.g., Budesonide/Formoterol) as both a maintenance controller and an as-needed reliever.

Omalizumab

An anti-IgE biologic medication used for severe uncontrolled allergic asthma with high IgE levels.

Chronic Obstructive Pulmonary Disease (COPD)

A progressive, preventable, and treatable respiratory disease characterized by persistent, irreversible airflow limitation usually caused by exposure to noxious particles or gases.

Chronic Bronchitis (Phenotype)

Defined clinically as a cough and sputum production for at least $3$ months per year for $2$ consecutive years.

Emphysema

Parenchymal destruction caused by protease-antiprotease imbalance leading to alveolar wall destruction, air trapping, and hyperinflation.

GOLD Grade 4 (Very Severe)

COPD severity classification where the post-bronchodilator FEV1 is $< 30\%$ predicted.

"Blue bloater"

A clinical description of a chronic bronchitis patient typically characterized by cyanosis, edema, being overweight, and hypercapnia.

"Pink puffer"

A clinical description of an emphysema patient typically characterized by being thin, breathless, using pursed-lip breathing, and having no initial cyanosis.

Cor Pulmonale

Right heart failure resulting from chronic lung disease and pulmonary hypertension, affecting $20$-$30\%$ of severe COPD patients.

Pneumonia

An acute infection of the lung parenchyma, primarily affecting the alveoli, characterized by inflammation, consolidation, and impaired gas exchange.

CURB-65 Score

A severity assessment tool for pneumonia consisting of Confusion, Urea $> 7\,mmol/L$, Respiratory Rate $\geq 30/min$, Blood Pressure ($systolic < 90$ or $diastolic \leq 60$), and Age $\geq 65$.

Walking Pneumonia

A common name for atypical pneumonia caused by Mycoplasma pneumoniae, characterized by gradual onset, dry cough, and headache in young adults.

Legionella pneumophila

A pathogen associated with water exposure (AC, cooling towers) causing high fever, confusion, GI symptoms, and hyponatremia.

Community-Acquired Pneumonia (CAP)

An acute infection of the lung parenchyma acquired outside of healthcare settings.

Hospital-Acquired Pneumonia (HAP)

Pneumonia occurring $\geq 48$ hours after hospital admission that was not incubating at the time of admission.

Ventilator-Associated Pneumonia (VAP)

Pneumonia occurring $> 48$ hours after endotracheal intubation and mechanical ventilation.

CPIS (Clinical Pulmonary Infection Score)

A scoring system where a result of $\geq 6$ suggests a diagnosis of pneumonia.

Pleurisy

Inflammation of the pleura characterized by sharp, unilateral, stabbing chest pain worsened by deep breathing or coughing.

Light's Criteria

A set of rules used to distinguish exudative from transudative pleural effusions based on protein and LDH ratios.

Pleural Friction Rub

A creaking or leather-like auscultatory sound heard in both inspiration and expiration, indicative of dry (fibrinous) pleurisy.

Empyema

An infected pleural effusion characterized by turbid/purulent appearance and a $pH < 7.2$, requiring mandatory chest tube drainage.

Adenosine Deaminase (ADA)

A biomarker used in pleural fluid analysis that is typically elevated in tuberculous pleurisy.

LAMA (Long-Acting Muscarinic Antagonist)

A class of inhaled bronchodilators, such as Tiotropium, used as first-line maintenance therapy for COPD to reduce exacerbations.