13.1 Asthma vs COPD

Question 1

Asthma onset and why onset at this time?

Answer 1

• Asthma is most often associated with onset during childhood and is common in those with a family history of atopy (genetic tendency to develop allergic diseases) or asthma.
• Symptoms typically increase with exposure to allergens and triggers, such as pollen, dust mites and animal dander.
• In some cases, asthma symptoms disappear after childhood.

Question 2

When do asthma and COPD mainly occur?

Answer 2

Asthma mainly occurs in children and COPD mainly occurs in older adults.

Question 3

What are the clinical features for differentiating asthma and COPD?

Answer 3

Question 4

What is a common causes of COPD?

Answer 4

• SMOKING
• Indoor air pollution
• Outdoor air pollution
• Passive smoke exposure

Question 5

What are the risk factors of COPD?

Answer 5

• Low birth weight
• Low socioeconomic status
• Childhood infection
• Asthma

Question 6

What are the causes of asthma?

Answer 6

1. GENETICS
2. Epigenetics (caused by environmental factors - behaviours and environment can cause changes that affect the way your genes work)
3. Environmental factors

Question 7

What are the triggers of asthma?

Answer 7

Question 8

Is it possible to tell asthma from COPD by CXR?

Answer 8

YES

• CXR in asthma most often NORMAL but may be hyperexpanded
• In COPD hyperinflation is more common
  
  • Consists of a loss of height of the convexity of the hemidiaphragm

Question 9

What are the prodominant inflammatory cell type in asthma and COPD?

Answer 9

1. ASTHMA
   
   • Eosinophillic (main)
   • Neutrophilic asthma = very severe & persistent
     
     • Frequent exacerbations
     • Categorised by fixed airway obstruction
     • Associated with:
       
       • Obesity
       • Respiratory infections
2. COPD
   
   1. ​Neutrophilic (main)
   2. Less = eosinophilic (usually inflammation)

Question 10

Explain airway obstruction in asthma

Answer 10

• Airway obstruction results from constriction of bronchial smooth muscle, airway hyper-reactivity to allergens, and inflammation accompanied by increased eosinophils and activated T-cells.
• Intermittant and reversable (unless chronic fixed from severe disease or undertreatment)

Question 11

Explain airway obstruction in COPD

Answer 11

• Airway smooth muscle is not usually constricted and obstruction is associated mainly with mucus hypersecretion and mucosal infiltration by inflammatory cells, leading to cellular damage and the loss of alveolar structure
• Cellular destruction and structural changes associated with COPD interfere with oxygenation and pulmonary circulation

Question 12

Explain the steps in pharmacological treatment of asthma

Answer 12

Question 13

What is the proportion of people with asthma and COPD?

Answer 13

• 1/12 adults have asthma
• 1/20 adults have COPD