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Patho 2 > 18 COPD > Flashcards

18 COPD Flashcards

1
Q

• What are the 2 types of lower resp diseases?

A
  1. Obstructive —>contraction of airway —> obs of airflow

2. Restrictive —>⬇️ of lung volume

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2
Q

• What is the diff btwn COPD & asthma acc to pts age?

A

Asthma —> mainly in children

COPD —> mainly in elderly

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3
Q

• What is the diff btwn COPD & asthma acc to disease prod?

A

Asthma —> self produced

COPD —> preventable

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4
Q

• What is COPD?

A

Common preventable disease, characterized by persistent airflow limitation (usually progressive) associated w/enhanced chronic inf response in the airways & lungs in response to noxious gases or particles

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5
Q

• What can increase the severity of COPD in pts?

A

exacerbations/comorbidities ex: bac or viral inf or ❤️ disease

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6
Q

• What causes COPD?

A
  1. Cigarette smoking
  2. Occupational dust and chemicals
  3. Environmental tobacco smoking (passive smoking)
  4. Indoor / outdoor air pollution
  5. Genes
  6. Infections
  7. Socio-economic status
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7
Q

• How can genes cause COPD?

A

the loss of a1 antitripsin —> tripsin is not inhibited —> tripsin digests parenchyma—> emphysema like changes and COPD

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8
Q

• What is the diff btwn COPD & asthma acc to main cause?

A

Asthma —> allergen

COPD —> cigarette smoking

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9
Q

• What is the cellular mechanisms of COPD?

A

Cigarette smoking —> alveolar macrophage in epithelial cells —> releases neutrophil chemotactic factors + cytokines + mediators —> recruit neutrophils —> release neutrophil elastase + cathepsins + matrix metalloproteinases —> cause alveolar wall destruction (emphysema) + mucus hypersecretion (chronic bronchitis)

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10
Q

• What is the cytokine & mediator released by epi cells?

A
  1. cytokine —> IL-8

2. Mediator —> LTB4

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12
Q

• What is the diff btwn COPD & asthma acc to most imp cell involved in inf?

A

asthma —> eosinophils

COPD —> neutrophils

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13
Q

• Why does cigarette smoking cause COPD at first?

A

bcz it causes oxidatve stress bcz it contains O2 free radicals

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14
Q

• What does oxidative stress result in?

A
  1. ⬇️ antiproteases

2. Cause inf by act proinf cytokine + transcription factor

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15
Q

• What are the results of COPD?

A
  1. Increased mucus production and reduced mucociliary clearance - sputum production and cough
  2. Loss of elastic recoil - airway collapse
  3. Pulmonary hyperinflation
  4. Increased smooth muscle tone
  5. Gas exchange abnormalities - hypoxemia and/or hypercapnia ( ⬆️CO2 )
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16
Q

• What does the proteases released by neutrophils do?

A

breakdown the structure of lungs components

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17
Q

• What are the mechanisms involved in airway narrowing?

A
  1. Small airway disease: airway inf/fibrosis + luminal plugs + bronchoconstriction
  2. Parenchymal destruction: loss of alveolar attachments + ⬇️ of elastic recoil
  3. Gas exchange abnormalities: hypoxemia / hypercapnia
18
Q

• What causes luminal plugs?

A

excessive mucus secretion

19
Q

• What causes bronchoconstriction?

A

airway smooth muscle contraction

20
Q

• What is spirometry?

A

it is a technique to measure lung function by FEV1: forced expiratory volume in 1 sec + volume capacity

21
Q

• What is FVC?

A

forced vital capacity : the amount of air out when exhaling

22
Q

• What is the value of normal FEV1/FVC?

A

0.8 is the normal value in ppl w/o lung diseases

23
Q

• When does spirometery indicate COPD?

A

if FEV1/FVC <0.8 —> ⬇️ in FEV1 > ⬇️ in FVC

24
Q

• What are the key indicators for COPD diagnosis?

A
  1. Chronic cough
  2. Chronic sputum production
  3. Dyspnoea
  4. Acute bronchitis
25
Q

How should chronic cough be to indicate COPD?

A

present everyday and throughout the day

26
Q

• How should chronic sputum prod be to indicate COPD?

A
  1. Present for many years
  2. Worst in winter
  3. Mucoid becomes purulent w/exacerbation
27
Q

• What are the characteristics of dyspnoea in COPD pts?

A
  1. persistent (everyday )
  2. Progressive ( worsens after )
  3. Worse on exercise
  4. Worse w/resp inf
28
Q

• How can acute bronchitis diagnose COPD?

A

if there are repeated episodes —> once in 2-4 mns

Patho 2 (2 decks)

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