9.4 - Chronic obstructive pulmonary disease

Question 1

what is the result of COPD on:

• FEV
• FVC
• FEV : FVC
• TLC

Answer 1

• FEV: depressed
• FVC: very depressed
• FEV : FVC: depressed
• TLC: increased (air trapping)

Question 2

what is the reid index?

Answer 2

• measure of chronic bronchitis

- thickness of mucus glands relative to bronchial wall thickness (over 0.5 is abnormal)

Question 3

what are the PaCO2 and PaO2 levels in chronic bronchitis?

Answer 3

• PaCO2 elevated

- PaO2 decreased

Question 4

smoking results in what type of emphysema? where is it most severe?

Answer 4

centriacinar - most severe in upper lobes

Question 5

A1AT deficiency results in what type of emphysema? where is it most severe?

Answer 5

panacinar - most severe in lower lobes

Question 6

where does mutant A1AT protein accumulate within hepatocytes?

Answer 6

ER

Question 7

how is the FRC affected by emphysema?

Answer 7

increased

Question 8

in asthma, allergens induce what type of immune response?

Answer 8

• allergens induce Th2 phenotype in CD4 T cells

- Th2 cells secrete IL-4 (class switch to IgE), IL-5 (attract esosinophils), and IL-10 (stimulates Th2, inhibits Th1)

Question 9

what curschmann spirals? when / where are they seen?

Answer 9

• spiral shaped mucus plugs

- asthma

Question 10

what are charcot-leyden crystals? when / where are they seen?

Answer 10

• eosinophil-derived crystals

- asthma

Question 11

what are causes of bronchiectasis?

Answer 11

• CF
• kartagener syndrome
• tumor, foreign body
• necrotizing infection
• allergic bronchopulmonary aspergillosis

Question 12

what are complications of bronchiectasis?

Answer 12

• hypoxemia
• cor pulmonale
• secondary amyloidosis