Aetiology

Question 1

What does COPD cover?

Answer 1

•	Smoking-related lung disease
             Chronic bronchitis
             Emphysema 
•	Asthma
•	Bronchiectasis
•	Rarities 
             Obliterative bronchiolitis
             Langhans cell hystiocytosis

Question 2

What is chronic bronchitis?

Answer 2

Defined clinically as a cough, sputum production on most days for 3 months of 2 successive years

Question 3

What is emphysema?

Answer 3

Defined histologically as enlarged air spaces distal to terminal bronchioles

Question 4

What is COPD?

Answer 4

COPD is characterised by airflow obstruction.

This is usually progressive, not fully reversible and does not change markedly over several months.

Question 5

What is the main genetic cause of COPD?

Answer 5

alpha-1-antitrypsin deficiency

Question 6

What are the environmental causes of COPD?

Answer 6

• Tobacco smoke exposure
• Cannabis
• Other smokes
• Mineral dusts (coal, cadmium)

Question 7

What is the pathophysiology of COPD?

Answer 7

1. Inflammatory response to tobacco smoke
2. Inflammation mediates:
   Goblet cell hyperplasia
   Airway narrowing
   Bronchial scarring
   Alveolar destruction

Question 8

What are the risk factors for COPD?

Answer 8

•	Tobacco smoking
•	Occupational exposure
•	Air pollution
•	Genetics
o	Alpha1-antitrypsin deficiency (typically presents in patients <45 years)
•	Lung development
•	Asthma