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Respiratory > Airway disease > Flashcards

Airway disease Flashcards

1
Q

what are three forms of obstructive airway syndrome

A

asthma, chronic bronchitis, emphysema

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2
Q

what determines whether it is restrictive of obstructive

A 
airways= obstructive 
lungs= restrictive
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3
Q

what is ACOS

A

asthma/ COPD overlap syndrome; COPD with reversibility and eosinophilia that respond to steroids

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4
Q

who gets ACOS

A

long standing smokers

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5
Q

what inflammatory agent causes asthma

A

eosinophils

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6
Q

what causes chronic bronchitis and which inflammatory agent in involved

A

smoking

neutrophils

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7
Q

what is emphysema due to and how is it characterised

A

due to destruction of alveolar walls leading to loss of alveolar support and collapsing

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8
Q

which division of the airways starts the conducting/as exchange section of the lungs

A

after 17

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9
Q

what maintains the integrity of the alveoli

A

alveolar walls

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10
Q

what does onset mean

A

age in which it started

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11
Q

what is atopic asthma

A

caused by an allergen

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12
Q

what is intrinsic asthma

A

no obvious extrinsic trigger involved

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13
Q

what is extrinsic asthma

A

caused by extrinsic trigger factor

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14
Q

what is airway hyperresponsiveness

A

when the airways are excessively twitchy to stimuli

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15
Q

what does chronic airway inflammation lead to

A

exacerbations and airway hyper responsiveness

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16
Q

what airway remodelling lead to

A

fixed airway obstruction

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17
Q

describe remodeling and how it is prevented

A

collagen deposition, thickening, hypertrophy;

via treatment

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18
Q

what can monocolonal antibodies target

A

leukotrine D4, LT3,4,5, histamine, IgE

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19
Q

describe two pathological features of severe asthma

A

epithelial shedding, mucus plugging

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20
Q

what follows (3) the inhalation of noxious substances that results in COPD

A

inflammation, mucociliary dysfunction, tissue damage

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21
Q

what are the characteristics of COPD

A

reduced lung function and exacerbations

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22
Q

what are the symptoms of COPD

A

breathlessness and reduction in quality of life

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23
Q

when can inflammation of the lungs lead to COPD

A

when normal repair/ protective mechanisms are overwhelmed or defective

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24
Q

describe the 5 pathological features of chronic bronchitis

A

chronic neutrophilic inflammation, mucus hypersecretion, mucociliary dysfunction, altered lung microbiome, smooth muscle spasm and hypertrophy, partially reversible

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25
Q

describe the 4 pathological characteristics of emphysema

A

alveolar destruction, impaired gas exchange, loss of bronchial support, irreversible

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26
Q

what are the symptoms of COPD

A

chronic- not episodic, non-atopic, daily productive cough, progressive breathlessness, frequent ineffective exacerbations

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27
Q

what is a specific symptom of chronic bronchitis

A

wheezing

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28
Q

what is a specific symptom of emphysema

A

reduced breath sounds

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29
Q

what is the chronic cascade in COPD

A

progressive fixed airflow obstruction, impaired alveolar gas exchange, respiratory failure, right ventricular hypertrophy/failure, death

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30
Q

describe how ACOS is diagnosed

A

COPD with blood >3% eosinophilia, more reversible to salbutamol

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31
Q

what are the 4 non pharmacological managements for COPD

A

stopping smoking, immunisation, physical activity, oxygen

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32
Q

what are the 4 pharmacological treatments for COPD

A

LAMA or LABA mono,
LABA/LAMA combo,
ICS/LABA combo,
ICS/LABA/LAMA combo

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33
Q

Asthma vs COPD

caused by smoking

A

COPD

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34
Q

Asthma vs COPD

allergic

A

asthma

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35
Q

Asthma vs COPD

only late onset

A

COPD

36
Q

Asthma vs COPD

intermittent not chronic

A

asthma

37
Q

Asthma vs COPD

non productive cough

A

asthma

38
Q

Asthma vs COPD

non progressive

A

asthma

39
Q

Asthma vs COPD

neutrophillic inflammation

A

COPD

40
Q

Asthma vs COPD

eosinophillic inflammation

A

asthma

41
Q

Asthma vs COPD

diurnal variability

A

asthma

42
Q

Asthma vs COPD

poor corticoidsteriod response

A

COPD

43
Q

Asthma vs COPD

good response to bronchodilators

A

asthma

44
Q

Asthma vs COPD

reduced FVC and TLCO

A

COPD

45
Q

Asthma vs COPD

impaired gas exchange

A

COPD

46
Q

what does DLPD stand for

A

diffuse parenchymal lung disease

47
Q

what are 3 causes of thoracic restriction outwith the lungs

A

skeletal; curved spine, deformity, broken ribs
muscle weakness; intercostal or diaphragmatic
abdominal obesity/ascites; compression of thoracic contents

48
Q

describe the causes of thoracic restriction due to disease within the lungs

A

disease of alveolar structures; alveolar walls/lumen, ipaired gas exchange

49
Q

what are the three classifications of chronic DLPD

A

due to occupational pr environmental agents or drugs, with evidence and without evidence of systemic disease

50
Q

describe the gas exchange of O2 and CO2 in restrictive thoracic disease

A

impaired alveolar barrier to O2 gas exchange decreased PaO2

CO2 unchanged as alveolar ventilation the same and solubility of CO2 v high

51
Q

describe the cause of DLPD

A

fluid in the alveolar air sacs; cardiac pulmonary oedema- due to increased PO venous pressure or
non cardiac po oedema- normal pressure with leaky vessels due to sepsis or trauma

52
Q

what does ARDS stand for

A

acute respiratory distress syndrome

53
Q

what is the consolidation of alveolar air spaces

A

when regions of lung tissue fill with fluid

54
Q

what diseases can cause consolidation

A

infective pneumonia, infarction (interruption of blood supply e.g pulmonary emboli), BOOP (bronchitis obliterans organising pneumonia), COP (cryptogenic organising pneumonia)

55
Q

what is an alveolitis

A

inflammatory infiltrate of alveolar walls

56
Q

in terms of an alveolitis what is farmers lung

A

extrinsic-allergic-alveolitis

57
Q

farmers lung is an example of a granulomatous-alveolitis, name another

A

sarcoidosis

58
Q

what is a type 1/3 allergic response composed of mediated by

A

eosinophils

mediated by IgE

59
Q

what else can cause alveolitis (4)

A

drug, fumes, pulmonary fibrosis, autoimmune

60
Q

what is a glandular adenoma

A

a cancer that metastasises via lungs or lymph nodes to the lungs

61
Q

what are the two categories of dust disease

A

fibrotic (lays down collagen) and non fibrotic

62
Q

what is it called when a cancer causes DPLD

A

carcinomatosis

63
Q

give the four things that cause an eosinophilic type 1/3 allergic response

A

parasites, drug, fungal, autoimmune

64
Q

what is the clinical presentation of DLPD

A

breathless on exertion, cough no wheeze as no obstruction to airflow, finger clubbing, inspiratory lung crackles, central cyanosis (if hypoxaemic), pulmonary fibrosis- end stage f chronic inflammation

65
Q

what are the other causes of finger clubbing (4)

A

inflammatory heart/bowel disease, liver disease, lung cancer, interstitial lung disease

66
Q

what are crackles the sound of

A

the alveolar opening

67
Q

what does DLCO stand for

A

diffusion lung capacity of oxygen

68
Q

true or false; inhaled steroids are effective in the treatment of interstitial lung disease

A

false- not effective

69
Q

what type of steroids should be used to treat interstitial lung disease

A

oral/systematic

70
Q

what type of drugs dissolve collagen

A

don’t exist

71
Q

what can slow the process of fibrosis

A

drugs

72
Q

what are two antifibrotic agents

A

pirfenidone, nintedanib

73
Q

is fibrosis completely irreversible

A

yeah

74
Q

how can history be used to diagnose DLPD

A

occupation, pets, drugs, arthritis

75
Q

how can lung volumes show a patient has DLPD

A

reduced lung volumes;
reduced FEV1
reduced FVC
normal ratio >75%

76
Q

diangosis- what is peak flow like in DLPD

A

normal

77
Q

diagnosis- how if DLCO in DLPD

A

reduced

78
Q

diagnosis-what is arterial saturation like in DLPD

A

decreased PaO2 and SaO2

79
Q

can an x-ray be used to diagnose DLPD

A

yes

80
Q

how can an echocardiogram diagnose DLPD

A

exclude heart failure and diagnose secondary pulmonary hypertension

81
Q

what immunolgical component can be used to diagnose DLPD

A

antibodies

82
Q

how can an a CT scan be used in the diagnosis of DLPD

A

distinguishes between inflammatory ground glass and fibrotic nodular component in alveolar infiltrates

83
Q

is ground glass opacity treatable

A

yes

84
Q

how is DLPD treated

A

removal of allergen, treat any reversible alveolitis (e.g. ground glass in HRCT) via immuno-suppressants,
1st line treatments= systemic steroids,
2nd line treatment= steriod sparing (e.g oral Azathioprine),

85
Q

what is IPF

A

idiopathic pulmonary fibrosis

86
Q

how is IPF treated (holistic)

A

anti-fibrotic agents, O2 if hypoxaemic, treatment of secondary po hypertension, last resort lung transplant

87
Q

what does idiopathic mean

A

unknown cause

Respiratory (26 decks)

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