Asthma and COPD Flashcards
What are the obstruction mechanisms at play in asthma?
Acute inflammation, Chronic inflammation and Airway remodelling
What is acute inflammation in asthma?
Bronchoconstriction due to an immune response to noxious stimuli, leading to oedema, secretions and cough
What is chronic inflammation in asthma?
Epithelial damage and early structural changes of the bronchioles
What is airway remodelling in asthma?
Adaptation to injury of the lung taking the form of cellular structure changes in response to uncontrolled asthma
What is the difference between a normal airway and an asthmatic airway
An asthmatic airway will have a thicker bronchial wall and a narrower lumen with slightly more mucus than a non-asthmatic airway
What are the management strategies for asthma?
- Know the asthma exacerbation triggers
- Reduce bronchospasm with inhaled corticosteroids
- Peak flow training and education for patients to understand when their lung condition is changing
What is COPD?
What is the main cause of COPD?
Chronic obstructive pulmonary disease (COPD) is a disease state characterised by progressive airflow limitation associated with abnormal inflammatory responses to noxious stimuli, which is not fully reversible
Smoking is the main cause of COPD
What are some symptoms of COPD?
Easily fatigued
Frequent respiratory infections
Wheezing
Chronic Cough
Pursed lip breathing
Barrel chest
Use of accessory muscles to breath
Prolonged expiratory time
Dyspnea
Orthopnea
What are some risk factors for COPD?
Host factors
- Childhood respiratory infections
- Immune hyperactivity
- Familial aggregation
- Socio-economic status
- Demographic factors
- alpha-1 antitrypsin deficiency (rare)
Environmental factors
- Smoke exposure
- Heavy exposure to occupational dusts and chemicals
- Air pollution
What are the management strategies for COPD?
Stop smoking
Bronchodilators to increase airway diameter and maximise gas exchange
Physiotherapy for chest clearance techniques
Recognition of early signs of infection
Steroids for severe exacerbations
Oxygen therapy (Not too high as to not deactivate hypoxic drive, not too low as to maintain oxygenation)
What drives people to breathe?
What can happen to this drive in COPD patients and what may they start using instead?
Increased CO2 in blood (Hypercapnic drive) will usually make people breathe
The bodies of patients with COPD will be used to increased blood CO2, so their hypercapnic drive may be weaker. Their low blood oxygen (Hypoxic drive) will then make them breathe
What is chronic bronchitis?
The presence of a chronic cough with sputum, leading to narrowing of small airways (bronchiolitis) and bronchitis, as well as blockage of airways and alveoli with mucus
What are the symptoms of chronic bronchitis?
“Blue Bloater”
Symptoms:
- Cough with sputum
- Recurrent infections
- Exacerbations with dyspnoea
Examination:
- Cyanosis
- Overweight
- Prolonged expiration with wheezing
- Elevated haemoglobin
- Signs of right heart failure (cor pulmonale)
What is emphysema?
The destruction of alveolar walls
What are the symptoms of emphysema?
“Pink Puffer”
Symptoms:
- Progressive dyspnoea
- No cough or orthopnoea
Examination:
- Tachypnoea
- Physical weakness/fatigue
- Pink colour
- Barrel chest
- Prolonged expiration
- Reduced air-entry
- Hyper-resonant chest
- Low diaphragm
- Distant heart sounds
