Asthma and COPD

Question 1

What type of disease is asthma

Answer 1

Obstructive

Question 2

What type of disease is COPD

Answer 2

Obstructive

Question 3

What does COPD stand for?

Answer 3

Chronic obstructive pulmonary disease

Question 4

What does chronic poor controlled asthma do?

Answer 4

More smooth muscle, more interstitial fluid, more mucus secretion, epithelial damage, epithelial fibrosis

Question 5

What does the parasympathetic division cause in the lungs?

Answer 5

Bronchoconstriction - stimulation of postganglionic non cholinergenic fibers

Question 6

What mediates the parasympathetic division?

Answer 6

NO and VIP

Question 7

What does the sympathetic division cause in the lungs?

Answer 7

Broncho relaxation via B2 adrenoreceptros

Question 8

What does adrenaline do to the airways

Answer 8

• Opens them - through B2 adrenoreceptos

Question 9

What happens to mucus in response to B2 receptor stimulation?

Answer 9

It gets cleared up by cilia, and isnt secreted

Question 10

What is thought to be the major cause of asthma?

Answer 10

TH1 and TH2 imbalance

Question 11

What happens after TH2 lymphocyte activation?

Answer 11

… Activate B cells that mature to IgE secreting P cells.

Also cause mast cells to express IgE receptors

Question 12

What do IgE receptors on mast cell do?

Answer 12

Release leukotrines which leads to smooth muscle contraction

Question 13

What does OSHITMAN stand for?

Answer 13

O- O2 100%
S- Salbutamol (nebulised)
H - hydrocortisone IV
I - IV ipatropium bromide
T - theophylline
M - Magnesium sulfate (MGSO4)
Anesthetist

Question 14

What happens during airway remodeling in asthma?

Answer 14

BM thickening
Submucosa collagen depostiion
Smooth muscle hypertrophy

Question 15

How would you diagnose asthma?

Answer 15

Check history, diurnal variation, reduced expiratory flow ratio (FEV1/FVC), reversible to salbutamol. provocation testing

Question 16

What is diurnal variation?

Answer 16

That peak flow changes throughout the day

Question 17

What peak flow is moderate asthma?

Answer 17

50-75%

Question 18

What peakflow is severe asthma?

Answer 18

33-50%

Question 19

What happens during severe asthma?

Answer 19

Resp rate >25, HR > 110. Cant speak

Question 20

What happens during life threatening asthma?

Answer 20

PEF < 33% O2 <92%

Question 21

What is the risk factor for COPD?

Answer 21

Smoking for a long time

Question 22

How does COPD develop?

Answer 22

Irritants activate macrophages in the airways leading to IL-8 and leukotrine B4 release. Proteases then released by neutrophils and macrophages = breakdown of lungs and mucus secretion

Question 23

What destroys alveolar wall epithelial cells?

Answer 23

CD8+ Lymphocytes

Question 24

What 2 diseases are related to COPD?

Answer 24

Emphysema and chronic bronchitis

Question 25

What happens in chronic bronchitis?

Answer 25

Neutrophillic inflammation, mucus secretion, ciliary malfunction

Question 26

What happens in emphysema?

Answer 26

Alveolar destruction

Question 27

What are the symptoms of COPD?

Answer 27

Smoking, non allergenic, productive cough, progressive breathlessness, frequent infective exacerbations `

Question 28

What defines COPD overlap syndrome/ACOS?

Answer 28

COPD with blood eosinophilia > 3%

Question 29

How would you treat COPD?

Answer 29

1 Any SA()A
2 LAMA
3 LABA + LAMA or ICS
4 All

Question 30

B2 agonists include?

Answer 30

SABA and LABA(with glucocorticoid)

Question 31

CysLT1 antagonists do what?

Answer 31

Block CysLTs on mast cells - bronchodilator

Question 32

What is the suffix for xantines?

Answer 32

phylline

Question 33

What is the ending for steroids

Answer 33

One/ide, - Severe=prednisolone

Question 34

What do B2 agonists do? **

Answer 34

Bronchodilator