asthma COPD Flashcards
signs symptoms COPD
(productive) cough
dyspnoea gets worse over time
worse dyspnoea with exertion
FEV1/FVC in COPD
<0.7
pathophysiology COPD - which molecules, which impact(3)
- fibrosis smooth muscle
- emphysema (alveolar wall destruction)
- mucus hypersecretion
diagnostic differential asthma vs COPD
- Atopy/non atopy
- Allergy/not affected
- IgE/TH1 cytotoxic
- AHR/Not
- Eosinophil+Masts/ Neutrophils
- good days and bad days/ progressive
- good steriod response/poor
why do COPD pts end up in hosp
chest infections
2 assessment tools for COPD
GOLD, assesses FEV/FVC fraction
ABCD assesses severity of symptoms vs lung ftn
explain COPD ABCD assessment tool
Saba
Laba
Lama
Everything including ics
Group a and b 0-1 exacerbations not req hosp
Group c and d 2 mod or >1 hospital
consider ICS in COPD when
eosinophil count is high
mainstay trtment in COPD
LAMA or LABA
inflam genes affected by ICS
CXCL-8
TNF-alpha
IL-6
ICS in COPD increased risk of
pneumonia
steroid use risk factors
osteoporosis
skin
central adiposoty
what is bronchiectasis
chronic progressive
loss of wall
dilation of airways
mucus hypersecretion
irreversible
bronchiectasis = airway dilation so how come narrowed airway
hypersectretion of mucus, and can’t clear it - leads to increased LRTI
most common risk factor for bronchiectasis
frequent LRTI
most common comorbidities bronchiectasis
asthma
copd
also CF, IBS, RA
3+ exacerbations of COPD, suspect…
bronchiectasis
bronchiectasis signs and symptoms
8wks cough
much prurulent sputum
dyspnoea
diagnostic bronchiectasis
spirometry
Chest High Resolution CT
managemnet bronchiectasis
7-14d abx (correct one - sputum culture)
Pulmonary rehab - airway clearance
smoking cessatin
oral hydration
sometimes longterm abx
no ICS
is bronchiectasis reversible
no
2 key features of asthma
VARIABLE resp symptmos
VARIABLE exp airflow limitation
asthma triad symptoms
bronchospasm
mucus hypersecretion
airway inflam & remodelling
what common meds can trigger asthma
NSAIDS
