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Year 2 CR > asthma COPD > Flashcards

asthma COPD Flashcards

1
Q

signs symptoms COPD

A

(productive) cough
dyspnoea gets worse over time
worse dyspnoea with exertion

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2
Q

FEV1/FVC in COPD

A

<0.7

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3
Q

pathophysiology COPD - which molecules, which impact(3)

A
  • fibrosis smooth muscle
  • emphysema (alveolar wall destruction)
  • mucus hypersecretion
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4
Q

diagnostic differential asthma vs COPD

A
  • Atopy/non atopy
  • Allergy/not affected
  • IgE/TH1 cytotoxic
  • AHR/Not
  • Eosinophil+Masts/ Neutrophils
  • good days and bad days/ progressive
  • good steriod response/poor
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5
Q

why do COPD pts end up in hosp

A

chest infections

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6
Q

2 assessment tools for COPD

A

GOLD, assesses FEV/FVC fraction
ABCD assesses severity of symptoms vs lung ftn

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7
Q

explain COPD ABCD assessment tool

A

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

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8
Q

consider ICS in COPD when

A

eosinophil count is high

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9
Q

mainstay trtment in COPD

A

LAMA or LABA

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10
Q

inflam genes affected by ICS

A

CXCL-8
TNF-alpha
IL-6

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11
Q

ICS in COPD increased risk of

A

pneumonia

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12
Q

steroid use risk factors

A

osteoporosis
skin
central adiposoty

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13
Q

what is bronchiectasis

A

chronic progressive
loss of wall
dilation of airways
mucus hypersecretion
irreversible

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14
Q

bronchiectasis = airway dilation so how come narrowed airway

A

hypersectretion of mucus, and can’t clear it - leads to increased LRTI

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15
Q

most common risk factor for bronchiectasis

A

frequent LRTI

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16
Q

most common comorbidities bronchiectasis

A

asthma
copd

also CF, IBS, RA

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17
Q

3+ exacerbations of COPD, suspect…

A

bronchiectasis

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18
Q

bronchiectasis signs and symptoms

A

8wks cough
much prurulent sputum
dyspnoea

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19
Q

diagnostic bronchiectasis

A

spirometry
Chest High Resolution CT

20
Q

managemnet bronchiectasis

A

7-14d abx (correct one - sputum culture)
Pulmonary rehab - airway clearance
smoking cessatin
oral hydration
sometimes longterm abx
no ICS

21
Q

is bronchiectasis reversible

A

no

22
Q

2 key features of asthma

A

VARIABLE resp symptmos
VARIABLE exp airflow limitation

23
Q

asthma triad symptoms

A

bronchospasm
mucus hypersecretion
airway inflam & remodelling

24
Q

what common meds can trigger asthma

A

NSAIDS

25
Q

where is asthma pathology

A

small airways

26
Q

what is desquamation

A
27
Q

IL-5 does what

A

triggers eosinophils -> mucus

28
Q

What do IL4 and 13

A

drive IgE and mucus production

29
Q

histamine causes…

A

smooth muscle to contract

30
Q

3 most important interleukins in asthma

A

IL4, 5, 13

31
Q

how can viruses affect asthma

A

Virus can activate the epithelium to release Alarmin cytokines e.g. TSLP to active T2 cells

32
Q

what happens if TH2 immunity is upregulated

A

other sides of immunity are downregulated

33
Q

tests to measure if TH2 immunity is activates

A

FeNO breeath test and raised eosinophilia

34
Q

key in asthma diagnostic

A

variable episodic nature of symptoms

35
Q

what is wheexe

A

polyphonic tones in wheeze

36
Q

asthma diagnostic pathway

A
37
Q

key feature on asthmatic flow volume curve

A

scalloping - then reversed somewhat by salbutamol

38
Q

what improvement feature in asthma diagnosis

A

12% improvement with salbutamol

39
Q

when is peak flow worst

A

4am

40
Q

peak flow chart?

A

3 best attempts once on wakin and once mid afternoon

41
Q

asthma management ladder

A
42
Q

beta 2 agonists bind to

A

G coupled receptor

43
Q

beta 2 agonists should be given with .. because..

A

steroids
effect is better and steroid blocks downregulation of b2 agonist receptors

44
Q

how do MAbs work in asthma (2)

A

either bind eg IL33 or block receptor

45
Q

high FeNO is marker of

A

IL4/IL13

46
Q

what is MART inhaler

A

maintenance and relief.
steroid is combined with reliever

47
Q
A

Year 2 CR (33 decks)

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