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820 > Asthma/COPD Patho > Flashcards

Asthma/COPD Patho Flashcards

1
Q

COPD

A

Preventable, common, Treatable
Persistent Respiratory symptoms and airflow limitation
Caused by exposure to noxious particles or gases
Exacerbation and Cormobidities contribute to severity.
ONCE DEVELOPED, CANNOT BE CURED

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2
Q

Factors that Influence COPD

A

Particle exposure, Genes, asthma, lung growth/development, age/gender, infections, Socioeconomic status.

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3
Q

Inflammatory Cells

A

Neutrophils, Macrophages, CD8 lymphocytes

Release inflammatory mediators and interact with the structural cells in airways and lung parenchyma.

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4
Q

Inflammatory Mediatiors

A

TNF alpha, Interleukin 8 and leukotriene B4

Attract inflammatory cells from circulation, amplify inflammatory process, induce structural changes

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5
Q

Protease break down

A

Increase proteases in COPD Patients from inflammatory and epithelial cells.

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6
Q

Protease Destruction of elastin

A

Major connective tissue in lung parenchyma

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7
Q

Peripherial Airway Limitation

A

Reduces inspiratory capacity. Dyspena/ limitation of exercise capacity and reduction in lung volumes. Correlated with forced expiratory volume.

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8
Q

Physiologial abnormalities/ symptoms of COPD

A

Gas exchange abnormalities

Possible low oxygen in blood (hypoxemia) and increased CO2 in blood (Hypercapnia)

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9
Q

Mucus Hypersecretion

A

Increased goblet cells and enlarged submucosal glands

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10
Q

Pulmonary Hypertension

A

Vasoconstriction of small pulmonary arteries

may lead to right ventricular hypertrophy and then to right side cardiac failure.

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11
Q

concomitant chronic diseases of COPD

A 
Skeletal muscle wasting
Osteoporosis
Anemia
CVD
Diabetes
Metabolic syndrome
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12
Q

Exacerbations of COPD

A

Triggers (Infections and enviornmental pollutants)
Increased Inflammation
Dyspnea, Hypoxemia
Increased hyperinflation and gas trapping

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13
Q

Goals of COPD management

A 
Prevent disease progression
§ Relieve symptoms
§ Improve exercise tolerance
§ Improve health status
§ Reduce exacerbations
§ Reduce mortality
§ Prevent or minimize side effects from
treatment
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14
Q

Treatment of COPD Pharm and NONpharm

A

Helps to get exercise
Pulmonary Rehab which includes groups B-D
Vaccines

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15
Q

Group A COPD

A

Bronchodilator

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16
Q

Group B COPD

A

Long acting Bronchodilator

17
Q

Group C COPD

A

Long acting anticholinergic

18
Q

Group D COPD

A

Long acting anticholinergic +/- Long acting Beta 2 agonist
Or
Long acting Beta 2 agonist+/- inhaled corticosteroid

19
Q

Does long term oxygen been shown to help?

A

Yes with pts with severe resting hypoxemia greater than 15 hours per day

20
Q

Death By COPD

A

CVD, Lung cancer, and respiratory failure

21
Q

Asthma definition

A

Chronic inflammatory Disorder that involves interactions between host and environment

22
Q

Host factors for asthma

A

Genes, Obesity, gender, and early growth characteristics

23
Q

Enviornmental Exposures to Asthma

A 
Allergens
• Occupational sensitizers
• Infections
• Socioeconomic
inequalities
• Exposure to tobacco
smoke
• Air pollution
• Diet
• Stress
24
Q

Asthma Pathophysiology

A

Inflammation causes recurrent episodes of wheezing, SOB, Breathlessness, chest tightness and coughing.
Inflammation causes Bronchial Hyperresponsivenes and can lead to airway obstruction.

25
Q

Mast Cells Asthma

A

Release bronchoconstrictor mediatiors

Cysteinyl leukotrienes histamine, PGD2

26
Q

Eosinophils Asthma

A

Increased numbers of the cells in airways of most people with asthma. Possible marker

27
Q

Neutrophils Asthma

A

Increased numbers of cells in airways and sputum with severe asthma and pts with asthma that smoke

28
Q

Airway narrowing Asthma

A

Smooth Muscle Contraction
Response to Bronchoconstrictor mediators. reversed by bronchodilators
Airway edema
Micro vascular leakage in response to inflammatory mediators.

29
Q

Bronchial Hyperresponsiveness

A

Exaggerated Bronchoconstriction response to stimuli that is innocuous to a healthy person.
Used to diagnose asthma
Inflammation is a major factor in determining the degree of airway hyperresponsiveness

30
Q

Airway remodeling

A

Possibly an irreversible process.
Thickening of sub-epithelial reticular BM
Increase in airway smooth muscle mass
mucus gland hyperplasia and hypersecretion.

31
Q

Nitric Oxide

A

Produced in the respiratory tract
Induced in pro inflammatory cells
amplifies inflammatory process
Useful measurement of ongoing lower airway inflammation

820 (6 decks)

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