Chronic Obstructive Pulmonary Disease (COPD) Flashcards
What are the general considerations for COPD?
- Airflow OBSTRUCTIONS
- Decrease in the 1-sec FEV and increase in FVC = decreased FEV:FVC ratio
Bronchial asthma includes what?
Intrinsic and extrinsic asthma
What is extrinsic asthma?
- Type 1 hypersensitivity response - IgE bound to mast cells
- Childhood disease
What is intrinsic asthma
- Associated w Chronic bronchitis
- Exercise/cold-induced asthma
- Adulthood disease
Bronchial asthma characteristics
- Dyspnea
- Wheezing expiration
- Curschmann spirals (epithelial accumulations)
- Charcot-Leyden crystals (eosinophil crystals)
Bronchial asthma complications
- superimposed infection
- chronic bronchitis
- pulmonary emphysema
What may bronchial asthma eventually lead to that can cause death?
Status asthmaticus
Chronic bronchitis
- productive cough, 3 months, >2 years
- Cigarette smoking –> cor pulmonale
- hyperplasia of mucus-secreting submucosal glands
What are some general considerations of emphysema?
- DILATION of air spaces - no elastic recoil
- increased A-P chest, increase TVC, hypoxia, cyanosis
What are the four types of emphysema?
- Centrilobular
- Panacinar
- Paraseptal
- Irregular
What is panacinar emphysema associated with?
deficiency of alpha-1-antitrypsin
Paraseptal emphysema is associated with what?
Large subpleural bullae, or BLEBS = pneumothorax
Complications of emphysema
- Exist w chronic bronchitis
- interstitial emphysema - air into interstitial tissues
- Rupture of a surface bleb = pneumothorax
What are some postulated causes of emphysema?
- Cigarette - inactivation alpha-1-antitrypsin, neutrophils/macrophages
- Hereditary - variants in pi gene (chromosome 14)
Hereditary causes of emphysema also have to do with what two alleles?
- piZ - interferes with hepatic secretion
- piZZ - decrease alpha-1-antitrypsin, hepatic cirrhosis
