COPD 1 - Background

Question 1

is a disease of ? airway limitation that’s not fully ?, ass w infl resp in lungs to noxious particles of gases, predominantly inhaled ? ?

airflow limited by decreased outflow pressure (?) and incr airway resistance (?/?)

Answer 1

progressive 
reversible
cig smoke
emphysema
chronic bronchitis/bronchiolitis

Question 2

Emphysema

• dilation of any part of resp ? (air spaces distal to ? bronchiole) and destructive changes in ? walls - absence of any ?
• centrilobular -> changes limited to central ? directly around the ? ?, normal alveoli elsewhere - most common form, ass with ?

Answer 2

acinus
terminal
alveolar
scarring
lobule
terminal bronchiole
smx

Question 3

Emphysema

• panacinar -> destruction and distension of the ? ?, can happen in smokers but more common in ? ? ? - this normally inactivates neutrophil ?
• dilated air spaces >?cm are termed ?
• loss of ? tissue in alveolar walls -> lost ? ? of lungs -> air entrapment and inadequate ?
• reduction in area available for gas exchange means there is reduced ? uptake

Answer 3

whole lobule
a1 antitrypsin def
elastase
1
bullae
connective
elastic recoil
ventilation
oxygen

Question 4

Chronic bronchitis
? cough with ? for at least ? months per year for ? years
-primarily see abnormal amounts of ? -> ? of the airway lumen
-this is ass w incr size/amount of bronchial ? ? ?
-can be shown by ? index, the ratio of ?:wall thickness in bronchus, ? in chronic bronchitis
-? is not typically present, although freq ? develop with secondary inflam and squamous metaplasia

Answer 4

daily
sputum
3
2
mucus
plugging
mucus secreting glands
reid
gland
incr
inflam
LRTIs

Question 5

Bronchiolitis
-cig smokers also develop ? of the airways under ?mm in diameter, i.e. the ?, with macrophage and ? infiltration.
o This is actually the first ? change in COPD.
o It may lead to ?, and ? of the airways.

Answer 5

inflam
2
bronchioles
lymphocyte
pathological
scarring 
narrowing

Question 6

RFs

? ? exposure

• stimulates ? to produce elastase
• can inactivate ?
• directly causes ? ? hypertophy

occasional exp to ?

? deficiency

• 1/10 are ?, accounts for ?% of emphysema cases
• small minority also get ? disease

recurrent ? ? in childhood

low ? ?

asthma/?

Answer 6

cig smoke
neutrophils
a1 anti
mucus gland

dust

a1 anti
carriers
2
liver

chest infections

SE status

atopy