COPD

Question 1

COPD

Answer 1

group of chronic and slowly progressing respiratory disorders
reduced forced expiratory volume in one second
fixed obstruction with variable degrees of reversibility
may exist with asthma
3rd most common cause of death in the USA

Question 2

Chronic bronchitis

Answer 2

impacts the bronchus
mucus gland hyperplasia and hyper secretion
symptoms: cough, sputum

cough with sputum not attributable to other causes
present on most days for at least 3 consecutive months per year for at least 2 years in a row
small airway disease

Question 3

Bronchiectasis

Answer 3

impacts bronchus
airway dilation and scarring
symptoms: cough, purulent sputum, fever, PUS, infection

Question 4

Asthma

Answer 4

impacts bronchus
smooth muscle hypertrophy, excessive mucus, inflammation
symptoms: episodic wheezing, cough, dyspnea

Question 5

Emphysema

Answer 5

impacts acinus (sac that is given air by the terminal bronchiole)
airspace enlargement, wall destruction, decreased respiratory membrane
symptom: dyspnea

Question 6

Small airway disease

Answer 6

impacts bronchiole
inflammatory scarring, obliteration of bronchioles
symptoms: cough, dyspnea

Question 7

First symptoms of COPD

Answer 7

dyspnea, gasping
coughing, wheezing
weight loss
reduced FEV1

Question 8

Pink puffers

Answer 8

when emphysema predominates in COPD
lung can’t expel enough air
sit forward to squeeze air out of lungs
dyspnea, hyperventilating
oxygenated

Question 9

Blue bloaters

Answer 9

emphysema with extreme chronic bronchitis in COPD
history of recurrent infections
purulent sputum
less prominent dyspnea, become hypoxic
not well oxygenated
peripheral edema, obesity, heart failure

Question 10

How does chronic bronchitis block airways ?

Answer 10

goblet cell hyperplasia and hypertrophy
inflammatory cells in airways
scarring/fibrosis thickens the airways
cilia become immobilized and reduced in numbers

Question 11

Emphysema

Answer 11

permanent enlargement of airspace’s distal to terminal bronchioles without obvious fibrosis
irreversible due to destruction by proteases, reduces gas exchange, fatigue

Question 12

When exposed to cigarette smoke/other stimuli, macrophages and lung epithelial cells become activated which leads to ?

Answer 12

cytokine release, recruitment of neutrophils and T cells, release of proteases, and reduction of antiproteases

Question 13

Elastase

Answer 13

degrades elastin and collagen
inhibited by anti-elastase
released by activated neutrophils

Question 14

matrix metalloproteinases

Answer 14

break down extracellular matrix and collagen
released by activated neutrophils

Question 15

Alpha 1 antitrypsin

Answer 15

antiprotease
inhibits proteases
found in serum and tissue fluids
inactivated by cigarette smoke and neutrophils

Question 16

Tobacco stimulates oxygen radicals which leads to ?

Answer 16

inactivation of antiproteases, increase of neutrophil elastase, and tissue damage

Question 17

Who gets COPD?

Answer 17

cigarette smokers, those exposed to air pollution
associated with low birthweight
those with genetic factors contributing to alpha1 antitrypsin deficiency

Question 18

Is COPD irreversible?

Answer 18

no

Question 19

Options for treating COPD

Answer 19

stop smoking
update vaccines
antibiotics
corticosteroids
bronchodilators/ beta 2 agonists
cholinergic blockers
alpha 1 antitrypsin replacement therapy