COPD Flashcards
COPD is?
chronic, inflammatory response a/w pollutants
preventable, treatable
Inflammation in lungs results in? (2)
1) Small airway disease:
airway inflamm and remodeling
2) Parenchymal destrutction:
loss of alveolar attachments and recoil
Emphysema-caused COPD characteristics?
"Pink Puffer" Maintains adequate O2 for longer time Pursed lip breathing, Pink skin color, Thin body
Chronic Bronchitis-caused COPD characteristics?
“Blue Bloater”
Hypoxemia/respiratory acidosis (C)
Cor pulmonale (enlarged R heart from pulm HTN)
Overweight
Chronic Bronchitis definition?
Chronic, productive cough
Lasting 3 mo during 2 yrs
With no other cause
Chronic Bronchitis structural Δs? (3)
Mucous gland hyperplasia ->
excess mucus and narrowed bronchioles
Bronchial squamous metaplasia (non-squ replaced w/ squamous cells)
Lost ciliary transport
(Less parenchymal damage than emphysema)
Chronic Bronchitis structural Δs results from?
Inflamm of submucosa of bronch wall by neutrophils
Chronic bacterial inf/hyper-active reaction
Chronic Bronchitis causes what type of obstruction?
Results in?
inspiratory and expiratory
hypoxemia and hypercarbia
Emphysema definition?
Pathological enlargement of air spaces DISTAL to terminal bronchs
Due to destruction of alveolar walls
Emphysema destructive process?
(P) > elastase or < antitrypsin
Emphysema structural Δs?
↓ alveolar SA available for gas exchange
↓ recoil -> limits airflow
↓ alveolar support structure -> airway narrowing
Destruction of capillary beds -> ↓ CO2 diffusion capacity
Emphysema causes what type of obstruction?
Results in?
exhalation
hypercarbia
Emphysemia vs. Chronic Bronch sxs:
Onset
Dyspnea
Cough
Sputum Production
Sputum Appearance
Onset: E = > 50, B = 30s-40s
Dyspnea:
E = progressive, constant, severe
B = intermitt, mild-mod
Cough:
E = absent -mild
B = persistent, severe
Sputum Production:
E = absent - mild
B = persistent, severe
Sputum Appearance:
E = clear, mucoid
B = mucopurulent
COPD presentation?
(U) 50s/60s
Dyspnea OE -> DAR
Chronic cough (U) a.m.
Sputum
Asthma definition?
Chronic inflamm of AIRWAYS
(U) eosinophils
Hyper-reactive airway -> ↑ secretion, mucosal edema, C of bronch sm mm
Reversible
COPD risk factors?
Smoking (80%) Pollution 2nd hand smoke Airway hyper-response Genetic RF (⍺1 anti-trypsin deficiency)
Cigarette smoke mechanism of destruction? (2)
stims elastase -> degenerated elastin/alveolar structures
releases cytotoxic oxyrads from WBC
⍺1 Antitrypsin Deficiency (AATD)?
AAT is protease inhibitor
w/o AAT elastase/proteases destroy lung tissue
smoking accelerates destruction