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Medicine > COPD > Flashcards

COPD Flashcards

1
Q

Definition of COPD

A

A chronic, progressive respiratory disease characterized by airflow limitation.

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2
Q

Causes of COPD

A

Long-term exposure to irritants such as tobacco smoke, air pollution, chemical fumes, and dust.

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3
Q

Main Types of COPD

A

Chronic bronchitis and emphysema.

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4
Q

Symptoms of COPD

A

Chronic cough, sputum production, shortness of breath (dyspnea), wheezing, and chest tightness.

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5
Q

Pathophysiology of COPD

A

Chronic inflammation leads to structural changes in the airways, destruction of alveoli, and mucus hypersecretion.

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6
Q

Chronic Bronchitis

A

Inflammation of the bronchial tubes, leading to excessive mucus production and chronic cough.

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7
Q

Emphysema

A

Damage to alveoli, leading to reduced gas exchange and air trapping.

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8
Q

Risk Factors for COPD

A

Smoking, exposure to secondhand smoke, occupational exposures, and genetic factors (e.g., alpha-1 antitrypsin deficiency).

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9
Q

Alpha-1 Antitrypsin Deficiency

A

A genetic condition that can cause COPD by reducing lung protection from proteolytic enzymes.

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10
Q

Diagnosis of COPD

A

Based on spirometry, showing reduced FEV1/FVC ratio (< 0.7), along with clinical symptoms.

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11
Q

COPD Stages (GOLD Classification)

A

Based on FEV1: mild (≥80%), moderate (50-79%), severe (30-49%), and very severe (<30%).

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12
Q

Treatment of COPD

A

Includes smoking cessation, bronchodilators, corticosteroids, oxygen therapy, and pulmonary rehabilitation.

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13
Q

Bronchodilators

A

Medications that relax airway muscles, including beta-agonists (e.g., salbutamol) and anticholinergics (e.g., tiotropium).

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14
Q

Corticosteroids in COPD

A

Used to reduce inflammation, especially in patients with frequent exacerbations (e.g., inhaled budesonide).

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15
Q

Oxygen Therapy

A

Indicated in severe COPD with hypoxemia (PaO2 < 55 mmHg or SaO2 < 88%).

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16
Q

Exacerbations of COPD

A

Acute worsening of symptoms, often triggered by infections or environmental pollutants.

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17
Q

COPD and Respiratory Failure

A

Severe COPD can lead to hypoxic (type 1) or hypercapnic (type 2) respiratory failure.

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18
Q

Complications of COPD

A

Pulmonary hypertension, right-sided heart failure (cor pulmonale), and frequent infections.

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19
Q

Prevention of COPD Exacerbations

A

Vaccinations (influenza, pneumococcal), proper inhaler technique, and avoidance of triggers.

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20
Q

COPD and Forensic Considerations

A

In post-mortem cases, signs of COPD like hyperinflated lungs, bullae, and airway remodeling are noted in forensic pathology.

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21
Q

What are common obstructive lung diseases?

A

Chronic obstructive pulmonary disease (COPD), asthma, and bronchiectasis.

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22
Q

What are the two major clinicopathologic manifestations of COPD?

A

Emphysema and chronic bronchitis.

23
Q

What is the WHO’s definition of COPD?

A

“A common, preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities caused by exposure to noxious particles or gases.”

24
Q

What is the primary etiologic factor for COPD?

A

Cigarette smoking.

25
Q

What percentage of heavy smokers develop COPD?

A

35% to 50% of heavy smokers.

26
Q

Which groups are more susceptible to COPD?

A

Women and African Americans who smoke heavily.

27
Q

What additional risk factors are associated with COPD?

A

Poor lung development early in life, exposure to environmental pollutants, airway hyperresponsiveness, certain genetic polymorphisms.

28
Q

What are the two main types of emphysema that cause airflow obstruction?

A

Centriacinar and panacinar emphysema.

29
Q

Describe centriacinar emphysema.

A

Most common form, affecting central parts of acini in heavy smokers; upper lobes are more affected.

30
Q

Describe panacinar emphysema.

A

Associated with α1-antitrypsin deficiency; acini uniformly enlarged from respiratory bronchiole to terminal alveoli.

31
Q

What is distal acinar emphysema associated with?

A

Underlies many cases of spontaneous pneumothorax in young adults; proximal acinus is normal, distal part is involved.

32
Q

What characterizes irregular emphysema?

A

Irregularly involved acini associated with scarring; usually clinically insignificant.

33
Q

What are the mechanisms contributing to the development of emphysema?

A

Toxic injury from inhaled particles, protease-antiprotease imbalance, oxidative stress, infection.

34
Q

What role does toxic injury and inflammation play in emphysema?

A

Inhaled smoke damages respiratory epithelium, causing inflammation and parenchymal destruction.

35
Q

How does protease-antiprotease imbalance contribute to emphysema?

A

Deficiency of protective antiproteases leads to excessive connective tissue breakdown.

36
Q

What is oxidative stress and its role in emphysema?

A

Oxidants from tobacco smoke cause tissue damage and inflammation.

37
Q

How can infections affect emphysema?

A

Infections can exacerbate existing disease but do not initiate tissue destruction.

38
Q

What is the significance of α1-antitrypsin deficiency in emphysema?

A

Patients with genetic deficiency have enhanced emphysema risk, especially with smoking.

39
Q

What are the clinical features of advanced emphysema?

A

Barrel-chested, dyspneic, prolonged expiration, low diffusion capacity, relatively normal blood gas values, significant weight loss.

40
Q

What is chronic bronchitis defined as?

A

Persistent cough with sputum production for at least 3 months in 2 consecutive years.

41
Q

What are the primary factors contributing to chronic bronchitis?

A

Exposure to noxious inhaled substances like tobacco smoke and dust.

42
Q

What is mucus hypersecretion in chronic bronchitis?

A

Hypersecretion of mucus in large airways; associated with gland enlargement and increased goblet cells.

43
Q

How does smoking affect mucus secretion and airway function?

A

Smoking damages airway-lining cells, leading to inflammation and reduced ciliary action.

44
Q

What are the gross and microscopic features of chronic bronchitis?

A

Hyperemia, swelling, edema of mucous membranes, chronic inflammation, goblet cell hyperplasia, enlarged mucus-secreting glands.

45
Q

What is the Reid index, and how does it relate to chronic bronchitis?

A

The ratio of the thickness of the mucous gland layer to the thickness of the airway wall; increased in chronic bronchitis.

46
Q

What clinical features are associated with COPD?

A

Slowly increasing dyspnea, chronic cough, sputum production; often worsens with superimposed infections.

47
Q

What are the two extremes of COPD presentation?

A

“Pink puffers” (emphysema dominates) and “blue bloaters” (chronic bronchitis dominates).

48
Q

What are the treatment options for COPD?

A

Smoking cessation, oxygen therapy, long-acting bronchodilators, inhaled corticosteroids, antibiotics, surgery.

49
Q

What can lead to pulmonary hypertension in COPD patients?

A

Pulmonary hypertension, cor pulmonale, and heart failure.

50
Q

What is compensatory hyperinflation?

A

Dilation of alveoli in response to loss of lung substance elsewhere.

51
Q

What is obstructive overinflation?

A

Lung expands due to trapped air; caused by obstruction or congenital issues.

52
Q

What is bullous emphysema?

A

Large subpleural blebs or bullae; can rupture leading to pneumothorax.

53
Q

What is interstitial emphysema?

A

Air enters connective tissue stroma of the lung or mediastinum.

Medicine (7 decks)

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