COPD

Question 0

What 2 conditions make up COPD?

Answer 0

1. Chronic bronchitis

2. Emphysema

Question 1

Definition of COPD

Answer 1

Persistent and irreversible airways obstruction

Question 2

Features common to both Chronic bronchitis and Emphysema

Answer 2

• Cause chronic airways obstruction
• Produce breathlessness and exercise intolerance
• Caused by smoking and often occur together

Question 3

Definition of chronic bronchitis

Answer 3

Persistent airways inflammation

Question 4

Cause of chronic bronchitis

Answer 4

Damage to mucosa from inhaled irritants (usually tobacco smoke)

Question 5

Clinical features of Chronic bronchitis

Answer 5

• Productive cough caused by mucus hyper-secretion
• Cyanosis caused by ventilation failure
• Overweight due to exercise intolerance

Question 6

Causes of obstruction in Chronic bronchitis

Answer 6

• Increased mucus in lumen
• Inflammatory oedema in wall
• Thickened bronchial smooth muscle

Question 7

How does Chronic bronchitis predispose to infection?

Answer 7

Mucus stagnates in airways due to overproduction and inhibition of mucociliary escalator

Question 8

Definition of Emphysema

Answer 8

Abnormal enlargement of airspaces distal to terminal bronchioles due to destruction of respiratory bronchioles and alveoli

Question 9

Term used to describe patient with chronic bronchitis

Answer 9

Blue bloater

Question 10

Pathogenesis of Emphysema

Answer 10

Protease/antiprotease imbalance hypothesis

Question 11

Important antiprotease enzyme

Answer 11

Alpha-1-antitrypsin

Question 12

How does cigarette smoke cause protease/antiprotease imbalance?

Answer 12

1. Causes increased inflammatory response so more proteases released by inflammatory cells
2. Free radicals produced by smoke inactivate antiproteases

Question 13

Net effect of protease/antiprotease imbalance

Answer 13

Proteases break down structural proteins of respiratory airways

Question 14

Rate inherited disorder associated with early onset of emphysema

Answer 14

Alpha-1-antiprotease deficiency

Question 15

What causes obstruction in emphysema?

Answer 15

Lack of elastin in the walls causes collapse of small airways during expiration

Question 16

Term used to describe patients with emphysema

Answer 16

Pink puffer

Question 17

Complication that may arise from emphysema

Answer 17

Bullae (air sacs below visceral pleura) may form, if rupture can cause pneumothorax