COPD

Question 1

smoking effect on cells in lungs

Answer 1

macro activated -> cytokines -> neutro CD8 and macros -> matrix metalloproteinases (eg. elastase) and free radicals

Question 2

Chronic bronchitis=

Answer 2

inflamed bronchi and bronchioles

cough clear mucoid sputum

Question 3

emphysema

Answer 3

distension and damage to alveoli causes walls between to breakdown

Question 4

M1 on the ____ cause _____

Answer 4

ganglia of the postganglionic neuron

fast ACh mediated transmition = a slow epsp that increases AP frequency of stimulation

Question 5

M2 on the ____ cause ____

Answer 5

postganglionic terminals

inhibition of autoreceptor by inhibiting Ca2+ influx and so ACh release

Question 6

M3 on the _____ cause ____

Answer 6

SM
contraction in response to ACh
increased mucus secretion

Question 7

In COPD it is desirable to block M receptors ____

Answer 7

1 and 3

Question 8

SAMA eg.s

Answer 8

ipratropium and oxitropium

Question 9

LAMA eg.s

Answer 9

tiotropium and aclidinium

Question 10

M antagonist with a tertiary amine that can thus get into the systemic circulation and has increased side effects …

Answer 10

atropine

Question 11

Effect of muscarinic antagonists

Answer 11

relax bronchospasm
block ACh transmission and block airway cells that produce ACH. Cause basal tone to relax.
decrease mucus secretion.

Question 12

Ipratropium is selective/non-selective

Answer 12

non-selective

Question 13

Tiotropium is selective/non-selective

Answer 13

M3 selective

Question 14

Muscarinic antagonists have a immediate/delayed onset

Answer 14

delayed (>30min)

Question 15

Ultra-LABA used for COPD

Answer 15

Indacaterol

Question 16

Selective PDE4 (on neutro, T and macros) inhibitor used in COPD

Answer 16

roflumilast
decreases inflam and emphysema
give orally
side effects: GI

Question 17

Inflammation in COPD is mediated by ___

Answer 17

neutrophils

Question 18

Chronic bronchitis characteristics

Answer 18

chronic neutro inflammation
mucus
mucociliary dysfunction
gram -ve bac in lung microbiome
ASM spasm and hypertrophy partially reversible

Question 19

In emphysema breath sounds are ___

Answer 19

reduced

Question 20

in chronic bronchitis a ___ can be heard on auscultation

Answer 20

wheeze