COPD Flashcards
What can COPD lead to?
May led to pulmonary hypertension, cynosis, hypoxia, right heart failure.
What is the defining criteria for COPD?
Progressive airflow limitation that is not fully reversible.
(Associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily cigarette smoke)
What does COPD include?
Chronic bronichitis: productive cough present over years. Excessive sputum production.
Emphysema: alveolar wall destruction, irreversible enlargement of the terminal air spaces.
Who is a blue bloater?
Chronic bronchitis. overweight, cyanotic, elevated hemoglobin, peripheral edema, rhonchi and wheezing.
Who is a pink puffer?
Emphysema: permanent enlargement and destruction or airspaces distal to the terminal bronchiole.
Older and thin, severe dyspnea, quiet chest, X-ray: hyperinflation with flattened diaphragms.
Risk factors for COPD:
Tobacco Smoke Urban pollution Industrial pollution Textile dust Biomass fuels
How does COPD progress?
Stage I: Asymptomatic
Stage II: Progressive dyspnoea
Stage III: Systemic disease, comorbidities.
Stage IV: respiratory failure, death.
How does the sputum differ between COPD and Asthma patients?
COPD: Neutrophil-rich sputum
Asthma: Eosinophilic rich.
Marked-hyper-responsiveness is associated with
Ashtma. Limited = COPD.
Reduced airflow which is very variable and has a diurnal variation is associated with:
Asthma. No variation = COPD.
Lymphocytes found in COPD are predominantly of what type?
TH1 and TC1
Lymphocytes found in Asthma are predominantly:
TH2
What is the Dutch hypothesis?
Asthma + Chronic bronchitis + Emphysema all overlap.
A: reversible airflow limitation
B: fixed obstruction, persistent sputum.
E: destruction of alveolar septa.
Neutrophil-rich sputum is associated with:
COPD
Fibrosis that is ______ is found in COPD.
Peribronchiolar,
Subepithelial is Asthma.
Eosinophilic sputum is associated with:
Asthma
How does excessive airway mucus occur in COPD?
Increased production: inflammatory cells, oxidative stress, viral infection, bacterial infection.
Reduced elimination: poor ciliary clearance, airway occlusion, reduced PEF, resp muscle weakness.
What are the three main mechanisms of airflow reduction in COPD?
Occlusion of airways by mucus.
Thickened airway walls
Loss of elasticity due to emphysema.
Leukocyte infiltration in COPD takes the form of:
Macrophages and CD8+ T cells.
Neutrophils in infection.
Chemoattractants found in COPD include:
IL-8 and LTB4
What are the consequences of the inflammation in COPD?
Epithelial damage: decreased ciliary cell function, increased mucus secretion from goblet cells.
Mucus cell hyperplasia - more cells, increased bronchial permeability –> airway oedema and protein exudation.
What is a cough?
Motor reflex in response to sensing chemicals, particulates and airway excessive mucus.
How can a cough be suppressed?
High dose opioids are effective,
OTC limited efficacy.
Most of the soothing benefit is from the sugar causing increased salivation.
What is emphysema?
Permanent enlargement of airspaces distal to the terminal bronchiole: destruction of the alveolar walls.
“Proteinase-antiproteinase hypothesis”
