COPD

Question 1

what are the three contributers to obstruction in COPD?

Answer 1

Emphysema, peribronchiolar fibrosis, chronic bronchitis (mucus gland hypertrophy and airway wall inflammation)

Question 2

How do we diagnose Bronchitis? COPD? Definition and indicators

Answer 2

Productive cough most day, 3 consec months, 2 consec years. Obstructive pathology with hx of smoking. Age 40, 10 pack yr hx. FEV1/FVC<.7 and not reversible

Question 3

WHat percent of heavy smokers get COPD? Why?

Answer 3

32. There must be genetic predisposition AND noxious agent

Question 4

what inflammatory cells are involved in COPD? Asthma?

Answer 4

neutrophils, cd8, macrophages

eosinophils, cd4, mast cells

Question 5

what airway changes do we see in chronic bronchitis?

Answer 5

mucus gland hyperplasia. Squamous metaplasia but no BM thickening. No SM hypertrophy

Question 6

reid index

Answer 6

should be <0.4 Ratio of gland thickness to epithelial/cartilage distance

Question 7

Small airway remodeling includes what two major things?

Answer 7

peribronchial fibrosis and lymphoid follicles

Question 8

Where is emphysema typically worst

Answer 8

upper lobes

Question 9

Blue bloater vs. pink puffer

Answer 9

more bronchitis (early hypoxemia and wt gain) vs more emphysema (wt loss and late hypoxemia)

Question 10

What FEC1/FVC is diagnostic

Answer 10

<70%

Question 11

How does FEV1 correlate with severity of dz

Answer 11

generally correlates absolutely but with wide range for any given FEV1

Question 12

How does low IC/TLC correlate with severity of dz

Answer 12

means hyperinflation. Higher mortality if <25%

Question 13

WHat does a low BMI indicate in COPD

Answer 13

higher mortality

Question 14

What is the explanation of systemic co-morbidities in copd

Answer 14

systemic inflammatio

Question 15

what is the effect of quiting smoking on copd

Answer 15

progression of dz usually stops