COPD Flashcards
What are three components/changes seen in COPD?
- Airway inflammation
- Mucocilliary dysfunction
- Tissue damage
Single biggest cause of COPD?
Smoking
Summarise the pathogenesis of COPD? (4steps)
- Toxic particle, cigarette smoke
- Alveolar macrophages release neutrophil chemotactic factors ( IL8)
- Macrophages + neutrophils release proteases
- Proteases destroy lung parenchyma and cause mucus hyper secretion.
What are the two end results of the COPD process?
- Emphysema
2. Chronic bronchitis
What is emphysema?
Alveolar wall destruction
What is chronic bronchitis?
Mucus hyper-secretion
What causes mucus hyper secretion?
Neutrophil elastase released in the process of COPD damages cilia.
Mucociliary clearance reduced= hyper-secretion
What are COPD patients prone to getting?
Infection
Most common pathogen associated with COPD?
H. influenzae
What is the cause of emphysema?
Imbalance between protease and anti-proteases
Signs/symptoms of COPD?
- Chronic
- Smoking
- Non atopic
- Daily productive cough
- Progressive breathlessness
Signs
6. Frequent infective exacerbations
7. chronic bronchitis- wheezing
emphysema- reduced breath sounds
What can be the progressive disease cascade in COPD if not treated?
- Fixed airflow obstruction
- Impaired gas exchange
- Low pO2, High pCO2
- Pulmonary hypertension
- Right ventricular hypertrophy/failure (cor pulmonale)
- Death
What is cor pulmonale?
Pulmonary hypertension leading to right sided heart failure
What is the key pathological feature in asthma copd overlap syndrome?
COPD caused by eosinophilic inflammation not neutrophilic.
What is the most important Non pharmacological intervention?
STOP smoking
Improves lung function- better FEV1/FEVR
