COPD

Question 1

COPD

Answer 1

chronic obstructive pulmonary disease
• Chronic Bronchitis
• Emphysema

Question 2

Pathophys COPD

Answer 2

• airways become obstructed
• Lungs don’t empty properly
• Trapped air inside lunges
• FVC and FEV 1 is reduced

Question 3

Chronic bronchitis

Answer 3

type of COPD diagnosed on clinical symptoms

• EXCESS MUCUS IN THE LUNGS

• irritants from smoking cause hypertrophy of mucinous glands and goblet cells in bronchioles
• > Airway obstruction

Question 4

Symptoms of Chronic Bronchitis

Answer 4

• Coughing up alot of mucus (Productive cough)
• Wheeze due to narrowing of airway
• Crackles
• Hypoxemia // Hypercapnia// - mucus blocks airflow
• Cynosis
• Vasoconstriction of large proportion of pulmonary blood vessels -> Pulmonary hypertenison -> Right sided heart failure

Question 5

Emphysema

Answer 5

Defined by structural changes

1. alveolar air sacs become destroyed
2. Alveoli enlarge and lose elasticity
3. Difficulty exhaling due to recoil difficulty

Question 6

Pathophys of emphysema

Answer 6

1. Exposure to irritants from cigarettes causes inflammatory reaction
2. This attracts immune cells and cytokines and proteases
3. Proteases - breakdown structural proteins in connective tissue of alveoli
4. Loss of elastin causes collapsing of airways during exhalation
5. Results in air trapping inside lungs as unable to leave due to collapsed airway
6. Lungs become more compliant during inhalation - holding onto the air
7. Breakdown of walls between alveoli - alveolis merge into larger air spaces
8. Reduces surface area to volume ration thus gas exchange is affected

Question 7

Panacinar empysema

Answer 7

• Assoc with alpha-1 antitrypsin deficiency

* Alpha-1 antitrypsin is a protease inhibitor which protects against damage from proteases

Question 8

Symptoms of emphysema

Answer 8

1. Dyspnea - shortness of breath from reduced gas exchange
2. Exhale slowly through pursed lips - increases pressure in airways and prevents collapse
   - > Pink Puffers
3. Weight loss
4. Hypoxemia over time
5. Cough with some sputum // different from productive cough in chronic bronchitis
6. Barrel shaped chest - result of hyperinflation of lungs
7. Hypoxic vasoconstric -> Pulmonary hypertension -> R. Heart failure