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Pulmonology > COPD > Flashcards

COPD Flashcards

1
Q

what happens in COPD with chronic inflammation

A

small airways narrowing and lung parechyma destruction

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2
Q

abnormal permanent distal (respiratory bronchioles) airspace enlargement

A

emphysema

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3
Q

genetic predisposition of COPD:

  1. increased/decreased macrophage elastase
  2. increased/decreased alv MMP* (matrix metalloproteinase, collagenase)
  3. increased/decreased MMP inhibitor (TIMP)
  4. increased/decreased predisposition to oxidative injury
  5. increased/decreased anti-oxidant vitamins (C,E)
A

Increased macrophage elastase

Increased alv MMP* (matrix metalloproteinase, collagenase)

Decreased MMP inhibitor (TIMP)

Increased predisposition to oxidative injury

Decrease anti-oxidant vitamins (C,E)

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4
Q

emphysema due to deficiency

A

alpha-1-antitrypsin- palnolubar(lower lobe)

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5
Q

how do we treat panlolbular emphysema

A

replacement therapy

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6
Q

panlobular found in

A

lower lobe

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7
Q

mechanism of coPD dx,

A
  1. chronic inflammation
  2. imbalance btw elastase and anti-elastase
  3. oxidant stress
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8
Q

why is there airway collapse in expiration?

A

loss of radial traction

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9
Q

loss of elastic recoil results in

A

decreased alveolar driving pressure

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10
Q

hyperinflation on respiratory muscles

A

altered neuromechanical coupling and decreased neuromuscular capacity

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11
Q

do we see V/Q mismatch in COPD

A

yasssssssssss

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12
Q

treatment of COPD?

A
  • pulmonary rehab
  • improving nutrition to increase strength and immunocompetence
  • SABD
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13
Q

Acute exarcebation can lead to

A

increase in mortality and decrease in lung function

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14
Q

what happens when elastic fibers are destroyed?

A

resistance increases due to the intra-dependence loss

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15
Q

irreversible airspace enlargement without obvious fibrosis

A

emphysema

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16
Q

subpleural involvement with formation of blebs and bullae

A

distal acinar emphysema

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17
Q

irregular emphysema

A

emphysema adjacent to scars

18
Q

mucous gland hyperplasia

A

chronic bronchitis

19
Q

lymphocytes are a marker for

A

chronic inflammation

20
Q

complications of COPD (3)

A
  • PH
  • cor pulmonale
  • pneumothorax
21
Q

Chronic inflammatory disorder of airways characterized by recurrent episodes of bronchoconstriction that are at least partially reversible

A

asthma

22
Q

asthma histologic changes

A

goblet cell hyperplasia, thickened basement membrane and submucosal eosinophil-rich inflammation

23
Q

permanent dilatation of bronchi resulting from or associated with chronic necrotizing infections

A

bronchiectasis

24
Q

_____ and _____ are major factors of bronchiectasis

A

obstruction and infection

25
Q

how is the cough in bronchiectasis

A

persistent, foul-smelling and may be bloody

26
Q

acute inflammation in bronchiectasis is shown with the presence of

A

neutrophils

27
Q

distal acinar emphysema has a increased risk fro

A

pneumothorax

28
Q

strongest risk factor for asthma

A

atopy–> increased levels of circulating IgE

29
Q

prevalence of asthma has

what can account for this?

A

increased

  • hygiene hypothesis
30
Q

3 hallmarks of asthma

A
  1. airway inflammation
  2. airway hyperresponsiveness
  3. airflow obstruction
31
Q

astham: early vs late response

A

early: bronchospams
late: bronchospasm, edema and inflammation

32
Q

will asthma show increased resistance

A

yes

33
Q

history suggestive of asthma

A
  • nocturnal cough and dyspnes

- cough or wheeze post-exercise

34
Q

wheezes= asthma

A

false, it can but there are a lot of other dx. that will also have wheezing

35
Q

what do we need to be aware of giving supplemental O2 to COPD patients

A

respiratory rate and minute ventilation to drop due to over-oxygenation

36
Q

what difference does chronic bronchitis and emphysema have early in its disease course?

A

chronic bronshitis causes respiratory acidosis and hypoxia

37
Q

mechanism of SABA

A

activates adenyl cyclase leading to increase in cAMP and thus smooth muscle relaxation

38
Q

causes of bronchiectasis

A

idiopathic or hereditary (CF, kartageners)

39
Q

most common mutation in CF

A

delta F508

40
Q

treatment in CF that can help clear mucous

A

nebulized DNase

41
Q

what does inhaled tobramycin do?

A

supress pseudomonas

Pulmonology (13 decks)

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