COPD

Question 1

how is COPD caused?

Answer 1

cigarette smoke-> 
alveolar macrophages->
neutrophils, CD8->
proteases->
EMPHYSEMA + CHRONIC BROCNHITIS->
PROGRESSIVE airflow narrowing

Question 2

what is emphysema

Answer 2

alveolar wall destruction

Question 3

what is chronic bronchitis

Answer 3

chronic NEUTROPHILIC inflammation, mucous hyper secretion, mucociliary escalator dysfunction

Question 4

COPD symptoms

Answer 4

smoking, 
late onset,
non atopic, 
daily productive cough, 
progressive deterioration, 
frequent infective exacerbations, 
WHEEZE (cb), 
reduced breathing sounds (em)

Question 5

COPD prognosis

Answer 5

progressive airflow obstruction (cb) + alveolar destruction (em) =
resp failure + pulmonary hypertension

Question 6

Pulmonary hyper tension causes + prognosis

Answer 6

pulmonary arteries narrowed = RV hypertrophy/ failure (cor pulmonale)

Question 7

Asthma + COPD= …

Answer 7

Asthma COPD overlap syndrome (ACO)-
COPD with blood eosinophilia > 4%.
Responds better to ICS (inhaled corticosteroids).

Question 8

asthma vs COPD drug response

Answer 8

poor CS response,

poor bronchodilator response?.

Question 9

asthma vs COPD symptoms

Answer 9

asthma has normal gas exchange in alveoli.

asthma has normal FVC (no alveoli destroyed).

Question 10

what are SAMAs and types

Answer 10

Short acting muscarinic antagonist- they don’t stop COPD progression but do reduce bronchospasm + mucous secretion.
IPRATROPIUM.

Question 11

LAMA types

Answer 11

tiotropium,
glycopyrronium,
aclinidium,
umeclidinium

Question 12

types of PDE4 inhibitors

Answer 12

rofumilast

Question 13

combination inhalers have

Answer 13

LABA + LAMA.

triple inhalers exist too.

Question 14

what is hyperinflation

Answer 14

Emphysema= air getting trapped in lungs due to loss of elasticity= high residual volume.