COPD and OSA

Question 1

Asthma: Definition

Answer 1

chronic reactive airway disorder, characterized by:

• reversible airway restriction w/ bronchospasm
• mucous secretion
• increased mucosal edema

tracheal and bronchial linings overreact to various stimuli causing smooth muscle spasms and narrow airways. Mucosal edema and thickened secretions further block airways.

Question 2

COPD: Risk Factors

Answer 2

• white (even though other ethnicities have higher rates of smoking)
• men (but more women die from COPD)
• hispanics have lower death rates related to COPD than other ethnic groups

Question 3

COPD

Answer 3

preventable, treatable, often progressive disease characterized by:

• persistent airflow limitation
• chronic inflammatory response in airways and lungs (primarily caused by cigarette smoking and other noxious particles or gases)
• exacerbations and other coexisting illness contribute to severity of disease

main characteristic of COPD = inability to expire air

Question 4

Chronic Bronchitis

Answer 4

presence of cough and sputum production for at least 3 months in each of 2 consecutive years

Question 5

Emphysema

Answer 5

progressive lung disease caused by over-inflation of alveoli. Leads to destruction of alveoli (walls get destroyed and they become big blobs not individual)

-closely associated with smoking and AAT deficiency

Question 6

COPD: Risk Factors

Answer 6

Smoking: hyperplasia of cells (goblet cells increase production of mucus, reduced airway diameter b/c of bigger cells), lost or decreased ciliary activity, abnormal distal dilation and destruction of alveolar walls, chronic enhanced inflammation results in remodeling. 
Infection
Severe, recurring respiratory infections in childhood
HIV
TB
Air Pollution
Occupational dusts and Chemicals
Asthma
Aging
Genetics (AATD)

Question 7

AAT

Answer 7

alpha-antitrypsin deficiency

protein made in the liver that protects the lungs and liver from damage

Question 8

COPD: Pathophysiology

Answer 8

inflammatory response -> tissue destruction -> disruption of normal defense mechanisms and repair processes -> structural changes of lungs:

• loss of elastic recoil
• airflow obstruction d/t mucous hypersecretions, mucosal edema, and bronchospasm

progression noted by worsening airflow, air trapping (results in barrel chest), gas exchange

pt becomes dyspneic and has limited exercise capacity as they try to inhale against overinflated lungs

Question 9

COPD: Severe Disease Defintion

Answer 9

Pulmonary HTN

Systemic manifestations: cardiovascular disease, osteoporosis, diabetes, metabolic syndrome