Emphysema

Question 1

What is emphysema?

Answer 1

Damage to alveoli (lung parenchyma) leading to compromised gas exchange
Leads to histologically enlarged airways distal to terminal bronchioles

Question 2

What causes emphysema?

Answer 2

Smoking/Air pollution/Dust/Chemical fumes
-long term exposure to these chemicals induces and immune response which causes inflammation and obstruction of airflow

Alpha- 1 antitrypsin deficiency

• elastase produced by neutrophils to break down elastin in membranes of alveoli
• alpha-1 anti-trypsin normally regulates elastase activity
• deficiency leads to unregulated elastase activity i.e. increased lung damage over time

Question 3

What are the signs and symptoms of emphysema?

Answer 3

Progressively worsening shortness of breath
Productive cough
Wheezing
Weight loss
Barrel chest when disease more pronounced
Decreased exercise tolerance due to fatigue, weakness and SOB

Note: sometimes early on in disease progress the only signs are prolonged expiration and wheezing on forced exhalation

Question 4

How is emphysema treated?

Answer 4

Smoking cessation= reduces progression

Long-acting bronchodilators= tiotropium

Inhaled steroids= fluticasone

Short-acting bronchodilators= prescribed for exacerbations

Pulmonary rehabilitation

Pneumonia and flu vaccination (increased risk for respiratory disease)