High-Yield Concepts in COPD Flashcards
Asthma and COPD are variations of the same basic disease
Dutch hypothesis
Asthma (allergic phenomenon) and COPD (smoking-related inflammation and damage) are fundamentally different diseases
British hypothesis
Pathogenesis behind emphysema
Imbalance between Protease (Elastase) and Anti-Protease (Alpha-1-Anti-Trypsin)
First symptom of emphysema
Progressive dyspnea
Ratio of mucus gland layer thickness to the thickness of the wall between the epithelium and the cartilage of the trachea and bronchi
Reid’s Index (>0.4 in Chronic Bronchitis)
Most highly significant predictor of FEV1
Pack-years of cigarette smoking
Important causes of COPD exacerbations
Respiratory infections
Most common form of severe α 1-AT deficiency
PiZ: two Z alleles or one Z and one null allele
Most typical finding in COPD
Persistent reduction in forced expiratory flow rates
Accounts for essentially all of the reduction in PaO2 that occurs in COPD
Ventilation-perfusion mismatching
Major site of increased resistance in COPD
Small airways
Type of emphysema frequently associated with cigarette smoking, characterized by enalrged air spaces found (initially) in association with respiratory bronchioles
Centriacenar emphysema: prominent in the upper lobes and superior segments of lower lobes and often focal; involves the respiratory bronchiole
(Mnemonic: SENTROacinar, Smoking)
Type of emphysema usually observed in patients with α1-AT deficiency, chracterized by abnormally large air spaces evenly distributed within and across acinar units
Panacinar emphysema: predilection for lower lobes and involves the entire respiratory unit (respiratory bronchiole, alveolar duct, alveoli)
Type of emphysema associated with spontaneous pneumothorax
Distal acinar emphysema: predilection for upper lobes and involves the aveoli
Most common type of emphysema with irregular involvement and often asymptomatic
Irregular emphysema
