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Irm > L10: Airway Disease > Flashcards

L10: Airway Disease Flashcards

1
Q

What is the basic lung function test to asses airways

A

Spirometry

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2
Q

In obstructive airway diseases how does the spirometry trace present

A

Low FEV1/FVC ratio

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3
Q

In a restrictive lung condition what does the spirometry show

A

Normal or high FEV1/FVC but lower FVC lower

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4
Q

What is FEV1/FVC

A

The rate of expiration

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5
Q

Name examples of obstructive airway diseases

A

Asthma
COPD
Bronchiestasis

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6
Q

Name restrictive lung disease

A

Pulmonary fibrosis

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7
Q

In airflow obstruction what does the flow volume loop look like

A

Collapse of flow volume loop

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8
Q

What does the flow volume loop in restriction look like

A

Similar shape but smaller volume

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9
Q

What is asthma

A

Chronic inflammatory disorder of the airways that leads to airflow obstruction

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10
Q

What is the diagnostic criteria for asthma in spirometry

A

FEV1 will improve by 12% and 200ml after giving a bronchodilator

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11
Q

What is the diagnostic criteria for asthma for peak expiratory flow rate

A

Diurnal variability is less than 20%

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12
Q

Wha is asthma commonly associated with

A

Allergies

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13
Q

Describe the mechanism of asthma

A

1) allergens interact with dendritic cells
2) th2 responce is triggered
3) th2 causes the release of IgE from B cells, leukotriene from eosinophil and mast cells

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14
Q

What happens to the lumen of the airways in asthma

A

Becomes narrow

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15
Q

What happens to the smooth muscle in asthma

A

Contract

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16
Q

What are the symptoms of asthma

A

Coughing
Wheezing
Chest tightness
Shortness of breath

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17
Q

Does wheezing occur during inspiration or expiration

A

Expiration

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18
Q

What happens during an asthma attack

A

More contraction of smooth muscle
Swelling of epithelium
Increase in mucus production

19
Q

What is good asthma control

A 
No daytime symptoms 
No night time awakening
No need for reliever
No exacerbation 
No limitation of physical activity
Normal lung function (FEV1) above 80%
20
Q

What are the asthma triggers as allergens

A 
Moulds 
Dust mites
Animal dander
Pollens 
Food
21
Q

What are the other asthma triggers apart from allergens

A 
Irritants 
Viral infections 
Changes in weather
Exercise
Endocrine factors such as mentrual period or pregnancy
22
Q

What are irritants

A

Second hand smoke
Aerosols
Ozone
Particulate matter

23
Q

What can cause occupation asthma

A

Paint
Soldering
Cleaners
Bakers

24
Q

How do we manage asthma

A

Identify the trigger
Medication
Peak flow monitoring
Emergency plan

25
Q

What are the inhaled asthma medications

A

Beta agonist

Steroids

26
Q

What do beta2 agonist do

A

Target beta2 receptors on smooth muscle for bronchodilation

27
Q

Name beta 2 agonist drugs

A

Salbutamol

Salmeterol

28
Q

What is the role of steroids

A

Target inflammation

29
Q

What does the stepwise approach to asthma medication involve

A

Steps that increase the intensity of the medication

30
Q

Describe step 1 in asthma medication

A

Short acting beta agonist

31
Q

Describe step 2 in asthma medication

A

Add inhaled steroid

32
Q

Describe step 3 in asthma medication

A

Add long acting beta agonist

33
Q

Describe step 4 in asthma medication

A

Increase the steroid dosage

34
Q

Describe step 5 (last step) in asthma medication

A

Use steroid tablets

35
Q

Name a medication that is anti IgE

A

Omaluzimab

36
Q

What does COPD stand for

A

Chronic obstructive pulmonary disease

37
Q

What is COPD

A

Airflow obstruction that is not reversible

38
Q

What causes COPD

A

Smoking

39
Q

What is the mechanism of smoking for COPD

A

Smoking stimulate proteases and oxidants

This leads to parenchymal damage and mucus hypersecretion

40
Q

What changes do you get in the lungs with COPD

A 
Mucocillary dysfunction 
Airflow limitation 
Breakdown of alveoli 
Osteoporosis 
Loss of muscle mass
41
Q

What would the FEV1/FVC ratio be in COPD

A

Less than 0.7

42
Q

How do we differentiate between asthma and COPD

A

COPD:
Smoker
Chronic productive cough
Persistent breathless

Asthma:
Night time waking with breathlessness or wheeze
Signification diurnal variability of symptoms

43
Q

What is the management of COPD

A 
Short acting beta agonist 
Then 
Long acting muscarinic antagonist 
Then 
Add steroid in patients with elevated inflammation

Irm (21 decks)

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