L14 COPD and cancer

Question 1

What NTs does nicotine cause the release of

Answer 1

dopamine, serotonin, acetylcholine, norepinephrine, beta-endorphin

Question 2

What three cardiovascular effects does smoking cause

Answer 2

increased HR
vasoconstriction
increased chance of atherosclerosis (endothelial injury)

Question 3

What defense mechanisms does smoking attack

Answer 3

paralyses cilia
affects alveolar macrophages phagocytotic ability
reduces immune response
increases mucus secretion

Question 4

How long after stopping smoking do cilia take to regenerate

Answer 4

2-3 weeks for upper

3 months for lower

Question 5

What is COPD

Answer 5

regular obstruction in bronchial tree

Question 6

What are the risk factors for COPD

Answer 6

smoking
hereditary (deficiency of alpha-1 antitrypsin)
asthma
airway hyper-responsiveness

Question 7

What is rhonchi

Answer 7

prolonged wheezy crackles

Question 8

How is COPD diagnosed

Answer 8

decrease in FEV1

Question 9

What two reasons can cause FEV1 to be decreased

Answer 9

increased resistance (narrowed airway, chronic bronchitis)
decreased outflow pressure (loss of elastic recoil, emphysema)

Question 10

What are the five stages in pathogenesis of COPD

Answer 10

1. inflammation and fibrosis in bronchi wall (obstruct)
2. hypertrophy of submucosal glands (obstruct)
3. hypersecretion of mucus (obstruct)
4. loss of elastic lung fibres (impairs expiratory flow)
5. loss of alveoli (decreased SA)

Question 11

What are the clinical features of COPD

Answer 11

hypoxemia, hypercapnia, cyanosis

Question 12

Results of hypoxemia

Answer 12

vasoconstriction of pul. arteries
increased pul. artery pressure
Right heart failure (cor pumonale) and pul. oedema

Question 13

Treatment for COPD

Answer 13

stop smoking
oxygen therapy
immunizations against RTIs
bronchodilators (beta 2 adrenergic agonist)
lung transplant

Question 14

What is emphysema

Answer 14

abnormal permanent enlargement of alveoli

Question 15

What does alpha1 antitrypsin do

Answer 15

protects lungs from protease/elastase activity

Question 16

How do free radicals from cigarette smoke cause decreased outflow pressure

Answer 16

decrease alpha 1 antitrypsin
activate alveolar macrophages and neutrophils
loss of elastin
inactivation of antiproteases 
decreased outflow pressure

Question 17

Clinical features of emphysema

Answer 17

pink puffer
barrel chest
weight loss

Question 18

How is chronic bronchitis diagnosed

Answer 18

persistent cough with sputum for at least three months in 2 consecutive years

Question 19

Treatment of chronic bronchitis

Answer 19

stop smoking
antibiotics (associated infections)
drainage with a tube

Question 20

What are the later features of chronic bronchitis

Answer 20

mucus plugging
pigmented alveolar macrophages
inflammation

Question 21

What are the clinical features of chronic bronchitis

Answer 21

blue bloaters
cough
cor pulmonale
oedema

Question 22

Four types of bronchogenic carcinoma

Answer 22

small cell
squamous cell
adenocarcinoma
large cell

Question 23

Small cell carcinoma

Answer 23

lots of small cells, little cytoplasm

strong relationships to smoking

Question 24

Squamous cell carcinoma

Answer 24

found in areas that underwent squamous metaplasia

dividing cells + keratin pearls (hot pink blobs)

Question 25

Adenocarcinoma

Answer 25

dark cells = dividing cells

Question 26

Large cell carcinoma

Answer 26

combination of squamous cell and adenocarcinoma 
pleomorphic cells (no nucleus to same)