L14 COPD and cancer Flashcards
What NTs does nicotine cause the release of
dopamine, serotonin, acetylcholine, norepinephrine, beta-endorphin
What three cardiovascular effects does smoking cause
increased HR
vasoconstriction
increased chance of atherosclerosis (endothelial injury)
What defense mechanisms does smoking attack
paralyses cilia
affects alveolar macrophages phagocytotic ability
reduces immune response
increases mucus secretion
How long after stopping smoking do cilia take to regenerate
2-3 weeks for upper
3 months for lower
What is COPD
regular obstruction in bronchial tree
What are the risk factors for COPD
smoking
hereditary (deficiency of alpha-1 antitrypsin)
asthma
airway hyper-responsiveness
What is rhonchi
prolonged wheezy crackles
How is COPD diagnosed
decrease in FEV1
What two reasons can cause FEV1 to be decreased
increased resistance (narrowed airway, chronic bronchitis) decreased outflow pressure (loss of elastic recoil, emphysema)
What are the five stages in pathogenesis of COPD
- inflammation and fibrosis in bronchi wall (obstruct)
- hypertrophy of submucosal glands (obstruct)
- hypersecretion of mucus (obstruct)
- loss of elastic lung fibres (impairs expiratory flow)
- loss of alveoli (decreased SA)
What are the clinical features of COPD
hypoxemia, hypercapnia, cyanosis
Results of hypoxemia
vasoconstriction of pul. arteries
increased pul. artery pressure
Right heart failure (cor pumonale) and pul. oedema
Treatment for COPD
stop smoking oxygen therapy immunizations against RTIs bronchodilators (beta 2 adrenergic agonist) lung transplant
What is emphysema
abnormal permanent enlargement of alveoli
What does alpha1 antitrypsin do
protects lungs from protease/elastase activity
How do free radicals from cigarette smoke cause decreased outflow pressure
decrease alpha 1 antitrypsin activate alveolar macrophages and neutrophils loss of elastin inactivation of antiproteases decreased outflow pressure
Clinical features of emphysema
pink puffer
barrel chest
weight loss
How is chronic bronchitis diagnosed
persistent cough with sputum for at least three months in 2 consecutive years
Treatment of chronic bronchitis
stop smoking
antibiotics (associated infections)
drainage with a tube
What are the later features of chronic bronchitis
mucus plugging
pigmented alveolar macrophages
inflammation
What are the clinical features of chronic bronchitis
blue bloaters
cough
cor pulmonale
oedema
Four types of bronchogenic carcinoma
small cell
squamous cell
adenocarcinoma
large cell
Small cell carcinoma
lots of small cells, little cytoplasm
strong relationships to smoking
Squamous cell carcinoma
found in areas that underwent squamous metaplasia
dividing cells + keratin pearls (hot pink blobs)
