Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y2 - Resp > Lecture 9 - COPD And Bronchiectasis > Flashcards

Lecture 9 - COPD And Bronchiectasis Flashcards

1
Q

What is COPD?

A

A disease characterised by persistence respiratory symptoms and airflow limitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes COPD?

A

Significant exposure to noxious particles and gases affecting the airways and alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens to the airways in COPD?

A

Airway inflammation
Airway fibrosis
Increased airway resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens to the parenchymal tissue in the lungs with COPD?

A

Parenchymal destruction

Loss of alveolar attachments
Decrease of elastic recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some classic respiratory symptoms associated with COPD?

A

Breathlessness
Cough
Sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the main risk factor/causative toxin causing COPD?

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What airways are first affected in COPD?

A

Small airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the changes that occur in chronic bronchitis?

A

Airways become inflammed narrowing the airway
Has increased mucus production

This narrowing of the airways causes breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Emphyesma?

A

A disease of the lung parenchyma where the alveoli are broken down

This leads to less gas exchange occurring
Lose the elastic recoil of the lungs causing overinflation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some causes of COPD?

A

Smoking
Biomass exposure
Alpha-1-antitrypsin (genetic)
Air pollution
Illicit drug use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What illicit drugs cause COPD?

A

Heroin
Cannabis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why may certain people develop COPD without smoking?

A

As children the lung function may not have fully developed so as normal lung function decline occurs it can falll to COPD levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pathway to diagnosing COPD?

A

NEED SYMPTOMS
Then determine if they have risk factors for their symptoms
Then do spirometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms of COPD?

A

Breathlessness progressively
Cough
Sputum

History of risk factors:
Host factors
Smoke
Occupational dusts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Dyspnoea?

A

Breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs of COPD?

A

Purse lip breathing
Hyperinflation or barrel shaped chest
Prolonged expiratory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When the doctor examines a patient what are some signs of COPD?

A

Wheeze on auscultation

Cyanosis (rare)
Cor pulmonale (right sided heart failure with a respiratory cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does Cor pulmonale get caused with COPD?

A

COPD obstructs small bronchioles
Reduces ventilation of alveoli at the end of these bronchioles
Reduced pO2 in alveoli leads to hypoxaemia in blood
Pulmonary vasoconstriction occurs to redirect blood to better ventilated alveoli
Chronic pulmonary vasoconstriction leads to pulmonary hypertension
Cause right sided heart hypertrophy
Then right sided heart failure due to respiratory cause = Cor pulmonale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is spirometry used to measure?

A

FEV1
FVC

From that can determine the FEV1:FVC ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is FEV1?

A

Forced Expiratory Volume 1s

How much air can be moved out in one second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is the FEV1:FVC ratio affected in patients with COPD (Chronic Obstructive Pulmonary Disease)?

What value indicates COPD?

A

Reduced since less air can be exhaled in a certain time due to the airway obstruction

FEV1:FVC < 0.7 or 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What other investigations can be done if suspect COPD expect for spirometry?

A

CXR (may see hyperinflation)
High Resolution CT (HRCT) - may see emphysema or Brochiectasis
Pulmonary function tests
ABG

Alpha-1-antitrypsin bloodo test for younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are exacerbations of COPD?

A

Acute worsening of respiratory symptoms that need additional therapy

24
Q

What are some common infectious organisms that worsen COPD?

A

Bacteria:
Haemophilus influenzae
Streptococcus pneumoniae
Pseudomonas aeruginosa

Viruses:
Rhinoviruses
Influenza

25
What some therapies for improving symptoms of COPD?
Pulmonary rehabilitation Bronchodilators (Beta2 agonists and anti-muscarinics) Lung transplant Mucolytics
26
What are some therapies that help reduce risk of COPD?
Smoking cessation Oxygen therapy (Long term oxygen or ambulatory oxygen) Anti inflammatories (inhaled corticosteroids)
27
How is smoking cessation helpful for COPD?
Reduces mortality Improves symptoms Slow down loss of lung function Reduces exacerbations Drug work better
28
What is pulmonary rehabilitation?
An exercise program lasting 6-8weeks Its VERY EFFECTIVE
29
What are the 3 drugs that can be given in COPD?
2 bronchodilators Inhaled corticosteroids
30
What are the 2 bronchodilators that can be given in COPD?
B2 agonists (LABA) Long lasting Beta agonists Muscarinic antagonists (LAMA)
31
Why are inhaled corticosteroids so effective?
Directly delivered to organ (minimal systemic absorption) Prevents inflammation so helps reduce exacerbation frequency
32
What COPD patients are normally given Inhaled corticosteroids?
People with high eosinophils count since it works against T2
33
When is Long Term Oxygen Therapy given to a COPD patient?
When Hypoxaemia is occurring at rest to try and protect key organs like heart and kidneys If pO2 < 7.3kPa
34
When is Ambulatory oxygen given to a COPD patient?
If patients desaturate when walking and they then are able to walk further with the oxygen
35
Are the changes in the lungs in COPD reversible?
Irreversible
36
What is Bronchiectasis?
The permanent irreversible dilatation of airways
37
What is the pathophysiology of Bronchiectasis?
Destruction of elastic and smooth muscle in the bronchi leads to dilatation of airways Leads to mucus build up making prone to recurrent or chronic bacterial infections
38
What are the symptoms of Bronchiectasis?
Cough with sputum (significant amount, how much can you fill?) Recurrent infections/exacerbations Haemoptysis Weight loss
39
What are some causes of Bronchiectasis?
TB, Pneumonia, pertussis (whooping cough) Impaired muco-ciliary clearance : cystic fibrosis, Primary ciliary dyskinesia COPD Autoimmune = IBD, Rheumatoid arthritis Ataxia-Telangiectasia and Marfan’s
40
What do you do to diagnose Bronchiectasis? What imaging?
Productive Crackles on auscultation CT SCAN CAN DIAGNOSE
41
How can you diagnose Bronchiectasis using imaging? What is the sign? What actually is the sign?
CT scan Signet ring sign Where the bronchus/airway has a larger diameter than the blood vessel (pulmonary artery)
42
How is Bronchiectasis treated?
Clear airways of mucus (decreases infection risk): Mucolytics Hypertonic saline to make you cough Low dose macrolides Inhaled corticosteroids and bronchodilators
43
How are low dose macrolides helpful in treating Bronchiectasis?
Act as anti inflammatorys and antibiotics
44
Why do inhaled corticosteroids and bronchodilators have minimal effect in Bronchiectasis?
Will never reverse the effects fully
45
What are some infections that can cause/worsen Bronchiectasis?
Pseudomonas Aeruginosa Non-Tuberculous Mycobacteria (NTM)
46
Why is Pseudomonas Aeruginosa very bad for Bronchiectasis?
Chronically colonises the patient making the inflammation, dilatation and mucus build up in airways worse They produce a biofilm making it hard to eradicate
47
How can Pseudomonas aeruginosa infection be treated?
Nebulised colomycin
48
Why are Non-tuberculous mycobacteria sometimes missed?
Not picked up on routine sputum culture
49
What are the main 2 treatment goals for Bronchiectasis?
Airways clearance of mucus Medication (antiflammatories, antibiotics and Mucolytics)
50
What is cystic fibrosis?
Genetic condition which is a particular form Bronchiectasis Defect of chromosome 7 leads to problem in Cystic Fibrosis Conductance Regulator (CFTR)
51
What is the pathology of cystic fibrosis?
Issue in expression of CFTR means less Cl- put out into surfaces so less water follows producing thick sticky mucus
52
What can CF affect?
Many body systems and organs
53
How is cystic fibrosis diagnosed?
Newborn screening Sweat test (High Cl- levels in sweat)
54
What can happen to CFTR in CF?
Not made Gets stuck Doesnt work properly Not enough made Gets degraded too quickly
55
What is the drug that massively improves CF?
Kaftrio
56
Why do patients who have COPD have more issue with exhalation that inhalation?
Obstruction in airway has less affect in inhalation since airways expand but in expiration, airways narrow so obstruction blocks whole airway The loss of interstitium (Emphysema) leads to reduced radial traction so alveoli collapse more easily
57
Why do patients with COPD often breathe through pursed lips?
Adds PEEP (Postive end expiratory pressure) This helps keep the lungs and alveoli open at the end of expiration preventing their collapse

Y2 - Resp (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions