Lung Disease

Question 0

When discussing FEV & FVC what are the expected trends for normal lung function, obstructive lung disease, restrictive lung disease (graph)

Answer 0

Normal- FEV = 4, FVC = five; percent = 80

This graph will show quick steep drop

Obstructive-FEV = 1.3, FVC = 3.1; percent =42

The graph shows shallow long expiration

Restrictive-FEV= 2.8, FVC = 3.1; percent = 90

Graph shows steep short expiration

Question 1

What do you FEV and FVC stand for

Answer 1

FEV forced expiratory volume

FVC forced vital capacity

Question 2

What is asthma?

Answer 2

A group of symptoms and signs (a syndrome)

Symptoms-wheezing, cough, chest tightness, and SOB especially at night and early in the morning

Chronic episodes of airway symptoms and obstruction

Episodic chest symptoms and air obstruction

Chronic air information with increased eosinophils , lymphocyte and smooth muscle hypertrophy

Question 3

What is chronic bronchitis

Answer 3

Chronic air mucus hypersecretion

Neutrophils, submucosal gland and goblet cells hypertrophy

Nearly constant productive cough, variable airflow obstruction

Question 4

What is emphysema

Answer 4

Permanent destruction of alveoli

Fewer larger alveoli, reduce surface area & oxygen transfer to the blood, reduced elastic recoil

Constant airflow obstruction

Question 5

List the phenotypes of asthma

Answer 5

Early onset allergic asthma

Late onset Eosinophilia

Exercise-induced

Obesity related

Neutrophilic

Question 6

Explain the main points of early onset allergic asthma

Answer 6

Allergic symptoms

TH2 profile

Corticosteroid responsive

Question 7

Describe the main points of Eosinophilia

Answer 7

Less allergic

Eosinophilia

Not responsive to corticosteroids

Question 8

Describe the main points of exercise-induced asthma

Answer 8

TH2 cytokines

mast cell activation

Question 9

Explain the details of obesity related asthma

Answer 9

Adult onset

Mostly in women

No TH2 marker

Question 10

Explain the details of neutrophilic asthma

Answer 10

TH17

Question 11

How many people does asthma affect in the United States

Answer 11

25.7 million people

7 million under the age of 18 years old

Question 12

How do epidemiologist define people having asthma

Answer 12

By the responses given from an individual when asked have you ever been told by a doctor that you have asthma

Question 13

Breakdown asthma prevalence in different subgroups in the United States

Answer 13

Blacks > white or Hispanic

Children >adults

Young boys >young girls (0 to 14 years old)

Boys = girls (15 to 17 years old)

Women >men

Question 14

Define chronic bronchitis

Answer 14

Chronic cough chronic mucus production (productive cough)

Question 15

In what disease is alveolar destruction

Answer 15

Emphysema

Question 16

There’s a graph that shows methacholine introduced to those that are hyper responsive (as) and show an increase in histamine production

The faster the response the greater the________?

Answer 16

Sensitivity

Question 17

Explain the TH2 immune processes in the airways of people with asthma

Answer 17

One allergen enters

Taken up by antigen presenting cells

Antigen presenting cells process antigen present to TH2 cells

TH2 cells make cytokines

Some cytokines are present to this stimulate the epithelial layer, stimulates smooth cells to cause hypertrophy, some recruit and activate eosinophils , some activate B cells

B cells make anybody used in this instance they make IGE-which attached to the outside of mast cells then the next time the allergen is detected the mast cell is triggered to degranulation-releasing histamines, bronchoconstriction-causing an asthma attack

Question 18

Describe the process of a non-TH2 asthma development

Answer 18

Can be more associated with damage to the epithelial layer or viruses/microbes in the lungs

Binding to microphages

The damps that get released (by the broken cell)

Activated macrophages

Macrophages can activate neutrophil and TH17 cells

Question 19

List the classifications of occupational

Answer 19

Respiratory sensitization asthma

Acute irritant induced asthma

Recurrent low dose irritant induced asthma

Work aggravated asthma

Chronic obstructive pulmonary disease-end-stage asthma

Question 20

Give the main points of respiratory sensitization asthma

Answer 20

Adult onset as a result of exposure at work

Immune mechanisms may not be well defined

Latency

Question 21

List main points of acute irritant induced asthma

Answer 21

Adult onset asthma as a result of high dose exposure to irritants at work

Reactive airway dysfunction syndrome (RADS)

No latency

Question 22

Describe the main points of recurrent low dose irritant induced asthma

Answer 22

Adult onset asthma as a result of prolonged moderately high exposure to irritants at work

Latency

Question 23

Describe the main points of work aggravated asthma

Answer 23

Pre-existing asthma with new exposure to triggers at work

Loss of asthma control

Question 24

Describe the main points of chronic obstructive pulmonary disease-end stage asthma

Answer 24

Impairment resulting after many years of one of The other classifications of occupational asthma, usually without treatment or removal from exposure

Question 25

What protease degrades the elastic fibers of the alveoli and collagen?

Answer 25

Neutrophil elastase

Question 26

List and briefly describe the Serpina 1 variants

Answer 26

PiS-make less alpha-1 antitrypsin and so if you have a last of the alpha-1 antitrypsin then you have a lower threshold for a reaction

PiZ- make even less a one antitrypsin and so you have an even more elevated risk

These are affected by smoking because they block protease activity and smoking inhibits anti-protease activity

Question 27

Name the two branches of acquired immunity that are most relevant to asthma

Answer 27

TH2

TH17