obstructive airway disease Flashcards
airways =
obstructive airways
obstructive airway syndrome
Asthma
Chronic bronchitis
Emphysema
what is ACO
mixture between asthma/ COPD
- features of both asthma and COPD
Chronic Bronchitis:
inflammation of airways
Emphysema:
destruction of alveollar wall w dilation of airpace
Asthma -
upper airway, drugs combat airway smooth muscle contraction
COPD -
older people,
smokers,
pollutants,
affects upper and lower,
later stages (emphysema) has breakdown of elastic recoil of lung
what is contained in the asthma triad
- T2 airway inflammation
- Reversible Airflow Obstruction
- Airway hyper responsiveness
T2 airway inflammation
most asthma is type 2 high
- eosinophils
airway hyper responsiveness
twitchy airways in a response to a variety of exogenous stimuli
reversible airflow obstruction
melt away eosinophilic
relax smooth wall muscle with drugs
- open up away and becomes reversible
hallmarks of remodelling in asthma
- thickening of basement membrane
- collagen deposition in submucosa
- hypertrophy in smooth muscle
eosinophils purpose in T2 inflammation
mop up parasites
type 2 patients who are type 2 high
respond well to treatment
anti-inflammatory medications =
- corticosteroids
- theophylline
Type 2 cytokines =
4,5,13
twitchy smooth muscle (hyperactivity) medication
bronchodilators
- beta 2 agonists
- muscarinic antagonist
asthma trigger factors allergens
- animal dander
- dust mites
- pollens
- moulds
asthma - clinical syndrome
- episodic symptoms and signs
diurnal variability -nocturnal/early morning - non-productive cough, wheeze
Chronic Bronchitis
- Chronic neutrophilic* inflammation
- Mucus hypersecretion
- Mucociliary dysfunction
- Altered lung microbiome
- Smooth muscle spasm and
hypertrophy - Partially reversible
Emphysema
Alveolar destruction
* Impaired gas exchange
* Loss of bronchial support
* Irreversible
COPD -THE CLINICAL SYNDROME
- Chronic symptoms - not episodic
- Smoking
- Non-atopic
- Daily productive cough
- Progressive breathlessness
- Frequent infective exacerbations viral/bacterial
- Chronic bronchitis-mucous hypersecretion
- Emphysema- reduced breath sounds
CHRONIC CASCADE IN COPD
- Progressive fixed airflow obstruction (both FEV1 & FVC reduced ratio< 0.70)
- Impaired alveolar gas exchange
- Respiratory failure: ̄PaO2 PaCO2
- Pulmonary hypertension
- Right ventricular hypertrophy/failure
(i.e. cor pulmonale) - Death
Non Pharmacological COPD management
*Smoking cessation+/- nicotine/bupropion/varenicline
*Immunisation- Influenza/Cvoid/Pneumococcal
*Physical activity
*Oxygen –Domiciliary
