obstructive airway disease

Question 1

airways =

Answer 1

obstructive airways

Question 2

obstructive airway syndrome

Answer 2

Asthma
Chronic bronchitis
Emphysema

Question 3

what is ACO

Answer 3

mixture between asthma/ COPD
- features of both asthma and COPD

Question 4

Chronic Bronchitis:

Answer 4

inflammation of airways

Question 5

Emphysema:

Answer 5

destruction of alveollar wall w dilation of airpace

Question 6

Asthma -

Answer 6

upper airway, drugs combat airway smooth muscle contraction

Question 7

COPD -

Answer 7

older people,
smokers,
pollutants,
affects upper and lower,
later stages (emphysema) has breakdown of elastic recoil of lung

Question 8

what is contained in the asthma triad

Answer 8

• T2 airway inflammation
• Reversible Airflow Obstruction
• Airway hyper responsiveness

Question 9

T2 airway inflammation

Answer 9

most asthma is type 2 high
- eosinophils

Question 10

airway hyper responsiveness

Answer 10

twitchy airways in a response to a variety of exogenous stimuli

Question 11

reversible airflow obstruction

Answer 11

melt away eosinophilic
relax smooth wall muscle with drugs
- open up away and becomes reversible

Question 12

hallmarks of remodelling in asthma

Answer 12

• thickening of basement membrane
• collagen deposition in submucosa
• hypertrophy in smooth muscle

Question 13

eosinophils purpose in T2 inflammation

Answer 13

mop up parasites

Question 14

type 2 patients who are type 2 high

Answer 14

respond well to treatment

Question 15

anti-inflammatory medications =

Answer 15

• corticosteroids
• theophylline

Question 16

Type 2 cytokines =

Answer 16

4,5,13

Question 17

twitchy smooth muscle (hyperactivity) medication

Answer 17

bronchodilators
- beta 2 agonists
- muscarinic antagonist

Question 18

asthma trigger factors allergens

Answer 18

• animal dander
• dust mites
• pollens
• moulds

Question 19

asthma - clinical syndrome

Answer 19

• episodic symptoms and signs
  diurnal variability -nocturnal/early morning
• non-productive cough, wheeze

Question 20

Chronic Bronchitis

Answer 20

• Chronic neutrophilic* inflammation
• Mucus hypersecretion
• Mucociliary dysfunction
• Altered lung microbiome
• Smooth muscle spasm and
  hypertrophy
• Partially reversible

Question 21

Emphysema

Answer 21

Alveolar destruction
* Impaired gas exchange
* Loss of bronchial support
* Irreversible

Question 22

COPD -THE CLINICAL SYNDROME

Answer 22

• 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

Question 23

CHRONIC CASCADE IN COPD

Answer 23

• 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

Question 24

Non Pharmacological COPD management

Answer 24

*Smoking cessation+/- nicotine/bupropion/varenicline
*Immunisation- Influenza/Cvoid/Pneumococcal
*Physical activity
*Oxygen –Domiciliary

Question 25

pharmacological COPD management

Answer 25

*LABA/LAMA combo (Non-Eos)
*ICS/LABA/LAMA combo (Eos)