Obstructive Airway Disease Flashcards
Obstructive disease affects what?
The airways
Restrictive disease affects what?
The lungs
Asthma, chronic bronchitis and emphysema are what?
Pathological entities
Asthma is associated with what immunological cell?
Eosinophils
Bronchitis is associated with which neurological cell?
Neutrophils
What is emphysema?
Reduced breath sounds
A disease causing airway obstruction due to loss of alveolar support
cigarette smoking can lead to?
chronic bronchitis
Emphysema
ACOS means?
Asthma/COPD overlap syndrome
- usually chronic smokers who have features of both diseases
Trachea, bronchi and bronchioles are in which zone ?
Conducting zone
Terminal bronchioles and alveoli are in which zone?
Acinar zone
what layers of tissue are present in a bronchiole?
Lumen, mucosa, smooth muscle,alveolar walls
Asthma terminology?
Early/late onset
Atopic/non-atopic
extrinsic (extrinsic trigger factor- allergen, chemical, dust cloud etc.)/ intrinsic (no obvious externat trigger factor involved)
The asthma triad involves?
- Airway inflamation (eosinophilic)
- Reversible airflow obstruction
- Airway hyperresponsiveness
What are the three parts of the dynamic evolution of asthma?
Bronchoconstriction Chronic airway inflamation (exacerbations and AHR) Airway remodeling (layering down of collagen)
Hallmarks of remodeling in asthma?
Thickening of basement membrane
Collagen deposition in submucosa
Hypertrophy in smooth muscle
Which inter-leukins are associated with TH2 cells?
IL-4
IL-13
IL-5
which IL is favoured by eosinophils?
IL-5
which IL is favoured by mast cells?
IL-4
IL-13
Which antibody is associated with allergies?
IgE
IgE is associated with which types of cells?
Mast cells
Basophils
What are the steps of the inflammatory cascade in asthma?
- Genetic predisposition with extrinsic trigger factor (virus/allergen/chemical)
- Usually eosinophilic inflammation
- Production of mediators- Th2 cytokines
- Twitchy smooth muscle - hyperreactivity
What drugs can effectively stop eosinophilic inflammation?
CORTICOSTEROIDS
Cormones
Theophyline
What drugs can be used to stop the mediators?
Antihistamines
Anti-IgE
Anti-IL5
What drugs can be used to tackle bronchoconstriction?
Bronchodilators:
- B2-agonists (should be used with corticosteroids too)
- Muscarinic antagonists
what are some histological landmarks of inflamation in asthma?
Desquamatied epithelial cells
Basement membrane thickenes
Presense of eosinophils/mast cells
Mucus plugging
When do asthmatics usually have problems?
At night time
After exercise
Why do wheezes in asthma present?
Turbulent airflow
What is the main way to diagnose asthma?
History
What is the main cause of COPD?
Cigarette smoking
Neutrophilic inflamation, tissue damage and mucociliary dysfunction are signs of?
COPD
Characteristics of COPS are?
Exacerbations
Reduced lung function
Symptoms of COPD?
Breathlessness
worsening of life quality
Disease process in COPD includes?
CD8+ lymphocytes
Alveolar macrophages
neutrophils
proteases
Chronic bronchitis involves?
Chronic neutrophilic inflammation Mucus hypersecretion mucociliary dysfunction altered lung microbiome smooth muscle spasm & hypertrophy
Emphysema involves?
alveolar destruction
impaired gas exchange
loss of bronchial support
Patients high at risk of COPD?
FEV1 below 50% preducted rate
Two exacerbations within past year
Which COPD groups have more exacerbations?
C and D
Progressive fixed airflow obstruction, Impaired alveolar gas exchange, Respiratory failure: decreased PaO2, increased PaCO2, Pulmonary hypertension, Right ventricular hypertrophy/failure (i.e. cor pulmonale),Death are prograssions of what?
COPD
Diurnal variability is associated with which disease?
Asthma
