Obstructive Airway Disease Flashcards

1
Q

Obstructive disease affects what?

A

The airways

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2
Q

Restrictive disease affects what?

A

The lungs

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3
Q

Asthma, chronic bronchitis and emphysema are what?

A

Pathological entities

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4
Q

Asthma is associated with what immunological cell?

A

Eosinophils

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5
Q

Bronchitis is associated with which neurological cell?

A

Neutrophils

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6
Q

What is emphysema?

A

Reduced breath sounds

A disease causing airway obstruction due to loss of alveolar support

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7
Q

cigarette smoking can lead to?

A

chronic bronchitis

Emphysema

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8
Q

ACOS means?

A

Asthma/COPD overlap syndrome

  • usually chronic smokers who have features of both diseases
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9
Q

Trachea, bronchi and bronchioles are in which zone ?

A

Conducting zone

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10
Q

Terminal bronchioles and alveoli are in which zone?

A

Acinar zone

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11
Q

what layers of tissue are present in a bronchiole?

A

Lumen, mucosa, smooth muscle,alveolar walls

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12
Q

Asthma terminology?

A

Early/late onset
Atopic/non-atopic
extrinsic (extrinsic trigger factor- allergen, chemical, dust cloud etc.)/ intrinsic (no obvious externat trigger factor involved)

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13
Q

The asthma triad involves?

A
  1. Airway inflamation (eosinophilic)
  2. Reversible airflow obstruction
  3. Airway hyperresponsiveness
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14
Q

What are the three parts of the dynamic evolution of asthma?

A
Bronchoconstriction
Chronic airway inflamation (exacerbations and AHR)
Airway remodeling (layering down of collagen)
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15
Q

Hallmarks of remodeling in asthma?

A

Thickening of basement membrane
Collagen deposition in submucosa
Hypertrophy in smooth muscle

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16
Q

Which inter-leukins are associated with TH2 cells?

A

IL-4
IL-13
IL-5

17
Q

which IL is favoured by eosinophils?

A

IL-5

18
Q

which IL is favoured by mast cells?

A

IL-4

IL-13

19
Q

Which antibody is associated with allergies?

A

IgE

20
Q

IgE is associated with which types of cells?

A

Mast cells

Basophils

21
Q

What are the steps of the inflammatory cascade in asthma?

A
  1. Genetic predisposition with extrinsic trigger factor (virus/allergen/chemical)
  2. Usually eosinophilic inflammation
  3. Production of mediators- Th2 cytokines
  4. Twitchy smooth muscle - hyperreactivity
22
Q

What drugs can effectively stop eosinophilic inflammation?

A

CORTICOSTEROIDS
Cormones
Theophyline

23
Q

What drugs can be used to stop the mediators?

A

Antihistamines
Anti-IgE
Anti-IL5

24
Q

What drugs can be used to tackle bronchoconstriction?

A

Bronchodilators:

  • B2-agonists (should be used with corticosteroids too)
  • Muscarinic antagonists
25
Q

what are some histological landmarks of inflamation in asthma?

A

Desquamatied epithelial cells
Basement membrane thickenes
Presense of eosinophils/mast cells
Mucus plugging

26
Q

When do asthmatics usually have problems?

A

At night time

After exercise

27
Q

Why do wheezes in asthma present?

A

Turbulent airflow

28
Q

What is the main way to diagnose asthma?

A

History

29
Q

What is the main cause of COPD?

A

Cigarette smoking

30
Q

Neutrophilic inflamation, tissue damage and mucociliary dysfunction are signs of?

A

COPD

31
Q

Characteristics of COPS are?

A

Exacerbations

Reduced lung function

32
Q

Symptoms of COPD?

A

Breathlessness

worsening of life quality

33
Q

Disease process in COPD includes?

A

CD8+ lymphocytes
Alveolar macrophages
neutrophils
proteases

34
Q

Chronic bronchitis involves?

A
Chronic neutrophilic inflammation
Mucus hypersecretion
mucociliary dysfunction
altered lung microbiome
smooth muscle spasm & hypertrophy
35
Q

Emphysema involves?

A

alveolar destruction
impaired gas exchange
loss of bronchial support

36
Q

Patients high at risk of COPD?

A

FEV1 below 50% preducted rate

Two exacerbations within past year

37
Q

Which COPD groups have more exacerbations?

A

C and D

38
Q

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?

A

COPD

39
Q

Diurnal variability is associated with which disease?

A

Asthma