Obstructive Airway Disease

Question 1

Obstructive disease affects what?

Answer 1

The airways

Question 2

Restrictive disease affects what?

Answer 2

The lungs

Question 3

Asthma, chronic bronchitis and emphysema are what?

Answer 3

Pathological entities

Question 4

Asthma is associated with what immunological cell?

Answer 4

Eosinophils

Question 5

Bronchitis is associated with which neurological cell?

Answer 5

Neutrophils

Question 6

What is emphysema?

Answer 6

Reduced breath sounds

A disease causing airway obstruction due to loss of alveolar support

Question 7

cigarette smoking can lead to?

Answer 7

chronic bronchitis

Emphysema

Question 8

ACOS means?

Answer 8

Asthma/COPD overlap syndrome

• usually chronic smokers who have features of both diseases

Question 9

Trachea, bronchi and bronchioles are in which zone ?

Answer 9

Conducting zone

Question 10

Terminal bronchioles and alveoli are in which zone?

Answer 10

Acinar zone

Question 11

what layers of tissue are present in a bronchiole?

Answer 11

Lumen, mucosa, smooth muscle,alveolar walls

Question 12

Asthma terminology?

Answer 12

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

Question 13

The asthma triad involves?

Answer 13

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

Question 14

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

Answer 14

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

Question 15

Hallmarks of remodeling in asthma?

Answer 15

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

Question 16

Which inter-leukins are associated with TH2 cells?

Answer 16

IL-4
IL-13
IL-5

Question 17

which IL is favoured by eosinophils?

Answer 17

IL-5

Question 18

which IL is favoured by mast cells?

Answer 18

IL-4

IL-13

Question 19

Which antibody is associated with allergies?

Answer 19

IgE

Question 20

IgE is associated with which types of cells?

Answer 20

Mast cells

Basophils

Question 21

What are the steps of the inflammatory cascade in asthma?

Answer 21

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

Question 22

What drugs can effectively stop eosinophilic inflammation?

Answer 22

CORTICOSTEROIDS
Cormones
Theophyline

Question 23

What drugs can be used to stop the mediators?

Answer 23

Antihistamines
Anti-IgE
Anti-IL5

Question 24

What drugs can be used to tackle bronchoconstriction?

Answer 24

Bronchodilators:

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

Question 25

what are some histological landmarks of inflamation in asthma?

Answer 25

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

Question 26

When do asthmatics usually have problems?

Answer 26

At night time | After exercise

Question 27

Why do wheezes in asthma present?

Answer 27

Turbulent airflow

Question 28

What is the main way to diagnose asthma?

Answer 28

History

Question 29

What is the main cause of COPD?

Answer 29

Cigarette smoking

Question 30

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

Answer 30

COPD

Question 31

Characteristics of COPS are?

Answer 31

Exacerbations | Reduced lung function

Question 32

Symptoms of COPD?

Answer 32

Breathlessness | worsening of life quality

Question 33

Disease process in COPD includes?

Answer 33

CD8+ lymphocytes Alveolar macrophages neutrophils proteases

Question 34

Chronic bronchitis involves?

Answer 34

``` Chronic neutrophilic inflammation Mucus hypersecretion mucociliary dysfunction altered lung microbiome smooth muscle spasm & hypertrophy ```

Question 35

Emphysema involves?

Answer 35

alveolar destruction impaired gas exchange loss of bronchial support

Question 36

Patients high at risk of COPD?

Answer 36

FEV1 below 50% preducted rate Two exacerbations within past year

Question 37

Which COPD groups have more exacerbations?

Answer 37

C and D

Question 38

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?

Answer 38

COPD

Question 39

Diurnal variability is associated with which disease?

Answer 39

Asthma