Obstructive Airway Disease Flashcards

1
Q

Airways

A

Obstructive

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2
Q

Lungs

A

Restrictive

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3
Q

Name the 3 most common OBSTRUCTIVE airway conditions.

A

Asthma
Chronic bronchitis
Emphysema

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4
Q

What is ACOS? What type of condition is it?

A

Asthma and COPD overlap syndrome

Obstructive

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5
Q

If mucosa becomes larger, the ….. becomes smaller

A

Lumen

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6
Q

Name the 3 points of the Asthma Triad.

A
  1. Airway inflammation
  2. Airway hyperresponsiveness
  3. Reversible airflow obstruction
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7
Q

Describe airway hyper-responsiveness.

A

Easily triggered bronchospasm

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8
Q

What are the 3 stages in the evolution of Asthma.

A
  1. Bronchoconstriction
  2. Chronic airway inflammation
  3. Airway remodelling
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9
Q

Fixed airway obstruction is known as what stage?

A

Stage 3 - airway remodelling

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10
Q

Bronchoconstriction causes ….. symptoms

A

BRIEF

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11
Q

What are the 3 hallmarks of airway remodelling in asthma? State which layer they arise in.

A
  1. Thickening - basement membrane
  2. Collagen deposition - submucosa
  3. Hypertrophy - smooth muscle
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12
Q

What drug is given in eosinophilic inflammation?

A

Anti-inflammatory

e.g Corticosteroid

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13
Q

What drug is given to mediate TH2 cytokines?

A

Anti-leukotrience/histamine
Anti-IgE
Anti-IL5

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14
Q

What drug is given for twitchy smooth muscle (hyper-reactivity)?

A

Bronchodilatory

e.g beta2-agonist, muscarinic antagonist

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15
Q

Name some potential allergens (triggers) in asthma.

A

Animal dander
Dust mites
Pollens
Fungi

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16
Q

The signs and symptoms of asthma are ……..

A

EPISODIC

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17
Q

Asthma patients usually have a productive cough

A

FALSE

non-productive

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18
Q

Why do people get a wheeze?

A

Turbulent airflow

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19
Q

People with asthma usually have associated …….

A

Atopy

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20
Q

Name 3 conditions which are closely associated with asthma (esp atopy related)

A

Rhinitis
Conjunctivitis
Eczema

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21
Q

Describe the day time variation in asthma.

A

DIURINAL

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22
Q

Describe the forced expiratory ratio in asthma. Explain this.

A

<75% - REDUCED
FEV1 is reduced
FVC is normal

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23
Q

What is the reduced forced expiratory ratio in asthma reversed by? How much is this by?

A

Salbutamol

>15%

24
Q

Emphysema is IRREVERSIBLE

A

TRUE

25
Q

Chronic Bronchitis is IRREVERSIBLE

A

FALSE

Partially reversible

26
Q

Describe emphysema.

A

Alveolar destruction
Impaired gas exchange
Loss of bronchial support

27
Q

Describe the inflammation in chronic bronchitis.

A

Chronic neutrophilic inflammation

28
Q

Mucus hyposecretion occurs in chronic bronchitis

A

FALSE

HYPERSECRETION

29
Q

What happens to the smooth muscles of bronchioles in chronic bronchitis.

A

Spasm

Hypertrophy

30
Q

Mucociliary dysfunction is a side effect of what condition?

A

Chronic bronchitis

31
Q

What protein is imbalanced in emphysema?

A

Protease

32
Q

The air sacs in emphysema become ……. and ……..?

A

Damaged

Enlarged

33
Q

What 4 things should be considered in the assessment of COPD?

A
  1. Symptoms
  2. Degree of airflow limitation
  3. Risk of exacerbations
  4. Comorbidities
34
Q

How is degree of airflow limitation assessed?

A

Spirometry

35
Q

What classifies as high risk for a COPD patient?

A

Two exacerbations or more within the past year or FEV1 < 50 % predicted

36
Q

What does stopping smoking do?

A

Arrests further decline in lung volume

37
Q

Progressive fixed airway obstruction occurs in what condition?

A

COPD

38
Q

What is type 2 respiratory failure classify as?

A

Decreased PaO2

Increased PaCO2

39
Q

Pulmonary hypertension occurs as a result of?

A

COPD

40
Q

What can COPD do to the heart?

A

Right ventricular hypertrophy/failure

i.e cor pulmonale

41
Q

Describe ACOS.

A

COPD with blood eosinophilia >3%

42
Q

What is ACOS difficult to distinguish form?

A

Difficult to distinguish from asthmatic smokers who have airway remodeling (ie reduced FVC)

43
Q

What does ACOS respond to?

A

Salbutamol

ICS

44
Q

Outline the management of COPD.

A
  1. LAMA
  2. LABA
  3. LAMA-LABA
  4. LABA-ICS
  5. LABA-LAMA-ICS
45
Q

LAMA

A

Tiotropium

Aclidinum

46
Q

LABA

A

Olodaterol

Formoterol

47
Q

ICS

A

Beclometasone

48
Q

Eosinophilic inflammation…

A

Asthma

49
Q

Neutrophilic inflammation…

A

COPD

50
Q

COPD has a …. bronchodilator and corticosteroid response

A

POOR

51
Q

Asthma has a …. bronchodilator and corticosteroid response

A

GOOD

52
Q

Asthma has …… gas exchange

A

NORMAL

53
Q

COPD has …….. gas exchange

A

IMPAIRED

54
Q

Asthma has ……… FVC and TLCO

A

PRESERVED

55
Q

COPD has …….. FVC and TLCO

A

IMPAIRED