Obstructive airway diseases Flashcards
What is the normal predicted value of FVC
4.95L
How can COPD be detected
Airflow limitaiton
PEFR reduced (Peak Expiratory Flow Rate)
FEV1 reduced
FVC may be reduced
FEV1/FVC less than 70%
What would the values of obstructive lung disease look like compared to normal:
FEV1 = 4 l
FVC = 4.9 l
FEV1/FVC = 0.81
FEV1 = 1.8L
FVC = 3.4L
FEV1/FVC = 0.53
What is bronchial asthma
Type 1 hypersensitivity in airways
Reversable Airway obstruction
What is the aetiology of Chronic bronchitis & Emphysema
Smoking
Pollution
Dust
Age & Susceptability
What does alpha-1-antiprotease (antitrypsin) deficiency cause
Rare cause of emphysema
What is chronic bronchitis defined as clinically
Sputum cough in 3 consecutive months for 2 or more consecutive years
When does complicated chronic broncitis occur
Sputum turns mucopurulent (contains mucous and pus)
FEV1 falls
What are the morphological changes in chronic bronchitis in the Large Airways
Mucouse gland hyperplasia
Goblet cell hyperplasia
Inflammation& fibrosis
What are the morphological changes in chronic bronchitis
Small airways
Goblet cells appear
Inflam. & fibrosis
Describe the image
Goblet cell hyperplasia
Small airway inflamed with fibrosis
What is the pathological definition of Emphysema
Increase beyond normal in size of airspaces distal to the terminal bronchiole
Arises from dilatation/destruction of their walls and without obvious fibrosis
Describe the image
Increase size of airspaces
Destruction of alveoli walls
What are the different forms of Emphysema
Centracinar
Panacinar
Periacinar
SCAR (irregular, bullous emphysema)
What is an asinus
What is centracinar
Begins as bronchiolar dilation
Then alveolar tissue lost
Occurs in upper regions of lungs
Most important clinically
What is panacinar
Uniform enlargement of airspaces in acinar
Usually occurs in lower region of lungs
What is periacinar
Contains a Bulla
What is a bulla
emphysematous space greater than 1cm
What is a bleb
Bulla formed underneath the plura
What is an identifyable trait of COPD on X-ray
Hyperinfalted Lungs
what does bullous emphysema look like on MRI
What is chronic Cor pulmonale
Hypertrophy of Right Ventricle resulting from disease affecting function and/or structure of the lung
What negative effects does smoking have
How does alpha-1-antitrypsin deficiency affect elastase
what type of Emphysema is it seen in
Panacinar
What are the mechanisms of airway obstruction in COPD
LArge airways- little contribution
Small airways:
[Smooth muscle tone
Inflammation] respond to Pharmalogical intervention
Fibrosis
Loss of alveolar attachments important in emphysema
What is the most common cause of cor pulmonale
Pulmonary hypertension
Cos it causes:
Pulmonary vasoconstriction
Pulmonary arterioles- muscle hypertrophy & intimal fibrosis
Loss of capillary bed
Secondary polycythaemia
