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MD3001 - Respiratory Disease/Pathology > Obstructive and Restrictive Lung Disease > Flashcards

Obstructive and Restrictive Lung Disease Flashcards

1
Q

What are obstructive airway diseases?

A
  • common
  • categorised on pattern of spirometry
  • quantitative, objective measurement of lung function
  • repeatable
  • monitor the course of disease
  • measurements include FEV1.0 and FVC
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2
Q

What is spirometry?

A

a common test used to assess how well your lungs work by measurinf how much air you inhale; how much you exhale nad how quickly you exhale

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3
Q

What is the meaning of forced vital capacity?

A
  • Forced = exhale as hard as possible
  • Vital = total volume in the lungs minus the residual volume
  • Capacity = sum of more than one volume
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4
Q

How happens the FVC ratio in restrictive lung diseases?

A

stays the same but everything is just decreased

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5
Q

What happens the ratio in obstructive lung diseases?

A

Ratio decreases

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6
Q

What is the FEV1.0/FVC ratio?

A

a measure if airflow obstruction

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7
Q

What is a normal FEV1.0/FVC ratio?

A

> 0.7

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8
Q

Draw a diagram of tbe FEV1.0/FVC ratio of:

  • normal lungs
  • restrictive diseases
  • Obstructive diseases
A
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9
Q

What does hypoxia tend to result from?

A

V/Q mismatching

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10
Q

What are the most common obstructuve lung diseases?

A
  • Asthma
  • COPD
  • Bronchiectasis
  • Cystic fibrosis
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11
Q

What is asthma?

A

Clinical diagnosis based on history and examination

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12
Q

What would one or more of what symptoms indicate asthma?

A
  • wheeze
  • breathlessness
  • chest tightness
  • cough
  • Especially if there is diurinal variation
  • symptoms in response to allergen, exercise and cold air
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13
Q

What are the 3 components of asthma?

A
  1. airway narrowing/ obstruction
  2. airway hyperresponsiveness
  3. airway inflammation

eosinophils

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14
Q

What are the important mediators in asthma?

A
  • leukotriene B4 and cystinyl-leukotrienes (C4 and D4)
  • interleukins 4, 5 and 13
  • tissue damaging eosinophil proteins
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15
Q

What can symptoms occur or worsen in the presence of?

A
  • viral
  • allergens
  • cold
  • food/nutrition
  • chemicals - smoke
  • exercise
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16
Q

What is the non-pharmacological treatment of asthma?

A
  • normal healthy BMI
  • breathing exercise programmes
  • stop smoking
17
Q

What are the characteristics of COPD?

A
  • Chronic = symptoms for more than 3 months in 2 consecutive years
  • Obstructive = predominant sign of wheeze (need spirometry for assessment)
  • Affects both the airways and the lung
18
Q

What is COPD?

A
  • persistent airflow limitation
  • progressive and assoiciated with an enhanced chronic inflammatory response in the airways
19
Q

Epidemiology of COPD

A
  • smoking
  • indoor/outdoor pollution from biomass fuels
  • host factrs effect progression of disease
  • genetic abnoramlities (alpha-1 antitripysin deficiency)
  • abnormal lung development
  • age and gender
20
Q

When should cannibas smoking be considered as a cause of COPD?

A
  • COPD at younger age
  • large bullae on x-ray
  • hotboxing (TB)
  • contaiminated joint (aspergillosis)
21
Q

What should be considered with an early onset of COPD?

A

alpha1 antitripypsin deficiency

  • enzyme produced in the liver - prevents the break down of lung tissue
  • counter acts proteinases - reduces elastase activity
  • autosomal co-dominance
22
Q

Pathophysiology of COPD

A
  • inflammation and fibrosis of the bronchial wall
  • hypertrophy of mucosal glands and hypersecretion of mucus
  • loss of elastic, parenchymal lung fibres (emphysema)
23
Q

Clinical presentation of COPD

A
  • insidious onset
  • usually 50s or 60s
  • chronic cough
  • sputum production (worse in morning)
  • SOB
  • diminishing exercise tolerance
  • history of exposure to risk factors
24
Q

Describe pink puffer

A
  • pink
  • increased SOB but with little cough
  • pursed lips
  • barrel chest due to air trapping
  • use of accessory muscles
  • decreased breath sounds
25
Q

Describe blue bloater

A
  • blue = cyanosed
  • Bloaters = signs of RHS heart failure
  • expectorant cough (productive)
  • crackles and wheezes
26
Q

What are the 5 fundamentals of COPD care?

A
  1. support to stop smoking
  2. pneumococcal and flu vaccine
  3. pulmonary rehab
  4. co-develop a personalised self-management plan
  5. optimise co-morbidities
27
Q

Name 4 restrictive lung diseases

A
  • idiopathic pulmonary fribsosi
  • hypersensitivity pneumonitis
  • Sarcoidosis
  • Connective tissue disease related ti lung disease
28
Q

Symtpoms of restrictive lung disease

A
  • dyspnoea
  • dry cough
  • malaise
29
Q

examination finding of restrictive lung disease

A
  • bilateral fine crackles
  • finger clubbing

MD3001 - Respiratory Disease/Pathology (7 decks)

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