Obstructive Disease

Question 1

What is the presentation of asthma?

Answer 1

Episodic wheezing, SOB, chest tightness, and cough
Affects medium sized bronchi
Reversible obstruction

Question 2

What is the presentation of chronic bronchitis?

Answer 2

Productive cough for 3 months per year for 2 years

Irreversible SM hypertrophy and mucus hypersecretion (resistance)

Question 3

What is the presentation of emphysema?

Answer 3

Irreversible air space enlargement by wall destruction
Cigarettes cause centriacinar of portions of respiratory bronchiole
Alpha-1-antitrypsin causes paracinar of entire respiratory bronchiole.

Question 4

What is the presentation of bronchiectasis?

Answer 4

Irreversible dilation of medium bronchi by SM and elastin destruction
Cough with foul smelling sputum
Inflammation decreases mucus clearence

Question 5

What is the presentation of cystic fibrosis?

Answer 5

Recurrent infections, failure to thrive and bowel obstruction
CFTR mutation impairs chloride transport and leads to excess mucus and infections

Question 6

What is the presentation of bronchiolitis?

Answer 6

Viral illness that progresses to fever, cough, and dyspnea
In adults bronchiolitis obliterans in more common (non-infectious) from toxins of rheum disease
Results in long-term obstruction

Question 7

What medications are used to immediately relieve asthma symptoms?

Answer 7

Beta-adrenergic agonists, anticholinergics, systemic glucocorticoids

Question 8

What medications are used to control asthma?

Answer 8

Inhaled glucocorticoids, Long acting beta-adrenergic agonists, immunomoduators, cromolyn, theophylline,

Question 9

Who is the typical COPD patient?

Answer 9

Mid-life onset, slowly progressive symptoms, long smoking history

Question 10

Who is the typical asthma patient?

Answer 10

Childhood onset, variable/episodic symptoms, worse at night/morning, allergies or eczema, family history