Obstructive Disease Flashcards
Disease of Trachea (20
Upper Airway Obstruction
Cystic Fibrosis
Disease of Bronchi (1)
Bronchitis
Disease of Bronchioles (2)
Asthma
Brochiectasis
Disease of Respiratory Bronchioles (1)
Bronchiolitis (viral pneumonia?)
Disease of Alveoli (1)
Emphysema
Spirometry Pattern
FEV1/FVC
P-V Curve Pattern
Steeper and Shifted Up from increased compliance
Airflow Pattern
Reduced flow at higher lung volumes with coving on end-expiration
Effect on Diaphragm
Hyperinflation reduces diaphragm length, puts at mechanical disadvantage
Asthma Pathology
Allergen induces Th2 cells which secrete IL-4 (IgE conversion); IL-5 (Eosinophil recruitment); and IL-10 (More Th2)
Second exposure causes IgE-activation of Mast cells, regrandulation. Early phase is histamine, leukotrienes, etc. Late phase is major basic protein bronchoconstriciton.
Asthma cough: productive or non-productive?
Productive (mucus plugs, Charcot-Leyden crystals [MBP])
Other causes of asthma?
Post-viral, chronic (cold air, exercise)
Chronic Bronchitis Diagnosis
Productive Cough 3+ months for 2 years+
Chronic Bronchitis Pathology
Mucus gland and goblet cell hyperplasia; smooth muscle hyperplasia
Chronic Bronchitis Signs/Symptoms
Productive Cough
Cyanosis (mucus plugging)
Increased Cor Pulmonale
Emphysema Pathology
Destruction of alveolar sacs from protease-anti-protease imablance (from chronic inflammation/PMNs or alpha-1 genetics)
Loss of elastic recoil, more dynamic airway collapse
Smoking-related emphysema
Inflammation-mediated, centri-acinar, most severe in upper lobes
Alpha-1-antitrypsin Emphysema
Enzyme-mediated, pan-acinar, more severe in lower lobes.
Might have associated cirrhosis from misfolded proteins
Emphysema Signs/Symptoms
DOE, dry cough, pursed lip breathing, weight loss, increased chest diameter, hypoxemia
