Obstructive Lung Disease-Tutorial Flashcards
Which diseases come under COPD?
Emphysema and chronic bronchitis (grouped together because they often coexist).
What is bronchiectasis?
Dilation of the bronchi due to destruction of their walls.
What is emphysema?
Destruction of the airspaces distal to the terminal bronchioles resulting in irreversible enlargement.
What are the two main types of emphysema and which is more common?
Centriacinar emphysema is most common and the respiratory bronchioles are affected but the distal alveoli remain normal.
The opposite is true for Panacinar emphysema but is less common.
What is anthracosis?
Blackened wholes in lungs with emphysema.
Why does smoking put someone at risk of emphysema?
Smoking releases oxidants into the lung tissue which causes inflammatory cells to accumulate in the lung. These inflammatory cells release elastase and proteases which degrades the lung tissue. Smoking also decreases the ability of alpha-1-antitrypsin which is an antiprotease.
What sort of emphysema will someone with A1AT deficiency get?
Panacinar emphysema.
What is bullous emphysema?
Is this diseased lung?
What do each of the letters stand for?
Is this diseased lung?
Centriacinar emphysema
Why is this lung diseased?
Why does emphysema cause obstructive problems?
How can you tell that someone has emphysema?
Loss of elastic recoil of the lung which causes the lung to collapse onto the airway during expiration. The patient will purse their lips when expiring to prevent this from happening.
- The patient has a barrel chest due to air being trapped in the lung tissue. This causes them to develop dyspnea. In advanced cases this can cause an increase in capillary pressure, causing side heart failure - called cor pulmonale.
What is chronic bronchitis diagnosis?
Persistent cough with sputum production for at least 3 months in at least 2 consecutive years.
What is the initiating factor of chronic bronchitis?
Inhalation of toxic substance, in 90% of cases this is from smoking.
What occurs in the bronchi of people with chronic bronchitis? What can this fatally lead to?
Chronic inflammation which causes mucous hypersecretion, recurrent infections and fibrosis.
Patients may become hypoxemic, cyanosed (blue), and have right side heart failure causing oedema.
What is metaplasia? What is its importance in chronic bronchitis?
Metaplasia: change of tissue type.
Which side is normal, which side is chronic bronchitis and why?
In both emphysema and chronic bronchitis there are elements of _________ inflammation and fibrosis. This contributes to the ___________ in COPD.
small airway disease, obstruction.
What are the types of asthma? Which is the most common?
- Atopic asthma: allergy induced (most common).
- Non-atopic induced asthma: caused by viral illness, cold and exercise.
- Drug induced asthma: NSAID.
- Occupational asthma: from inhaled fumes etc.
Is asthma permanent?
Not initially but structural changes can occur over time leading to permanent bronchoconstriction.
What is a type 1 hypersensitivity response with regard to asthma?
main points: allergen causing Th2 response and IgE production which attaches to Fc receptors on mast cells and eosinophils. This causes a release of histamines and prostaglandins and bronchoconstriction.
When re-exposed to the antigen, Th2 cells release 3 cytokines, one which stimulates IgE response, one which recruits eosinophils and one which causes mucous production. Which are each of these?
What is the late phase of asthma?
Leukocyte recruitment, mainly oesionophils, which produce major basic protein which destroys the epithelium of lining.
