Obstructive Lung Diseases Flashcards
What effect do obstructive diseases have on FEV and FVC? (3)
FEV1 is reduced
FVC may be reduced
FEC1 is less than 70% of FVC
What is the general term grouping together chronic bronchitis and emphysema?
COPD
Is bronchial asthma reversible?
Yes - either spontaneously or medical intervention
What type of reaction is bronchial asthma?
Type 1 hypersensitivity reaction in the airways
What are 3 main causes of COPD?
Smoking
Occupation (dust related)
Atmospheric pollution
What is the clinical definition of chronic bronchitis?
Sputum producing cough in at least 3 consecutive months for 2 or more consecutive years
What is the pathological definition of emphysema?
Increase in size of airways distal to terminal bronchioles (either by dilation or wall destruction)
What are the 3 main forms of emphysema?
Centriacinar
Panacinar
Periacinar (scar)
What 2 changes happen in centriacinar emphysema?
Bronchial dilation
Alveolar tissue is lost
What deficiency can lead to emphysema?
Alpha 1 antitrypsin deficiency
What 2 factors can be targeted for pharmacological intervention of COPD in small airways?
Smooth muscle tone
Inflammation
What are 4 abnormal states associated with hypoxaemia?
Ventilation/Perfusion imbalance
Diffusion impairment
Alveolar hypoventilation
Shunt
What effect in COPD does Ventilation/Perfusion imbalance have?
Airway obstruction
What effect in COPD does alveolar hypoventilation have?
Reduced respiratory drive
What effect in COPD does diffusion impairment have?
Loss of alveolar surface area
When does shunt in COPD have an effect?
Only during acute exacerbation
What is chronic (hypoxic) cor pulmonale?
Hypertrophy of R ventricle causing disease that affects lung function/structure
What is the main cause of pulmonary hypertension in hypoxic cor pulmonale?
Pulmonary vasoconstriction
What are the 5 main symptoms of COPD?
Breathlessness Cough & sputum Wheeze Weight loss Peripheral oedema (sign of cor pulmonale)
What are 2 of the main signs on examination of COPD?
Cyanosis Flapping tremor (CO2 retention)
What is the essential investigation that must be performed if COPD is suspected?
Spirometry
What are 5 other useful investigations in the diagnosis of COPD?
CXR Blood gases FBC ECG Sputum culture
What are 4 treatment options for acute exacerbations of COPD?
Nebulised bronchodilator (Beta-2 and anti-muscarinic)
Corticosteroid
Diuretic
Antibiotic
