Obstructive Lung Diseases Flashcards

1
Q

what 2 conditions make up COPD

A

emphysema and chronic bronchitis

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2
Q

what is emphysema

A

where there is a breakdown of elastin in the lungs causing bronchiole collapse and enlarged lung air spaces

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3
Q

why is there hyperinflation of the chest in emphysema

A

the lung has lost elastic tissue so no longer has its recoiling nature - therefore the chest wall can now expand

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4
Q

what is seen in chronic bronchitis

A

where inflammation of the airways causes hyper secretion of mucus - this leads to goblet cell proliferation and cilia damage

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5
Q

what are the causes of COPD

A

smoking, alpha-1-antitrypsin deficiency and pollution

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6
Q

what are the symptoms of COPD

A

cough, sputum, breathlessness, barrelled chest, increased breathing rate, wheezing use of accessory muscles, cyanosis

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7
Q

how do you diagnose COPD

A

history and spirometry

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8
Q

what would you see in spirometry for COPD

A

scooped expiration, lower FEV1

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9
Q

true or false: COPD is reversible with bronchodilators

A

false

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10
Q

what is the management for COPD

A
stop smoking
bronchodilators
inhaled steroids 
pulmonary rehabilitation 
long term oxygen therapy 
lung volume reduction surgery
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11
Q

what is pulmonary rehabilitation

A

getting patients to exercise as they are put off by their breathlessness as so the loss skeletal muscle mass which could lead to isolation and depression

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12
Q

give an example of a bronchodilator

A

salbutamol

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13
Q

what is the side effect of salbutamol

A

not fully selective so also works on beta 1 receptors on the heart to cause tachycardia

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14
Q

what receptors does salbutamol work on

A

beta 2 in the lungs causing airway relaxation

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15
Q

in an acute exacerbation of COPD what treatment would you give

A

oxygen
oral steroids - prednisone
nebulised bronchodilators

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16
Q

what is the inheritance pattern of cystic fibrosis

A

autosomal recessive

17
Q

what does the mutation in cystic fibrosis result in

A

the CFTR to not be inserted into the membrane

18
Q

what are the symptoms of cystic fibrosis

A

thick mucus - giving lung infections, malabsorption and digestive problems

19
Q

what is done to diagnose cystic fibrosis

A

sweat test

heel prick test in babies

20
Q

why do you get malabsorption in cystic fibrosis

A

as the mucus blocks pancreatic secretions so the chyme can’t be broken down

21
Q

why do patients experience recurrent chest infections in cystic fibrosis

A

due to the mucus trapping bacteria in their lungs

22
Q

What is bronchiectasis

A

chronic dilation of the bronchi

23
Q

how is the mucus affected in bronchiectasis

A

dilation of the bronchi means that the mucus can’t be cleared well - this predisposes to infection

24
Q

true or false: asthma is irreversible

A

false - reversible with bronchodilators

25
what is the difference of the breathlessness seen in asthma and COPD
asthma - breathlessness is variable and worse in the morning/night when the airways are narrower COPD - progressive and persistant
26
what is the difference in the age of diagnosis in asthma and COPD
in asthma it is seen in children where COPD is seen in the elderly
27
what is the difference in coughing in COPD and asthma
COPD have a chronic cough but asthma does not
28
what is asthma
chronic inflammation of the airways causing an obstructive airflow
29
what do the antigen trigger activation of in asthma
TH2 cells
30
what is the action of the TH2 cells in asthma
release cytokines which attract and activate eosinophils and IgE producing B cells
31
what type of hypersensitivity reaction occurs immediately in a asthma
type 1 - the IgE antigen interaction causes mast cell degranulation leading to bronchoconstriction
32
what type of hypersensitivity reaction occurs in the later stage of asthma
type 4 - where eosinophils cause inflammation
33
what does inflammation in asthma cause
mucosal swelling, thickening of bronchial walls, over production of mucus, hyper-responsiveness
34
what is hyper-responsiveness in asthma
where the inflammation makes the airways more susceptible to attacks by non-allergens
35
what are the symptoms of asthma
wheezing, shortness of breath
36
what are some triggers of asthma
allergens, cold air, exercise, smoke, stress
37
what is the treatment for asthma
inhaled steroids | bronchodilators
38
what is the treatment of asthma in acute worsenings
oxygen oral steroids (prednisone) nebulised bronchodilators
39
what type of respiratory disease is asthma
type 2