Obstructive Lung Diseases Flashcards
what 2 conditions make up COPD
emphysema and chronic bronchitis
what is emphysema
where there is a breakdown of elastin in the lungs causing bronchiole collapse and enlarged lung air spaces
why is there hyperinflation of the chest in emphysema
the lung has lost elastic tissue so no longer has its recoiling nature - therefore the chest wall can now expand
what is seen in chronic bronchitis
where inflammation of the airways causes hyper secretion of mucus - this leads to goblet cell proliferation and cilia damage
what are the causes of COPD
smoking, alpha-1-antitrypsin deficiency and pollution
what are the symptoms of COPD
cough, sputum, breathlessness, barrelled chest, increased breathing rate, wheezing use of accessory muscles, cyanosis
how do you diagnose COPD
history and spirometry
what would you see in spirometry for COPD
scooped expiration, lower FEV1
true or false: COPD is reversible with bronchodilators
false
what is the management for COPD
stop smoking bronchodilators inhaled steroids pulmonary rehabilitation long term oxygen therapy lung volume reduction surgery
what is pulmonary rehabilitation
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
give an example of a bronchodilator
salbutamol
what is the side effect of salbutamol
not fully selective so also works on beta 1 receptors on the heart to cause tachycardia
what receptors does salbutamol work on
beta 2 in the lungs causing airway relaxation
in an acute exacerbation of COPD what treatment would you give
oxygen
oral steroids - prednisone
nebulised bronchodilators
what is the inheritance pattern of cystic fibrosis
autosomal recessive
what does the mutation in cystic fibrosis result in
the CFTR to not be inserted into the membrane
what are the symptoms of cystic fibrosis
thick mucus - giving lung infections, malabsorption and digestive problems
what is done to diagnose cystic fibrosis
sweat test
heel prick test in babies
why do you get malabsorption in cystic fibrosis
as the mucus blocks pancreatic secretions so the chyme can’t be broken down
why do patients experience recurrent chest infections in cystic fibrosis
due to the mucus trapping bacteria in their lungs
What is bronchiectasis
chronic dilation of the bronchi
how is the mucus affected in bronchiectasis
dilation of the bronchi means that the mucus can’t be cleared well - this predisposes to infection
true or false: asthma is irreversible
false - reversible with bronchodilators
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
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
what is the difference in coughing in COPD and asthma
COPD have a chronic cough but asthma does not
what is asthma
chronic inflammation of the airways causing an obstructive airflow
what do the antigen trigger activation of in asthma
TH2 cells
what is the action of the TH2 cells in asthma
release cytokines which attract and activate eosinophils and IgE producing B cells
what type of hypersensitivity reaction occurs immediately in a asthma
type 1 - the IgE antigen interaction causes mast cell degranulation leading to bronchoconstriction
what type of hypersensitivity reaction occurs in the later stage of asthma
type 4 - where eosinophils cause inflammation
what does inflammation in asthma cause
mucosal swelling, thickening of bronchial walls, over production of mucus, hyper-responsiveness
what is hyper-responsiveness in asthma
where the inflammation makes the airways more susceptible to attacks by non-allergens
what are the symptoms of asthma
wheezing, shortness of breath
what are some triggers of asthma
allergens, cold air, exercise, smoke, stress
what is the treatment for asthma
inhaled steroids
bronchodilators
what is the treatment of asthma in acute worsenings
oxygen
oral steroids (prednisone)
nebulised bronchodilators
what type of respiratory disease is asthma
type 2
