Obstructive Pulmonary diseases Flashcards
define obstructive pulmonary disease
conditions characterized by increasing airflow resistance as a result of airway obstruction or narrowing
discuss asthma KNOW THIS
airway inflammation and airway hyper-responsiveness
what does degree bronchoconstriction in asthma related to ?
1) degree of airway inflammation
2) airway hyper-responsiveness
3) exposure to triggers (ex: infection, allergens)
discuss path of asthma in the early phase
allergen or irritant attaches to IgE receptors on mast cells which then release chemical inflammatory mediators like histamine
- epithelial damage
- intense inflammation
-increase vasodilation and permeability
- bronchial smooth muscle constriction
- peaks within 30-90 minutes after exposure to the trigger
- subsides in another 30-90 minutes
discuss asthma in the late phase response patho
inflammatory cells involved in asthma (eosinophils and neutrophils) infiltrate the airway, release mediators that induce further inflammation causing mast cells to degranulate basically histamine and other mediators released = self-sustaining cycle
- peaks 5-12 hours after exposure
- lasts from several hours to days
- primary characteristic is inflammation as opposed to bronchial smooth muscle contraction
discuss asthma key take aways
- reduction in airway diameter
- increase in airway resistance
- hypertrophy
what is an unpredictable sign of asthma?
Wheezing is an unpredictable
sign for gauging severity of attack
also note changes in vital signs
what is asthma status asthmaticus
life threatening medical emergency
- its basically an extreme form of acute asthma attack that doesnt respond to the medications
you get hypoxia, hypercapnia and acute respiratory failure all at once
NOTE: the first 2 happens because pt will hyperventilate to control to maintain oxygen but they will sooner or later become fatigued and CO2 will start to be retained
- happens bc of viral illness or pollution or poor management of asthma
what are 2 types of reliever medications for asthma?
1) bronchodilators: short acting inhaled beta adrenergic agnosists example: salbutamol, ventolin
used for fast relief of attack. not intended to be used for daily treatment.
2) anticholinergics/short-acting muscarinic antagonists: ipratropium, atrovent. THIS IS USED WHEN THE PT CANT HANDLE BETA AGONIST SO THEY USE THIS INSTEAD
what are 2 types of controller medications for asthma?
1) anti-inflammatory medications: corticosteroids
2) bronchodilators: long acting, methylxanthines
what is the primary cause of acute asthma attack?
viral respiratory infections
What do you call asthma where the only symptom is a cough?
cough variant asthma
discuss COPD
- it’s preventable
- characterized by persistent airflow limitation inflammation in the lung parenchyma (bronchioles and alveoli)
basically inflammation of bronchioles and excess sputum
how does COPD happen?
1) airflow limitations during forced exhalation that are caused by loss of elastic recoil and are not fully reversible - emphysema
2) airflow obstruction caused by mucus hyper secretion, mucosal edema and bronchospasm - chronic bronchitis
what does the inflammation from COPD cause?
destroys the tissues and hinders the normal defence mechanism and repair of the lungs
the inflammation also attracts inflammatory cells leukotrienes and interleukins for structural chnage
what is the shape of the chest with COPD?
Because air occurs due to the inability to expire, the chest hyper-expands creating a barrel chest as respiratory muscles cannot function properly
what is the ultra combination of COPD in someone?
suspect COPD in pt who
1) has cough
2) sputum production
3) dyspnea and history of smoking
what are the 2 types of COPD?
1) emphysema: destruction of alveoli which decreases gas exchange
2) chronic bronchitis : airway inflammation + excess sputum + cough
what are 4 complications of COPD?
1) Cor pulmonate - hypertrophy of right side of heart with or without heart failure as a result of pulmonary hypertension
2) Acute exacerbation of COPD: sustained worsening of COPD symptoms
- many exacerbations caused by bacterial infection
3) Acute respiratory failure: overall decline in lung function, deterioration in health status, risk of death
4) depression and anxiety
how is COPD treated?
bronchodilators and corticosteroids
usually pt education route so stop smoking, active lifestyle, short acting bronchodilators PRN. spirometry and prevention
if it gets really bad then its ling transplant or end of life care
what is the difference between asthma and COPD?
Asthma
- < 40 yrs old
- triggered
- stable with exacerbation
- spirometry normalizez condition
COPD
- > 40 yrs
- smoker
- sputum
- progressively worsens
- spirometry may improve but never normalize
What is the normal range for copd oxygen?
88-93
