Obstructive Respiratory Diseases

Question 1

What is obstructive respiratory Diseases? and what does it include

Answer 1

They are diseases that the problem is with Breathing out. There is a problem with expelling CO2 but no problem with breathing in O2

Question 2

What are the stats of obstructive disease

Answer 2

Typically the O2 levels are normal, CO2 is high, the pH is acidic (low) and breathing in is normal

Question 3

What is the respiratory pH of the Obstructive

Answer 3

Respiratory Acidosis

Question 4

What are the categories of presentation of obstructive

Answer 4

Hypoventilation, Acidosis, Asthma, COPD: Chronic Bronchitis, Emphysema, Bronchiectasis: Cystic Fibrosis, Opioids and Sedatives

Question 5

What is Asthma

Answer 5

Chronic inflammatory disorder of the airways due to BRONCHOCONSTRICTION. Is reversible airway disease.

Question 6

What do you tend to see in the smooth muscle

Answer 6

Macrophages, mucus, hypertrophy and hyperplasia

Question 7

What is the mechanism of Asthma

Answer 7

As the pollen dendritic cell, it activates the T cell receptor or the Th2 cells that starts the IL-4 and IL-5. IL-5 activates eosinophils. IL-4 activates the IgE B cells. On re-exposure to antigen (Ag), the immediate reaction is triggered by Ag-induced cross-linking of IgE bound to Fc receptors on mast cells. These cells release preformed mediators that directly and via neuronal reflexes induce bronchospasm,increased vascular permeability, mucus production, and recruitment of leukocytes.

Leukocytes recruited to the site of Reaction (neutrophils, eosinophils, and basophils; lymphocytes and monocytes)release additional mediators that initiate the late phase of asthma. Several factors released from Eosinophils (e.g., major basic protein, eosinophil cationic protein) also cause damage to the epithelium and airway constriction

Question 8

What are some of the mediators

Answer 8

Leukotrienes: C4,D4 and E4 - bronchoconstriction and vascular permeability
ACH - contraction
Histamine - potent constrictor
IL-13 - Increase airway/ hyper-responsive
ADAM33- Bronchial smooth muscle, proliferation and fibroblasts proliferation

Question 9

What are the types of mechanism

Answer 9

Hygiene, Atopic and Non-topic

Question 10

What is hygiene Asthma

Answer 10

Where the cause of the asthma is due the the cleanness of the environment now. not being exposure to the different allergies

Question 11

What is Atopic Asthma

Answer 11

It is dealing with hypersensitivity to allergens. you see this in patients that have had or have rhinitis or eczema.

Question 12

What is Non-Atopic Asthma

Answer 12

this is deals with viral infections like Rhinovirus, Parainfluenza or pollutants

Question 13

What does you see in the histology slides for asthma

Answer 13

Curshmanns crystals and Charot-Leaden crystals

Question 14

What are you signs and symptoms of Asthma

Answer 14

Coughing
Chest pain
SOB or Breathlessness
Wheezing

Question 15

What are the RED FLAGS of Asthma

Answer 15

Severe tachpnea/ tachycardia
Respiratory muscle fatigue 
Diminished expiratory effort 
cyanosis 
silent chest

Question 16

What are the triggers of asthma

Answer 16

allergens, Medications, Irritants and Upper respiratory infections

Question 17

What is drug induced Asthma

Answer 17

Aspirin exacerbated respiratory Disease (AERD) : Patients have intolerance to aspirin, and the NSAID—> Develop recurrent rhinitis, nasal polyps, urticaria, and brochospasms with 2 hrs of ingestion of NSAID

Question 18

What is one of the signs of drug induce Asthma and what are the signs

Answer 18

Salter’s Triad:

Aspirin, Asthma and Nasal Polyps

Question 19

What is COPD

Answer 19

Chronic obstructive Pulmonary Diseases where there is chronic obstructive or blockage of the airflow

Question 20

What are the types of COPD

Answer 20

Chronic Bronchitis and Emphysema

Question 21

What is chronic Bronchitis

Answer 21

it is a progressive cough that happens for 3 months with 2 years succession. it is the narrowing of the lumen with mucous and inflammation

Question 22

What is emphysema

Answer 22

it is a progressive SOB with a permanent enlargement or dilations of the terminal bronchioles.

Question 23

What are the types of emphysema? and what are the associated with

Answer 23

Centracine: Smoking

Paracinar- alpha anti-trypsin

Question 24

What are the complications with COPD

Answer 24

Right heart failure
ventricular hypertrophy
pulmonary hypertension

Question 25

What is bronchiectasis

Answer 25

permanent dilation of bronchi and bronchioles that is caused by destruction of the muscle and the supporting elastic tissue

Question 26

What causes bronchiectasis

Answer 26

there are two types of causes : acquired: it is due to chronic necrotizing infection (P.aeruginosa, S. aureus, Klebsielaa and TB). Secondary to resisting infection or obstruction

Congenital:( cystic fibrosis is the most common cause in US) and immundofiecices predisposing to repeating bacterial infection kartagenener Syndrome

Question 27

What are the manifestations of Bronchiectasis

Answer 27

Cough, Purulent sputum, hemolysis and clubbing

Question 28

What is Cystic Fibrosis

Answer 28

Autosomal recessive disease in Caucasians where there are defective protein folding that causes chloride transport dysfunction. this leads to thick secretion from glands in lungs, pancreas, skin, reproductive organs and blockage of secretory. there is also a defective CF transmembrane conductor regulator

Question 29

What are the manifestations of CF

Answer 29

Salty tasting skin, Poor growth, recurrent lung infection, meconium ileum, rectal prolapse, pancreatic insufficiency, Diabetes Mellitus, Osteoporosis, Infertility and Gallstones