Other respiratory conditions Flashcards
COPD
:D
COPD:
- Describe C
- Describe O
- Is airway obstruction both reversible (by what?) and non-reversible (due to what?
- What are the 2 types of COPD
Chronic and progressive
Airway is obstructed
Reversible by bronchodilators, non reversible due to airway remodelling
Chronic bronchitis and emphysema
Do you need to know about chronic bronchitis and emphysema?
Yes
Do you need to know the risk factors for COPD
/
Yes
Chronic and acute aspects of pathophysiology:
- what immune cell is predominant in each?
- Do you need to know more detail?
ChroNic: Neutrophils
AcutE: Eosinophils
Yes
Diagnosis: what will happen to: -FEV1 -FVC %FEV1/FVC Peak expiratory flow rate -Flow volume diagram -Do you need to know symptoms and FEV1 decreases for mild/mod/severe COPD?
FEV1 decreases FVC doesn't change FEV1/FVC decreases PEF decreases Cove shaped Yes
Asthma vs COPD: differences in terms of
- Nature of airway obstruction
- Whether airflow obstruction can be improved
- Age of onset
- Do you need to know immune cell changes?
More intermittent vs progressively worsening
Improvement vs less improvement
Young vs 60+
Yes
Do you need to know COPD epidemiology
Yes
What are early interventions for COPD?
Encourage smoking cessation
Encourage exercise
Encourage flu and pneumococcal vaccinations
Treat comorbidites
What are the pharmacological therapies for COPD
Dilators
Corticosteroids
Alpha-1 antitrypsin replacement
Do you need to know more about dilators?
Yes
Corticosteroids: describe efficacy in
- Chronic vs acute COPD
- COPD vs asthma
Not good in chronic (mainly neutrophils and macrophages), but good for acute (work on eosinophils)
Not as good as in treating asthma
Should corticosteroids by the oral route be used long term, why?
No, due to sdie effects
What factors should be considered when prescribing steroids for COPD
Frequency of exacerbations
Levels of eosinophils
Alpha 1 antitrpysin:
- Where is it usually produced?
- After it is produced, what is its mechanism?
- What happens with alpha 1 antitrypsin deficiency
Liver
Travels to lung and coats it; protects lung elastin from being degraded by neutrophil elastase.
Alpha-1 antitrypsin gets stuck in liver, neutrophil elastase degrades elastin
What medication is used to treat alpha 1 antitrypsin deficiency?
Alpha 1 proteinase inhibitor Zemaira
What are late stage interventions
Oxygen therapy
Surgery
Surgery
- Can surgery to reduce lung volume improve breathlessness?
- Is transplantation viable?
Yes
How much oxygen therapy is needed per day?
15 hours