Pulm - COPD Flashcards
How are FEV1, FVC, and their ratio affected in COPD?
decreased FVC
more decreased FEV1
FEV1/FVC is therefore decreased
Is TLC affected in COPD?
yes it is increased - air trapping
What are four diseases that can cause COPD?
- chronic bronchitis
- emphysema
- asthma
- bronchiecstasis
What is the requirement to be diagnosed with chronic bronchitis?
symptoms lasting at least 3 mos over 2 years
What pathologically occurs in chronic bronchitis?
hypertrophy and hyperplasia of mucus glands
thickness >50%
What causes obstruction in chronic bronchitis
mucus plugs
What is the nickname for people with chronic bronchitis?
blue bloaters - cyanosis and edema
What pathologically occurs in emphysema?
alveolar air sacs are destroyed
Why are the alveolar air sacs destroyed in emphysema?
imbalance of proteases and antiproteases
Where would the emphysema be located in a smoker?
centriacinar emphysema, upper lobes
lots of inflammation - increased proteases
Where would emphysema be located in alpha 1 antitrypsin deficiency?
panacinar emphysema, lower lobes
decreased antiproteases
What other organ tends to get damaged from alpha1 antitrypsin deficiency?
the liver - cirrhosis -protein accumulates in the ER
What allele is typically mutated in alpha1 antitrypsin?
PiZ
What is the nickname for people with emphysema?
pink puffers - prolonged expiration with pursed lips
- create back pressure to get air out
- remain oxygenated so they are pink
How does the body of a person with emphysema change?
barrel chest
What type hypersensitivity reaction causes asthma?
type 1
Asthma is a TH2 induced exaggerated immune response, what cytokines are therefore secreted and what are their roles?
IL4 - class switching to igE
IL5 - recruits eosinophils
IL10 - inhibit production of TH1
What is seen in the sputum of asthmatics?
curschmann spirals with charcot leyden crystals
What is bronchiecstasis?
permanent dilation of bronchioles and bronchi
destruction of elastic material
What two viruses usually cause localized nonobstructive bronchiecstasis?
adenovirus and RSV
what are two inherited conditions that can cause nonobstructive bronchiecstasis?
CF and kartageners
What are some complications of bronchiecstasis?
hypoxemia
cor pulmonale
secondary amyloidosis - chronic inflam
