Pulmonary Flashcards
what are the 2 classic types of COPD?
chronic bronchitis, emphysema
chronic bronchitis is
a clinical diagnosis
emphysema is
a pathologic diagnosis
the two chronic bronchitis and emphysema
often coexist (pure emphysema or pure chronic bronchitis is rare)
COPD is the 4th
leading cause of death in the US
4 risk factors for COPD?
- tobacco smoke (indicated in 90% of COPD pts)
- alpha1 antitrypsin def
- environmental factors (second had smoke)
- chronic asthma
explain the 2 pathogenesis of chronic bronchitis
- excess mucus production narrows the airways –> pts have productive cough
- inflammation and scarring in airways, enlargement of mucous glands, and smooth muscle hyperplasia lead to obstruction
explain the pathogenesis of emphysema
destruction of alveolar walls is due to relative excess in protease (elastase) activity, or relative deficiency of antiprotease (alpha 1 antitrypsin) activity in the lung
where does elastase come from?
macrophages, and it digests human lungs (alpha 1 antitrypsin blocks elastase)
how does tobacco smoking contribute to emphysema?
smoking increases the number of activated macrophages –> more elastase production and increases oxidative stress on the lung by free radical production
what is FEV1?
the amount of air that can be forced out of the lungs in 1 second.
what does it mean to have lower FEV1?
more difficulty one has breathing
what are the values of TLC and FEV1 in airway obstructive dz?
inc TLC, dec FEV1
FEV1/FVC of what value indicates airway obstruction?
less than 0.7
what are the 2 interventions that are shown to lower mortality in COPD?
- home oxygen therapy
2. smoking cessation
