Respi week: obstructive respiratory disease

Question 1

Describe pathophysiology of chronic bronchitis

Answer 1

Mucous gland hypertrophy + hyperplasia leading to chronic inflammation

Question 2

Describe pathophysiology of emphysema

Answer 2

Destruction of distal to terminal alveoli, loss of elastic recoil

Question 3

List risk factors for COPD

Answer 3

• Smoking
• Occupational exposure eg to dust
• Deficiency of alpha1-antitrypsin
• Age

Question 4

Complications of COPD

Answer 4

• respiratory failure

- cor pulmonale

Question 5

In managing COPD, what factors should be looked into before deciding on management plan?

Answer 5

1. Spirometry (FEV1/FVC ratio)
2. Frequency of exacerbations
3. Dyspnoea scale (grade 1 to 5 from mild to worst)

Question 6

What 3 things define asthma

Answer 6

1. airway limitation
2. airway hyperresponsiveness
3. bronchoconstriction

Question 7

What indicates severe acute asthma

Answer 7

• RR >25/min
• HR >110bpm
• PEFR 30-50% predicted
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Question 8

What indicates life threatening acute asthma

Answer 8

• Exhaustion, Confusion, Coma
• Silent chest, Central cyanosis
• Bradycardia or hypotension
• PEFR <30% predicted
• PaO2< 8kPa