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Pathology And Medicine > Respiratory System and Diseases 2 > Flashcards

Respiratory System and Diseases 2 Flashcards

1
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease

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2
Q

How is COPD characterised?

A

by poor reversible airflow limitation which is usually progressive

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3
Q

What is COPD associated with?

A

persistent inflammatory response of the lung

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4
Q

What is COPD caused by?

A

predominantly cause by smoking in developed countries

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5
Q

COPD Epidemiology

A
  • develops over many years - rarely symptomatic before middle age
  • common in UK - 18% of male smokers - 14% of female smokers - one of the leading causes of lost working days
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6
Q

Aetiology of COPD

A

smoking is the dominant causal agent

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7
Q

Pathogenesis of COPD

A

cigarette smoke -> macrophage epithelial cells ->chemotactic factors -> granulocytes -> proteases -> damage

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8
Q

Factors causing COPD

A

atmospheric pollution
- a minor role compared to smoking

alpha 1 - antitrypsin deficiency
- a rare cause of early-onset emphysema

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9
Q

Pathology of chronic bronchitis - COPD

A
  • chronic inflammation of the airways
    (predominantly lymphocytes)
  • enlargement of mucus-secreting glands of trachea and bronchi
  • airway narrowing and hence airflow limitation
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10
Q

Pathology of Emphysema - COPD

A
  • dilation and destruction of the lung tissue and distal to terminate bronchioles
  • loss of elastic recoil - expiratory airflow limitation and airtrapping
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11
Q

Characteristic symptoms of COPD

A

cough

sputum

breathlessness

wheeze

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12
Q

Signs of COPD

A

tachypnoea

use of accessory muscles of respiration

hyperinflation

poor expansion

others - cyanosis - cor pulmonale

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13
Q

Investigations of COPD

A
  • lung function tests
  • chest x-ray
  • arterial blood gases
  • haemoglobin and PCV
  • ECG or achocardiology
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14
Q

COPD results of lung function tests

A

decreased FEV1

decreased FEV/FVC

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15
Q

COPD results of chest x-ray

A

lungs hyperinflated

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16
Q

COPD results of arterial blood gases

A

normal or hypoxia and hypercapnia

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17
Q

COPD results of haemoglobin and PCV

A

high levels

18
Q

ECG or achocardiology of COPD

A

to assess cardiac status if clinical features of cor pulmonale

19
Q

Treatment of COPD

A
  • smoking cessation
  • drug therapy - bronchodilators, corticosteroids, antibiotics etc
  • treatment of respiratory failure
  • other measures - heart failure, secondary polycythaemia
20
Q

Complications of COPD

A
  • respiratory failure
  • cor pulmonale - right heart failure secondary to lung disease
21
Q

Prognosis of COPD

A
  • 50% patients with severe breathlessness die with in 5 years
22
Q

Asthma

A

a common chronic inflammatory condition of the lungs

23
Q

What is asthma?

A

hyper-reactivity of bronchial tree with paroxysmal narrowing of the airway

24
Q

What are the three characteristics of asthma?

A
  • airflow limitation
  • airway hyper-responsiveness
  • inflammation of the bronchi
25
Q

Are airflow limitation reversible in asthma?

A

yes

26
Q

Epidemiology of asthma

A

increasing prevalence

geographical variation

more common now in developed countries

much rarer in far easter countries

27
Q

Aetiology/development of asthma

A

atopy and allergy
- readily develop IgE against common environmental antigens - genetic and environmental factors affect IgE levels

increased responsiveness of the airways of the lungs (a fall in FEV1) stimuli

28
Q

Pathogensis of asthma

A

Primary Abnormality
- narrowing of the airway
- thickening of the airway wall
- secretions within the airway lumen

Inflammation
- cellular components
eosinophils, t-lymphocytes, macrophages and mast cells
-> release inflammatory mediators

Remodelling
- structural changes in the airway

29
Q

Precipitating factors of asthma

A

Occupational Sensitisers

Non-specific factors which may cause when you sneeze
-> drugs, cold air, exercise, viral infections

Rare cause of asthma
- airborne spores of aspergillum fumigates - a soil mould

30
Q

Clinical Features of asthma

A

wheezing attacks

episodic shortness of breath

some have one or two attacks a year - others have chronic symptoms

on examination during attack
- reduced chest expansion, prolonged expiratory time and bilateral expiratory polyphonic wheeze

31
Q

Treatment of Asthma

A

Control of extrinsic factors

Drug treatment
- bronchodilators

  • anti-inflammatory agents
32
Q

Examples of Bronchodilators used to treat asthma

A

beta2 adrenergic agonists

animuscarinic bronchodilators

theophyllines

33
Q

Examples of Anti-Inflammatory used to treat Asthma

A

Steroids

Chromones

Leukotriene receptors antagonist

Immunosuppressive agents

34
Q

Types of Lung Tumours

A

Primary
Secondary

35
Q

What percentage of primary lung tumours are primary carcinoma?

A

95%

36
Q

Factors about primary carcinoma of lungs?

A
  • most common malignant tumour in the world
  • poor prognosis
  • 5 year survival rate <10%
37
Q

Major risks of primary carcinoma?

A
  • directly related to smoking
  • associated with occupational exposure to carcinogens
  • pulmonary fibrosis
38
Q

Primary carcinoma pathology

A
  • most arising from bronchi - hilum
  • main histological types
    -> squamous cell carcinoma
    -> small cell lung carcinoma
    -> adenocarcinoma
    -> large cell undifferentiated carcinoma
39
Q

Clinical Features of Primary Carcinoma

A

cough

chest pain

haemoptysis

weight loss

40
Q

Diagnosis of Primary Carcinoma

A

Chests x-ray

CT

Biopsy and cytology

41
Q

Treatment of Primary Carcinoma

A

surgical resection
- non small cell lung cancer

chemotherapy
- small cell lung cancer

radiotherapy
- localised tumours

poor prognosis

Pathology And Medicine (15 decks)

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