Smoking Flashcards
What is the effect of smoking on lungs?
- Increases neutrophils
- Interferes with ciliary motility
- Damages epithelium + inhibits alveolar leukocytes = inflam
What is chronic bronchitis?
Inflam of airway = cough + sputum on most days
What is the pathology of chronic bronchitis?
- Hypertrophy of submucosal glands
- Increase no. goblet cells + mucociliary dysfunction = mucous hypersecretion + retention
- Retained mucus more likely to become infected = inflam > thickening (fibrous scar tissue) > narrowing
What is emphysema?
Abnormal + permanent dilation of airspace destruction of their walls
Loss of elastic recoil
What is alpha-1 antitrypsin deficiency associated with?
COPD
What is the pathology of emphysema?
Elastic degraded =
- Hyperinflation or ballooning of alveoli
- Destruction of alveolar + capillary walls
- Loss of lung elasticity
What are the symptoms of emphysema?
- Progressive breathlessness
- Cough with sputum
- Wheeze
- Oedema
- Fatigue, weight loss, loss of appetite
What are the clinical features of emphysema?
- Hyperinflated chest = air trapping
- Breathing quickly + using accessory muscles
- Cachexic
- Reduced breathing sounds/wheezing
- Prolonged expiration
- Pursed lip breathing
What is the FEV1:FEV in obstructive LD?
< 0.7
What is the FEV1:FEV in normal/restrictive LD?
> 0.7
If FEV1 + FVC >80% predicted = normal
If FEV1 + FVC <80% predicted = restrictive
How is COPD an example of premature ageing?
Stiff heart
Loss of bone density + skeletal mass + strength
Which receptors are sympathetic?
Adrenergic - B1, B2
Which receptors are parasympathetic?
Muscarinic - M1, M2, M3
What is the MOA of B2 agonists (LABA)?
Stimulate B2 = activation of adenylate cyclase = increased cAMP = smooth muscle relaxation
What is the MOA of muscarinic antagonists?
Compete with ACh for muscarinic receptors = inhibits contraction of airway smooth muscle
