Week 2 - COPD/Asthma

Question 1

Asthma

Answer 1

Chronic disorder of conducting airways caused by IMMUNE reaction.
Episodic bronchospasms.

Patho: Th2 secrete IL-4, production of IgE; IL-5, eosinophil activation; IL-13, stimulate mucus secretion & IgE production. IgE binds to Fc on mast cells releasing grannules. Bronchoconstriction directly triggered by mediators (produced by mast cells).
Mediators =
1. leukotrienes (C/D/E)4.
2. Histamine, PGD2.

Question 2

Emphysema
types?
patho?

Answer 2

Irreversible enlargement of airspaces distal to terminal bronchiole (resp bronchiole/aveolus).

Centriacinar* = resp bronchioles. Panacinar = alveolus/duct.

Centracinar = most common.
Patho: inflammation, protease-antiprotease imbalance (a1-antitrypsin deficiency) (break down connective tissue), oxidative stress lead to alveolar wall destruction.

Question 3

Bronchiectasis

Answer 3

Destruction of smooth muscle & elastic tissue by chronic necrotizing infection leads to DILATION of BRONCHI and BRONCHIOLE.

Uncommon.

Question 4

Sarcoidosis

Answer 4

Systemic granulomatous disease of unknown cause.
presents commonly with bilateral hilar lymphadenopathy (90%).

theory: disordered immune regulation (high CD4 in lung)

Can occur anywhere but typically in lungs and lymph nodes.

Question 5

Obstructive Lung
Diseases

Answer 5

1. Asthma
2. Emphysema
3. Bronchiectasis
4. Chronic bronchitis

VI. small airway disease/bronchiolitis
can be seen in any form of OLD.

Question 6

Restrictive Lung Diseases

Answer 6

Chronic Interstitial & Infiltrative:
1. Pneumoconioses
2. Interstitial fibrosis

Chest wall Disorders:
1. Poliomyelitis
2. Obesity
3. Pleural disease
4. Kyphoscoliosis