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PA1: Physiology > Week 3 Respiratory Disorders ✅ > Flashcards

Week 3 Respiratory Disorders ✅ Flashcards

1
Q

What is the difference between chronic bronchitis and emphysema?

A

Chronic bronchitis = productive cough

Emphysema = structural changes

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2
Q

How does FVC change in COPD?

A

FVC is lower

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3
Q

How does FEV1 change in COPD?

A

FEV1 is lower

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4
Q

What is a normal FEV1:FVC and in COPD?

A

Normal
FEV1:FVC = 4L:5L = 80%

COPD

FEV1:FVC = 2L:5L = 50%

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5
Q

How does TLC change in COPD?

A

Higher due to air trapping

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6
Q

How is elastin and collagen broken down in emphysema?

A

Smoking
Inflammatory reactions in alveoli
Produces IL-8, TNFa, leukotriene B4
Stimulates immune cells
Stimulates proteases (proteases and collagenases)
Breaks down collagen and elastin
Alveoli collapse

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7
Q

How does loss of elastin affect respiration?

A

Breakdown of septa
Larger spaces created
Reduced surface area
Affects O2 and CO2

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8
Q

What are the 3 different types of emphysema?

A

Centriacinar/centrilobular
Panacinar
Paraseptal

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9
Q

Where does emphysema usually affect?

A

Acinus (end of airway)

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10
Q

What is centriacinar/centrilobular emphysema?

A

Only damages central/proximal alveoli
Affects upper lobes

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11
Q

What is panacinar emphysema?

A

Entire acinus affected
Affects lower lobes

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12
Q

Which type of emphysema is associated with a1 anti-trypsin deficiency?

A

Panacinar emphysema

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13
Q

What is paraseptal emphysema?

A

Distal alveoli most affected
Affects periphery of lobes
Can rupture and cause pneumothorax

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14
Q

Which is the most common type of emphysema?

A

Centriacinar/centrilobular

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15
Q

What are the symptoms of emphysema?

A

Dyspnoea
Breathing slowly through pursed lips “pink puffers”
Weight loss due to extra effort breathing
Cough
Barrel chest - air trapping and hyperinflation

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16
Q

How does emphysema affect the heart?

A

If there is poor gas exchange in a healthy person, vasoconstriction can divert blood to efficient area

However

COPD too many vessels involved so right side of heart works harder –> cor pulmonae –> right sided heart failure

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17
Q

What is the treatment of emphysema?

A

Stop smoking
O2
Bronchodilators, inhaled steroids, antibiotics for secondary infections

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18
Q

What does the mucosa consist of?

A

Epithelial cells and lamina proper

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19
Q

What does the submucosa consist of?

A

Smooth muscle

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20
Q

What is the atopic triad?

A

Asthma
Atopic dermatitis
Allergic rhinitis

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21
Q

Which immune cells work against allergens?

A

TH2

22
Q

What is the role of dendrites in asthma?

A

Dendritic cells present allergen to TH2

TH2 releases IL-5 which recruits eosinophils –> cytokines and leukotrienes released

TH2 also releases IL-4 which activates IgE which releases histamine, prostaglandins etc

23
Q

When eosinophils release chemical mediators, what happens?

A

Damage endothelium

24
Q

What happens in type 1 asthma?

A

Smooth muscle spasm
Increased mucus
Airways narrowed
Increased vascular permeability
Increased immune cells

25
Q

What are the long term complications of asthma?

A

Oedema
Scarring
Fibrosis
Thickening basement membrane

26
Q

What are the TRIGGERS for asthma?

A

Pollution
Allergens
Mould
Cigarettes

27
Q

What are the symptoms of asthma?

A

Chest tightness
Dyspnoea
Wheeze
Cough
Sputum (curschmann spirals/charcot-leyden crystals)

28
Q

How is asthma classified?

A

Frequency of symptoms
Night time/early morning
FEV1
PEFR
Frequency of medication use

29
Q

What are the classifications of asthma?

A

Intermittent
Persistent
Moderate persistent
Severe persistent

30
Q

What are the treatments of asthma?

A

Avoid trigger
Medications:
Bronchodilators
Corticosteroids
Long acting B agonists
Leukotriene antagonists
IV steroids, magnesium sulfate, O2

31
Q

How is chronic bronchitis defined?

A

Productive cough >3m

32
Q

What are the risk factors for chronic bronchitis?

A

Smoking, air pollutants, dust, genetic factors

33
Q

What happens in the airways in chronic bronchitis?

A

Lungs do not empty properly, air is stuck, so lower volume of air expired (FVC), especially FEV1

34
Q

What is a normal FEV1:FVC radio and what is it like in COPD?

A

Normal FEV1:FVC is 4L/5L = 80%

COPD FEV1:FVC is 2L/4L = 50%

35
Q

What is the TLC of COPD and why?

A

Higher because of air trapping

36
Q

What is Reid Index and what is it in chronic bronchitis compared to normal?

A

Thickness of glands/thickness of wall

Normal = <40%
Chronic bronchitis = >40%

37
Q

What can vasoconstriction in the lungs lead to?

A

Increased pulmonary vascular resistance

Pulmonary hypertension

Right heart hypertrophy

Right heart failure

Cor pulmonale

38
Q

What is the treatment for chronic bronchitis?

A

Reduce risk factors (stop smoking)
Supplemental O2
Bronchodilators, inhaled steroids, antibiotics

39
Q

How is emphysema caused?

A

Phagocytes release elastase which breaks down elastin in alveolar walls

40
Q

What happens in emphysema?

A

Reduced elastic recoil

Alveoli and small airways collapse which leads to air trapping

Scar tissue thickens walls = obstruction

41
Q

What protects the lungs from elastase?

A

α-1 antitrypsin (produced in liver)

42
Q

What is AAT deficiency?

A

α-1 antitrypsin deficiency

43
Q

How is chronic bronchitis caused?

A

Damaged cells release inflammatory mediators which cause capillary dilation, increased capillary wall leakiness, increased goblet cells and attraction of WBC

44
Q

What does capillary dilation in chronic bronchitis lead to?

A

Red, hot tissue

45
Q

What does increased capillary wall leakiness in chronic bronchitis lead to?

A

Escape of plasma

46
Q

What does increased number of goblet cells in chronic bronchitis lead to?

A

Increased mucus production

47
Q

What does attraction of WBC in chronic bronchitis lead to?

A

Increased inflammation

48
Q

What are the triggers of asthma?

A

Infection, allergens, irritants, exercise

49
Q

What is the MOA of asthma?

A

Mediators are released from mast cells and other WBC including histamine and leukotrienes

50
Q

What does the release of mediators in asthma cause?

A

Swelling of mucosa, excess production of mucus, smooth muscle bronchoconstriction

51
Q

What is a blue bloater?

A

Cyanosis - chronic bronchitis

PA1: Physiology (7 decks)

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