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Airway disease Flashcards

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1
Q

what are three forms of obstructive airway syndrome

A

asthma, chronic bronchitis, emphysema

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2
Q

what determines whether it is restrictive of obstructive

A 
airways= obstructive 
lungs= restrictive
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3
Q

what is ACOS

A

asthma/ COPD overlap syndrome; COPD with reversibility and eosinophilia that respond to steroids

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4
Q

who gets ACOS

A

long standing smokers

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5
Q

what inflammatory agent causes asthma

A

eosinophils

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6
Q

what causes chronic bronchitis and which inflammatory agent in involved

A

smoking

neutrophils

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7
Q

what is emphysema due to and how is it characterised

A

due to destruction of alveolar walls leading to loss of alveolar support and collapsing

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8
Q

which division of the airways starts the conducting/as exchange section of the lungs

A

after 17

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9
Q

what maintains the integrity of the alveoli

A

alveolar walls

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10
Q

what does onset mean

A

age in which it started

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11
Q

what is atopic asthma

A

caused by an allergen

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12
Q

what is intrinsic asthma

A

no obvious extrinsic trigger involved

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13
Q

what is extrinsic asthma

A

caused by extrinsic trigger factor

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14
Q

what is airway hyperresponsiveness

A

when the airways are excessively twitchy to stimuli

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15
Q

what does chronic airway inflammation lead to

A

exacerbations and airway hyper responsiveness

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16
Q

what airway remodelling lead to

A

fixed airway obstruction

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17
Q

describe remodeling and how it is prevented

A

collagen deposition, thickening, hypertrophy;

via treatment

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18
Q

what can monocolonal antibodies target

A

leukotrine D4, LT3,4,5, histamine, IgE

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19
Q

describe two pathological features of severe asthma

A

epithelial shedding, mucus plugging

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20
Q

what follows (3) the inhalation of noxious substances that results in COPD

A

inflammation, mucociliary dysfunction, tissue damage

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21
Q

what are the characteristics of COPD

A

reduced lung function and exacerbations

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22
Q

what are the symptoms of COPD

A

breathlessness and reduction in quality of life

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23
Q

when can inflammation of the lungs lead to COPD

A

when normal repair/ protective mechanisms are overwhelmed or defective

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24
Q

describe the 5 pathological features of chronic bronchitis

A

chronic neutrophilic inflammation, mucus hypersecretion, mucociliary dysfunction, altered lung microbiome, smooth muscle spasm and hypertrophy, partially reversible

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25
describe the 4 pathological characteristics of emphysema
alveolar destruction, impaired gas exchange, loss of bronchial support, irreversible
26
what are the symptoms of COPD
chronic- not episodic, non-atopic, daily productive cough, progressive breathlessness, frequent ineffective exacerbations
27
what is a specific symptom of chronic bronchitis
wheezing
28
what is a specific symptom of emphysema
reduced breath sounds
29
what is the chronic cascade in COPD
progressive fixed airflow obstruction, impaired alveolar gas exchange, respiratory failure, right ventricular hypertrophy/failure, death
30
describe how ACOS is diagnosed
COPD with blood >3% eosinophilia, more reversible to salbutamol
31
what are the 4 non pharmacological managements for COPD
stopping smoking, immunisation, physical activity, oxygen
32
what are the 4 pharmacological treatments for COPD
LAMA or LABA mono, LABA/LAMA combo, ICS/LABA combo, ICS/LABA/LAMA combo
33
Asthma vs COPD | caused by smoking
COPD
34
Asthma vs COPD | allergic
asthma
35
Asthma vs COPD | only late onset
COPD
36
Asthma vs COPD | intermittent not chronic
asthma
37
Asthma vs COPD | non productive cough
asthma
38
Asthma vs COPD | non progressive
asthma
39
Asthma vs COPD | neutrophillic inflammation
COPD
40
Asthma vs COPD | eosinophillic inflammation
asthma
41
Asthma vs COPD | diurnal variability
asthma
42
Asthma vs COPD | poor corticoidsteriod response
COPD
43
Asthma vs COPD | good response to bronchodilators
asthma
44
Asthma vs COPD | reduced FVC and TLCO
COPD
45
Asthma vs COPD | impaired gas exchange
COPD
46
what does DLPD stand for
diffuse parenchymal lung disease
47
what are 3 causes of thoracic restriction outwith the lungs
skeletal; curved spine, deformity, broken ribs muscle weakness; intercostal or diaphragmatic abdominal obesity/ascites; compression of thoracic contents
48
describe the causes of thoracic restriction due to disease within the lungs
disease of alveolar structures; alveolar walls/lumen, ipaired gas exchange
49
what are the three classifications of chronic DLPD
due to occupational pr environmental agents or drugs, with evidence and without evidence of systemic disease
50
describe the gas exchange of O2 and CO2 in restrictive thoracic disease
impaired alveolar barrier to O2 gas exchange decreased PaO2 | CO2 unchanged as alveolar ventilation the same and solubility of CO2 v high
51
describe the cause of DLPD
fluid in the alveolar air sacs; cardiac pulmonary oedema- due to increased PO venous pressure or non cardiac po oedema- normal pressure with leaky vessels due to sepsis or trauma
52
what does ARDS stand for
acute respiratory distress syndrome
53
what is the consolidation of alveolar air spaces
when regions of lung tissue fill with fluid
54
what diseases can cause consolidation
infective pneumonia, infarction (interruption of blood supply e.g pulmonary emboli), BOOP (bronchitis obliterans organising pneumonia), COP (cryptogenic organising pneumonia)
55
what is an alveolitis
inflammatory infiltrate of alveolar walls
56
in terms of an alveolitis what is farmers lung
extrinsic-allergic-alveolitis
57
farmers lung is an example of a granulomatous-alveolitis, name another
sarcoidosis
58
what is a type 1/3 allergic response composed of mediated by
eosinophils | mediated by IgE
59
what else can cause alveolitis (4)
drug, fumes, pulmonary fibrosis, autoimmune
60
what is a glandular adenoma
a cancer that metastasises via lungs or lymph nodes to the lungs
61
what are the two categories of dust disease
fibrotic (lays down collagen) and non fibrotic
62
what is it called when a cancer causes DPLD
carcinomatosis
63
give the four things that cause an eosinophilic type 1/3 allergic response
parasites, drug, fungal, autoimmune
64
what is the clinical presentation of DLPD
breathless on exertion, cough no wheeze as no obstruction to airflow, finger clubbing, inspiratory lung crackles, central cyanosis (if hypoxaemic), pulmonary fibrosis- end stage f chronic inflammation
65
what are the other causes of finger clubbing (4)
inflammatory heart/bowel disease, liver disease, lung cancer, interstitial lung disease
66
what are crackles the sound of
the alveolar opening
67
what does DLCO stand for
diffusion lung capacity of oxygen
68
true or false; inhaled steroids are effective in the treatment of interstitial lung disease
false- not effective
69
what type of steroids should be used to treat interstitial lung disease
oral/systematic
70
what type of drugs dissolve collagen
don't exist
71
what can slow the process of fibrosis
drugs
72
what are two antifibrotic agents
pirfenidone, nintedanib
73
is fibrosis completely irreversible
yeah
74
how can history be used to diagnose DLPD
occupation, pets, drugs, arthritis
75
how can lung volumes show a patient has DLPD
reduced lung volumes; reduced FEV1 reduced FVC normal ratio >75%
76
diangosis- what is peak flow like in DLPD
normal
77
diagnosis- how if DLCO in DLPD
reduced
78
diagnosis-what is arterial saturation like in DLPD
decreased PaO2 and SaO2
79
can an x-ray be used to diagnose DLPD
yes
80
how can an echocardiogram diagnose DLPD
exclude heart failure and diagnose secondary pulmonary hypertension
81
what immunolgical component can be used to diagnose DLPD
antibodies
82
how can an a CT scan be used in the diagnosis of DLPD
distinguishes between inflammatory ground glass and fibrotic nodular component in alveolar infiltrates
83
is ground glass opacity treatable
yes
84
how is DLPD treated
removal of allergen, treat any reversible alveolitis (e.g. ground glass in HRCT) via immuno-suppressants, 1st line treatments= systemic steroids, 2nd line treatment= steriod sparing (e.g oral Azathioprine),
85
what is IPF
idiopathic pulmonary fibrosis
86
how is IPF treated (holistic)
anti-fibrotic agents, O2 if hypoxaemic, treatment of secondary po hypertension, last resort lung transplant
87
what does idiopathic mean
unknown cause

Respiratory (26 decks)

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