COPD Flashcards by Niko McCauley

____ respiratory disease:

decreased total lung capacity, O2, diffusing capacity, and compliance

restrictive

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paraseptal emphysema =

sub-pleural involvement

spontaneous pneumothorax

no COPD

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irregular emphysema =

localized, scar associated

no copd

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emphysema vs chronic bronchitis

pt appearance

blue bloater - CB
E - pink puffer

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cover 95% of alveolar surface

type I pneumocytes

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4 types of COPD

(obstruction to airflow out)

emphysema

chronic bronchitis

asthma

bronchiectasis

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emphysema vs chronic bronchitis

infections

CB common

E- occasional

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physical exam findings chronic bronchitis

productive cough

cyanosis

blue bloaters

dypsnea

expiratory wheezing and ronchi

cor pulmonae

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causes, bronchiectasis

cystic fibrosis

infections (TB adenovirus, H ifluenzae, Staph A.)

bronchial obstruction

primary ciliary dyskinesia

allergic bronchopulmonary aspergillosis

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gros findings bronchiectasis

bilateral lover lobes, distal bronchi, broncioles

dilated airways out to plueral surface

cut surface - bronchi = cystlike with mucopurlent scretions

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tissue distal to termial bronchiole

acinus

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CXR chronic bronchitis

enlarged, horizontal heart

increased bronchial markings

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physical exam findings, emphysema

severe, early onsset dyspnea

pink puffers

chronic bronchitis

cor pulmonae

diminished breath sounds (hyper inflation)

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gross morphology chronic bronchitis

hyperemia, swelling, and edema of mucous membranes

mucinous and mucopurulent secretions

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emphysema vs chronic bronchitis

age

CB - 40-56

E 50-75

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CXR bronciectasis

bronchial markings extending to periphery of lungs

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microscopic findings bronchiectasis

acute inflam exudate in bronchial walls

necrotizing ulceration

squamous metaplasia of bronchial epi

lung abcess

fibrosis > brochiolitis obliterans

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most common cause of bronchiectatsis

genetics?

cystic fibrosis

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pathogenesis cystic fibrosis

chr7 deletion (Phe) >

CFTR transporter for Cl >

increased Na and water reab from luminal secretions, decreased Cl secretion >

>dehydration due to lack of NaCl

emphysema vs chronic bronchitis

cor pulmonae

CB - common

E - rare, terminal

3 causes emphysema

smoking

pollution

a1 antitrypsin deficiency

chronic bronchitis =

productive cough for at least 3months for 2 consecutive years

FEV1/FVC ratio obstructive vs restrictive

obstructive = reduced FEV1/FVC ratio

restrictive = increased

FEV1 =

forced expiratory volume in one second

pathogenesis emphysema

increased macrophages, CD8 Tcells, PMNs \> \> activated by tissue damage \> \>elastase and free radicals from PMNs and macrophages \> \>destruction of elastic tissue \> increased compliance and decreased elasticity

a1-antitrypsin defiency emphysmea (proteas-antiprotease imbalance) impacts lower lung becasue

perfusion and neutrophil numbers greatest

permanent enlargement of all or part of the repiratory unit acompanied by wall destruction without obvious fibrosis

emphysema

Panacinar emphysema= areas affected

a1-antirypsin deficiency genetic (AD) or cigarette smoking lower lobes, all parts of respiratory unit

repair alveolar epithelium

type II pneumocytes

2 types of emphysema

cantriacinar (95%) panacinar

\_\_\_\_ smokers emphysema area of lung impact

centriacinar emphysema \> apical segments of upper lobes

clinical presentation bronchiectasis

copoius sputum hemoptysis clubbing cor pulmonale

reid index

rate of the thickeness of mucous gland later to thickness of epithelium and cartilage increased in chronic bronchitis

measured as lungs forcibly emptied at maximal speed from full inspiration

forced vital capacity FCV

destroyed in bronchiectasis

permanent destruction of cartilage and elastic tissue

pathogenesis chronic bronchitis

irratant \> mucus hypersecretion \> obstruction (more proximal than emphysema) \> irreversible fibrosis or infection bronchospasm

most common causes of death in cystic fibrosis

resp failure liver failure

oxidative injury from smoke inactive native anti-proteases, bring on a functional \_\_\_\_

a1-antitrypsin deficiency

location of disorders, obstructive and restrictive disease

obstructive - airway, trachea to terminal bronchiole restrictive - parenchymal - respiratoy bronchiole, alveoli and alveolar ducts

\_\_\_\_ respiratory disease: increased resistance to air flow and limited expiratory rates on forced expiration

obstructive

trapped air in airways in emphysema leads to

dilation and destruction of alveolie, alveolar ducts (also distal/terminal bronchioles)

tissue morphology proximal t bronchioles

pseudostratified ciliated columnar epithelium

clinical presentation cystic fibrosis

nasal polyps resp infxn\>failure (psuedomonas aeruginosa, Staph A, H influenzae, Cor pulmonae) Malabsorption DM I Vas deferens atresia (infertility) meconium ileus (small bowel obstruction in newborns) secondary billiary cirrhosis (bile duct obstrction by secretions)

CXR empysema

increased AP diameter hyerlucent lung fields verticle heart depressed diaphram

emphysema vs chronic bronchitis cxr

CB prominent vessels, large heart E - hyperinflation, small heart