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Flashcards in COPD/Emphysema Deck (57)
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1

What are some things that characterize COPD?

-Fibrosis of airways walls
-Inflammation with lymphocytes, neutrophils, and macrophages
-Smooth muscle hyperplasma
-hyper-secretion of mucus

2

Which disease of airway limitation is fully reversible?

Asthma

3

Which parts of the breathing cycle are hindered in COPD?

expiration

4

T or F. COPD is progressive

T.

5

What is the most common cause of COPD in the WORLD?

Wood smoke exposure

6

Risk factors for COPD?

-Smoking
-Occupational dust and chemicals
-Air pollution
-Aging

7

What protein is usually deficient in COPD?

alpha-1 antitrypsin

8

What does alpha-1 antitrypsin do?

protect the lungs from neutrophil elastase, an enzyme that can disrupt connective tissue

9

What cells promote Asthma inflammation?

mast cells, eosinophils, CD4, macrophages

10

What cells promote COPD inflammation?

neutrophils, CD8, macrophages

11

What mediators promote Asthma inflammation?

LTD, histamine, IL-4/5, ROS

12

What mediators promote COPD inflammation?

LTB, IL-8, TNF-a, ROS

13

Steroids in COPD mainly target what cell and what mediator?

macrophages and ROS

14

How does COPD limit airway flow?

-small airway disease via inflammation, fibrosis, and increased resistance

-parenchymal destruction via loss of alveolar attachments and decrease in elastic recoil

15

What is emphysema?

loss of alveolar attachments

16

T or F. The amount of residual air in COPD patients is higher

T. Leading to a barrel chest appearance (so the tendency for the airways to collapse is higher)

17

What are the two parts of COPD?

chronic bronchitis and emphysema

18

What is chronic bronchitis?

chronic or recurrent cough present on most days for a minimum of 3 months in a year and for not less than 2 straight years

19

What is the Reid index?

bronchial gland depth /total bronchial wall thickness (normally higher than 0.4)

20

How does the Reid Index change in chronic bronchitis?

increases, bronchial gland hypertrophy and goblet cell metaplasia lead to excessive mucous production

21

What kinds of airway changes accompany chronic bronchitis?

squamous metaplasia of airway epithelium, loss of cilia, and ciliary function, and increased smooth muscle and connective tissue

22

What cells make up the inflammation in chronic bronchitis?

CD8 and neutrophils

23

What do you see in small airways (less than 2mm) in CB?

-formation of goblet cells and mucus secretion
-fibrosis and collagen deposition
-this is the MAJOR site of airflow resistance

24

What is emphysema?

an abnormal enlargement of air spaces distal to the terminal bronchioles

25

What is centrolobular emphysema?

dilation and destruction of the respiratory bronchioles

26

What mainly causes centrolobular emphysema?

mostly an upper lobe process associated with smoking

27

What causes panlobular emphysema?

destruction of the entire acinus, predominantly a lower lobe process associated with A1AT deficiency

28

What are bull?

emphysematous spaces greater than 1cm in diameter

29

Common complication of emphysema?

small airway collapse during exhalation (dynamic airway collapse)

30

What things lead to IRREVERSIBLE airflow limitation in COPD?

-fibrosis
-loss of elastic recoil
-destruction of alveolar attachments