Flashcards in COPD/Emphysema Deck (57)
What are some things that characterize COPD?
-Fibrosis of airways walls
-Inflammation with lymphocytes, neutrophils, and macrophages
-Smooth muscle hyperplasma
-hyper-secretion of mucus
Which disease of airway limitation is fully reversible?
Which parts of the breathing cycle are hindered in COPD?
T or F. COPD is progressive
What is the most common cause of COPD in the WORLD?
Wood smoke exposure
Risk factors for COPD?
-Occupational dust and chemicals
What protein is usually deficient in COPD?
What does alpha-1 antitrypsin do?
protect the lungs from neutrophil elastase, an enzyme that can disrupt connective tissue
What cells promote Asthma inflammation?
mast cells, eosinophils, CD4, macrophages
What cells promote COPD inflammation?
neutrophils, CD8, macrophages
What mediators promote Asthma inflammation?
LTD, histamine, IL-4/5, ROS
What mediators promote COPD inflammation?
LTB, IL-8, TNF-a, ROS
Steroids in COPD mainly target what cell and what mediator?
macrophages and ROS
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
What is emphysema?
loss of alveolar attachments
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)
What are the two parts of COPD?
chronic bronchitis and emphysema
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
What is the Reid index?
bronchial gland depth /total bronchial wall thickness (normally higher than 0.4)
How does the Reid Index change in chronic bronchitis?
increases, bronchial gland hypertrophy and goblet cell metaplasia lead to excessive mucous production
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
What cells make up the inflammation in chronic bronchitis?
CD8 and neutrophils
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
What is emphysema?
an abnormal enlargement of air spaces distal to the terminal bronchioles
What is centrolobular emphysema?
dilation and destruction of the respiratory bronchioles
What mainly causes centrolobular emphysema?
mostly an upper lobe process associated with smoking
What causes panlobular emphysema?
destruction of the entire acinus, predominantly a lower lobe process associated with A1AT deficiency
What are bull?
emphysematous spaces greater than 1cm in diameter
Common complication of emphysema?
small airway collapse during exhalation (dynamic airway collapse)