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Flashcards in Final Exam Information Deck (268)
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1

2 main causes of bronchodilation?

1. Circulating catecholamines such as epinephrine and norepinephrine
2. Non-parasympathetic nerve releases vasoactive intestinal peptide (VIP) and NO

2

What type of G-protein binds with Beta 2 receptors after episode and norepinephrine stimulation to cause bronchodilation?

Gs protein

3

7 steps of bronchoconstriction starting with CN X innervation of airway smooth muscle?

1. CNX innervating airway smooth muscle
2. Cholinergic nerve endings release Act to muscarinic receptor-3
3. M3 is coupled of Gq protein
4. Activated Gq protein activates phospholipase C (PLC)
5. PLC activates inositol triphosphate (IP3) - 2nd messenger
6. IP3 stimulates calcium release from SR
7. Increased calcium leads to bronchoconstriction

4

What type of response does coughing, allergy and infection cause?

Inflammatory response mediated by IgE

5

6 mediators of bronchoconstriciton

1. Cytokines
2. Complement
3. Bradykinin
4. Platelet activtating factors
5. Histamine
6. Leukotrienes

6

What do non-cholinergic C fibers release that cause bronchoconstriction?

1. Substance P
2. Neurokinin A
3. Calcitonin gene related peptide

7

What type of pattern do COPD patients show on PFT?

Obstructive pattern

8

Describe the pathology behind COPD

Pathologic deterioration in elasticity or recoil within the lung parenchyma, which normally maintains the airways in an open position

9

What are the airways of COPD patients predisposed to?

Collapse during exhalation

10

What occurs with the gas velocity in COPD patients?

Increase in gas velocity in narrowed bronchiole, which lowers pressure inside the bronchiole and further favors airway collapse

11

What does bronchospasm and obstruction result from with COPD patients?

Increased pulmonary secretions

12

3 major characteristics of COPD patients?

1. Chronic cough
2. Progressive exercise limitation
3. Expiratory airflow obstruction

13

Patho behind Chronic Bronchitis? (Goblet cells and ciliary 5)

1. Increased mucous production
2. Loss of mucociliary clearance
3. Carina = cough
4. Inflammation causing more irritation
5. Air trapping

14

Patho behind Emphysema

1. Damage to collagen and elastin fibers
2. Airway almost collapse
3. Lung fibrosis and loss of elastic recoil is landmark sign of emphysema
4. SOB

15

Risk factors for COPD (4)

1. Tobacco = primary
2. Occupational exposure to dust; indoor and outdoor pollution
3. Respiratory infection
4. Genetic factors causing reduction in alpha 1 antitrypsin causing the enzyme to be too large

16

Clinical profile of COPD patients (9)

1. Progressive dyspnea
2. Chronic cough - mucous secretions
3. SOB
4. Expiratory airflow obstruction increases in severity
5. Decreased breath sounds
6. Expiratory wheezes
7. Increased A-P diameter
8. Hyperinflation in chest x-ray
9. Use of accessory muscles

17

PaCO2 characteristics of Emphysema

Normal to decreased

18

PaCO2 characteristics of Chronic Bronchitis

Increased

19

Mechanism of airway obstruction for Chronic Bronchitis

Decreased airway lumen due to mucus and inflammation

20

Mechanism of airway obstruction for Emphysema

Loss of elastic recoil

21

Hematocrit in Chronic Bronchitis patients

increased

22

Hematocrit in Emphysema patients

normal

23

Diffusing capacity in Chronic Bronchitis patients

normal

24

Diffusing capacity in Emphysema patients

decreased

25

Cor pulmonale severity in Chronic Bronchitis

Marked

26

Cor pulmonale severity in Emphysema

Mild

27

Prognosis of Chronic Bronchitis patients

Poor

28

Prognosis of Emphysema patients

Good

29

PaO2 characteristics in Chronic Bronchitis

Marked decrease (blue bloater)

30

PaO2 characteristics in Emphysema

Modest decrease (pink puffer)