Flashcards in Lecture 20 - Asthma and Chronic Obstructive Pulmonary Disease Deck (22):
Cells producing inflammatory mediators in asthma and COPD
Mast cells, alveolar macrophages
Airway cell transformation
Formation of goblet cells in epithelial layer.
Increase in airway smooth muscle (rarely seen in normal airways)
Epithelial collagen thickening.
Effect of obstructive lung disease on FEV1 and FVC
Decrease in FEV1.
FVC only decreased in severe obstructive disease
Infectious diseases that particularly affect asthmatics
How can symptom presentation rule out asthma?
If symptoms are persistent (asthmatics typically are healthy in between attacks)
Diagnostic test for asthma and COPD
Diagnostic criteria for asthma.
1) FEV:FVC ratio under 0.7 is diagnostic.
2) Look for improvement in forced expiratory ratio with exposure to a bronchodilator
Way to test for exercise-induced asthma
Bronchoprovocation (hyperventilation, inhalation of methocholine).
A greater than 20% drop in FEV1 is diagnostic of asthma
Appearance of FEV1 with asthma
'Scalloped' tail of graph.
Corticosteroid reserved for most-severe asthmatics
Are large doses of corticosteroids needed?
At what dose of corticosteroids does oral candiasis present?
What is COPD?
A heterogeneous group of phenotypes resulting in obstructive lung disease.
Fixed, non-improving airway obstruction.
Two types of COPD
1) Emphysema (destruction of lung parenchyma)
2) Chronic bronchitis (inflammation, sputum production)
Proportion of the time that COPD is associated with smoking in the developed world.
~95% of the time
What aspect of normal lung parenchyma keeps airways open
What is dynamic hyperinflation?
When the stimulus to breathe appears before all tidal volume is emptied from lungs. Results in progressive hyperinflation of the lungs.
Is dynamic hyperinflation more common in asthma or COPD?
Genetic cause of COPD
Autosomal dominant alpha-1 antitrypsin deficiency
Most effective drug for quitting smoking
A partial nicotine receptor agonist. Reduces the pleasure of smoking, cravings.
Side effect of long-acting anti-cholinergics