Lecture 20 - Asthma and Chronic Obstructive Pulmonary Disease Flashcards Preview

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Flashcards in Lecture 20 - Asthma and Chronic Obstructive Pulmonary Disease Deck (22):
1

Cells producing inflammatory mediators in asthma and COPD

Mast cells, alveolar macrophages

2

Airway cell transformation

Formation of goblet cells in epithelial layer.
Increase in airway smooth muscle (rarely seen in normal airways)
Epithelial collagen thickening.

3

Effect of obstructive lung disease on FEV1 and FVC

Decrease in FEV1.
FVC only decreased in severe obstructive disease

4

Infectious diseases that particularly affect asthmatics

Viral

5

How can symptom presentation rule out asthma?

If symptoms are persistent (asthmatics typically are healthy in between attacks)

6

Diagnostic test for asthma and COPD

Spirometry.

7

Diagnostic criteria for asthma.
1)
2)

1) FEV:FVC ratio under 0.7 is diagnostic.
2) Look for improvement in forced expiratory ratio with exposure to a bronchodilator

8

Way to test for exercise-induced asthma

Bronchoprovocation (hyperventilation, inhalation of methocholine).

A greater than 20% drop in FEV1 is diagnostic of asthma

9

Appearance of FEV1 with asthma

'Scalloped' tail of graph.

10

Corticosteroid reserved for most-severe asthmatics

Prednisolone

11

Are large doses of corticosteroids needed?

No

12

At what dose of corticosteroids does oral candiasis present?

Over 1000ug/day

13

What is COPD?

A heterogeneous group of phenotypes resulting in obstructive lung disease.
Fixed, non-improving airway obstruction.

14

Two types of COPD

1) Emphysema (destruction of lung parenchyma)
2) Chronic bronchitis (inflammation, sputum production)

15

Proportion of the time that COPD is associated with smoking in the developed world.

~95% of the time

16

What aspect of normal lung parenchyma keeps airways open

Parenchyma elasticity

17

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.

18

Is dynamic hyperinflation more common in asthma or COPD?

COPD

19

Genetic cause of COPD

Autosomal dominant alpha-1 antitrypsin deficiency

20

Most effective drug for quitting smoking

Varenicicline.
A partial nicotine receptor agonist. Reduces the pleasure of smoking, cravings.

21

Side effect of long-acting anti-cholinergics

Dry mouth

22

Vaccines that are recommended for COPD patients

Influenza, pneumococcal vaccines.