lecture 8 nature of airways obstruction

Question 1

what is the bronchialwall mainly made up of

Answer 1

smoooth muscle

Question 2

3 ways the airway bronchial lumen decrease

Answer 2

excess mucus
contraction of the smooth muscle
loss of outward traction

Question 3

what are the bronchi party held open by

Answer 3

alveoli mesh

Question 4

asthma colour of the airways, why

Answer 4

red

inflammation

Question 5

main immune cell in asthma

Answer 5

eosinophil

Question 6

feature of asthma

Answer 6

airways constrict to a very small amount of histamine and acetylcholine

Question 7

what does Th1 inflammation drive

Answer 7

gamma interferon production

Question 8

what does Th2 inflammation drive

Answer 8

production of IL4 and IL5

Question 9

in asthmatics what type of inflammation takes over

Answer 9

Th2

Question 10

how does the release of histamine come about

Answer 10

dendritic cells present the antigen to the T cell
T cell makes B cell produce antibodies
IgE binds to mast cells = degranulation

Question 11

what happens after mast cell degranulation

Answer 11

eosinophils are attracted to the area

Question 12

how would you measure how much eosinophil was in the airways

Answer 12

measure the nitric oxide exhaled

Question 13

problems with measureing nitric oxide for asthmatics

Answer 13

reduces in smoking
increases with some foods
increases with bronchitis

Question 14

chronic airway changes in asthma

Answer 14

smooth muscle hypertrophy

subepithelial fibrosis

Question 15

what is COPD

Answer 15

bronchiectasis and emphysema

Question 16

biggest risk factorfor COPD

Answer 16

smoking

Question 17

who is genetically more prone to COPD

Answer 17

people with alpha 1 antitrypsin disease

Question 18

mucus and bronchitis

Answer 18

mucus gland hypertrophy
excess mucus
goblet cell hyperplasia

Question 19

other changes in bronchitis

Answer 19

inflammatory cell infiltration

smooth muscle hypertrophy

Question 20

what is chronic bronchitis

Answer 20

having cough and sputum for 3 months

Question 21

do you get airway obstruction with chronic bronchitis

Answer 21

no

Question 22

emphysema

Answer 22

abnormal enlargement of airspace distal to the terminal bronchiole accompanied by destruction of their walls and without obvious fibrosis

Question 23

types of emphysema

Answer 23

normal, centrilobular and panlobular

Question 24

who does emphysema affect

Answer 24

chronic smokers

Question 25

occupations assosiated with COPD

Answer 25

coal minors
welders
biomass

Question 26

where does airway obstruction need to be for the patient to complain earlier

Answer 26

bigger airway

Question 27

blue bloater

Answer 27

chronic bronchitic
cough and sputum
cyanosed
swollen legs

Question 28

pink puffer

Answer 28

emphysema

cachexic

Question 29

cachexic

Answer 29

wasting syndrome

Question 30

cor pulmonale

Answer 30

ventilation perfusion mixmatch
vasoconstriction
chronic hypertension causes right heart hypertrophy
heart failure

Question 31

what will present with corpulmonale

Answer 31

leg oedema

Question 32

what part of the lobe is more affected by COPD

Answer 32

upper

Question 33

what can happen with an emphysematic upper lobe

Answer 33

squash the lower lobe

Question 34

how can you deal with a problematic upper lobe

Answer 34

surgery removal

one way valves

Question 35

how do valves in the upper lobe work

Answer 35

air can get in but not out

Question 36

bronchiectasis

Answer 36

dilation of the airways
recurrent infection
purulent sputem

Question 37

purulent

Answer 37

pus containing

Question 38

CF mucus

Answer 38

abnormally thick and sticky

Question 39

what happens in CF over time

Answer 39

scarring of the lungs

Question 40

in CF what is the mutation

Answer 40

CFTR

Question 41

what is the CF gene for

Answer 41

chloride channel

Question 42

what else does CF affect

Answer 42

pancreatic duct