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Flashcards in Lung Disease Deck (28)
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0
Q

When discussing FEV & FVC what are the expected trends for normal lung function, obstructive lung disease, restrictive lung disease (graph)

A

Normal- FEV = 4, FVC = five; percent = 80

This graph will show quick steep drop

Obstructive-FEV = 1.3, FVC = 3.1; percent =42

The graph shows shallow long expiration

Restrictive-FEV= 2.8, FVC = 3.1; percent = 90

Graph shows steep short expiration

1
Q

What do you FEV and FVC stand for

A

FEV forced expiratory volume

FVC forced vital capacity

2
Q

What is asthma?

A

A group of symptoms and signs (a syndrome)

Symptoms-wheezing, cough, chest tightness, and SOB especially at night and early in the morning

Chronic episodes of airway symptoms and obstruction

Episodic chest symptoms and air obstruction

Chronic air information with increased eosinophils , lymphocyte and smooth muscle hypertrophy

3
Q

What is chronic bronchitis

A

Chronic air mucus hypersecretion

Neutrophils, submucosal gland and goblet cells hypertrophy

Nearly constant productive cough, variable airflow obstruction

4
Q

What is emphysema

A

Permanent destruction of alveoli

Fewer larger alveoli, reduce surface area & oxygen transfer to the blood, reduced elastic recoil

Constant airflow obstruction

5
Q

List the phenotypes of asthma

A

Early onset allergic asthma

Late onset Eosinophilia

Exercise-induced

Obesity related

Neutrophilic

6
Q

Explain the main points of early onset allergic asthma

A

Allergic symptoms

TH2 profile

Corticosteroid responsive

7
Q

Describe the main points of Eosinophilia

A

Less allergic

Eosinophilia

Not responsive to corticosteroids

8
Q

Describe the main points of exercise-induced asthma

A

TH2 cytokines

mast cell activation

9
Q

Explain the details of obesity related asthma

A

Adult onset

Mostly in women

No TH2 marker

10
Q

Explain the details of neutrophilic asthma

A

TH17

11
Q

How many people does asthma affect in the United States

A

25.7 million people

7 million under the age of 18 years old

12
Q

How do epidemiologist define people having asthma

A

By the responses given from an individual when asked have you ever been told by a doctor that you have asthma

13
Q

Breakdown asthma prevalence in different subgroups in the United States

A

Blacks > white or Hispanic

Children >adults

Young boys >young girls (0 to 14 years old)

Boys = girls (15 to 17 years old)

Women >men

14
Q

Define chronic bronchitis

A

Chronic cough chronic mucus production (productive cough)

15
Q

In what disease is alveolar destruction

A

Emphysema

16
Q

There’s a graph that shows methacholine introduced to those that are hyper responsive (as) and show an increase in histamine production

The faster the response the greater the________?

A

Sensitivity

17
Q

Explain the TH2 immune processes in the airways of people with asthma

A

One allergen enters

Taken up by antigen presenting cells

Antigen presenting cells process antigen present to TH2 cells

TH2 cells make cytokines

Some cytokines are present to this stimulate the epithelial layer, stimulates smooth cells to cause hypertrophy, some recruit and activate eosinophils , some activate B cells

B cells make anybody used in this instance they make IGE-which attached to the outside of mast cells then the next time the allergen is detected the mast cell is triggered to degranulation-releasing histamines, bronchoconstriction-causing an asthma attack

18
Q

Describe the process of a non-TH2 asthma development

A

Can be more associated with damage to the epithelial layer or viruses/microbes in the lungs

Binding to microphages

The damps that get released (by the broken cell)

Activated macrophages

Macrophages can activate neutrophil and TH17 cells

19
Q

List the classifications of occupational

A

Respiratory sensitization asthma

Acute irritant induced asthma

Recurrent low dose irritant induced asthma

Work aggravated asthma

Chronic obstructive pulmonary disease-end-stage asthma

20
Q

Give the main points of respiratory sensitization asthma

A

Adult onset as a result of exposure at work

Immune mechanisms may not be well defined

Latency

21
Q

List main points of acute irritant induced asthma

A

Adult onset asthma as a result of high dose exposure to irritants at work

Reactive airway dysfunction syndrome (RADS)

No latency

22
Q

Describe the main points of recurrent low dose irritant induced asthma

A

Adult onset asthma as a result of prolonged moderately high exposure to irritants at work

Latency

23
Q

Describe the main points of work aggravated asthma

A

Pre-existing asthma with new exposure to triggers at work

Loss of asthma control

24
Q

Describe the main points of chronic obstructive pulmonary disease-end stage asthma

A

Impairment resulting after many years of one of The other classifications of occupational asthma, usually without treatment or removal from exposure

25
Q

What protease degrades the elastic fibers of the alveoli and collagen?

A

Neutrophil elastase

26
Q

List and briefly describe the Serpina 1 variants

A

PiS-make less alpha-1 antitrypsin and so if you have a last of the alpha-1 antitrypsin then you have a lower threshold for a reaction

PiZ- make even less a one antitrypsin and so you have an even more elevated risk

These are affected by smoking because they block protease activity and smoking inhibits anti-protease activity

27
Q

Name the two branches of acquired immunity that are most relevant to asthma

A

TH2

TH17