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My1 Resp > obstructive lung disease > Flashcards

obstructive lung disease Flashcards

(48 cards)

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1
Q

name the biggest obstructive diseases

A

asthma / COPD - chronic bronchitis and emphysema / alpha 1 antitrypsin deficiency

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2
Q

what are reversible aspects of asthma

A

bronchoconstriction and inflammation

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3
Q

what is airway remodelling

A

basement membrane thickens, collagen is deposited in submucosa and smooth muscle hypertrophy

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4
Q

what type of hypersensitivity is asthma, what is the brief immunological response

A

type 1 // inflammation –> APC –> TH2 –> B cells –> mast cells + eosinophils —> leukotrienes, histamine, chemokines

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5
Q

what can worsen asthma

A

allergens: animal hair, pollen, others: exercise, smoke, cold air

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6
Q

what are symptoms of asthma

A

periodic breathlessness, wheeze and dry cough, atopy, nasal polyps

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7
Q

what is a wheeze

A

high pitched sound on expiration

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8
Q

what indicates occupational asthma and what should be done for management

A

better at weekend –> refer

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9
Q

what causes occupational asthma

A

isocynataes, platinum salts, soldering, flour, epoxy

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10
Q

what can be done for asthma diagnosis

A

spirometry + FENO 1st line: reduced FEV1 and FEV1: FVC (FVC normal) / FENO >40 or >35 in children // PEFR (diurnal variation)

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11
Q

what age is testing for asthma advised from

A

5

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12
Q

after inhalation of a B2 antagonists, by what % should the FEV1/ PEFR increase by

A

more than 15%

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13
Q

what is the first line treatment guidelines for asthma

A
  1. SABA eg salbutamol when an attack happens
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14
Q

what is the second and 3rd line treatment to asthma

A
  1. ICS 3. ICS + SABA
  2. SABA + ICS + oral leukotriene eg montelukast
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15
Q

what is the 3rd line treatment in asthma

A
  1. increase dose of ICS, if no improvement add oral corticosteroid prednisolone
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16
Q

what would the PEFR be in moderate acute asthma

A

less than 80% predicted

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17
Q

what would the PEFR be in sever asthma

A

less than 50%

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18
Q

what would the PEFR be in life threatening asthma

A

less than 33%

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19
Q

if someone was hospitalised with severe asthma what would the treatment be

A

1) oxygen (40-60%) with salbutamol nebulised
2) add nebulised ipratropium 3) give hydrocortisone IV 4) Ipraprtium Neb 5) theophylinne (IV), 6) mag sulfate 7) anaeth

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20
Q

what are the symptoms of acute-severe asthma attack

Study These Flashcards
A

Unable to finish sentences
PEFR less than 50% predicted
Tachycardia
RR more than 25 breaths/min

21
Q

what are the symptoms of a life threatening asthma attach

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A

PEFR less than 30% predicted
Bradycardia, hypotension, silent chest
Exhaustion/confusion
Hypoxia, acidosis

22
Q

what is chronic bronchiectasis

Study These Flashcards
A

chronic neutrophilic inflammation and mucous hyper-secretion, and bronchospasm (partially reversible)

23
Q

what is emphysema

Study These Flashcards
A

alveolar collapse leading to impaired gas exchange, common with 1-antiprotease deficiency

24
Q

how can noxious particles eg smoking lead to inflammation

Study These Flashcards
A

activate macrophages which release neutrophillic chemokines and the production of proteases which destroy alveolar wall (emphysema) and mucous hyper-secretion

25
what is panicar emphysema
emphysema affecting the terminal bronchioles, everything in between damaged
26
what are the main symptoms and signs of COPD
not episoidic, non-atopic, daily cough, progressibe breathlessness, wheezing and reduced breath sounds, Better when sitting up
27
what can COPD progress too
impaired ABG, resp failure, right ventricular failure
28
how can emphysema lead to cor pulmonale
reduced PaO2 leads to vasocontriction which increased pressure to right ventricle
29
what diagnosis can be done for COPD
reduced FEV1, PEFR, FVC and normal FEV1: FVC ratio, less than 15% PEFR improvement with B2
30
what is the treatment plan for COPD
1) SAMA 2) LAMA + LABA 3) ICS (predisnolone) /LABA/LAMA (antibiotic if infection)
31
why do you need to be careful prescribing corticosteroids to COPD
can cause pneumonia
32
what are the main differences in asthma and COPD
asthma is allergic, intermittent symptoms, non productive cough or breathlessness, eosinophillic, diurnal variation, normal ABG
33
what are stabilisers used for
people with motility issues, makes it easier to take
34
what is ACOS
asthma COPD overlapping syndrome, COPD with blood eosinophillia
35
what is the target O2 sats of COPD patients and what % o2 is originally given
88% -92%, 24% - type II resp failure
36
why do COPD patients need to be on lower O2
patient in hypoxic drive and so increasing O2 will also increase PaCO2
37
what is type I resp failure
hypoxic + normal/ low CO2
38
what is type II resp failure
hypoxic + hypercapnia
39
which drugs are only given in asthma
cromones eg sodium chromoglicate, leukotriene antagonists eg monteleukast (CysLT1)
40
what drugs are only for COPD
PDE4 inhibitor eg roflumilast
41
what is bronchial hyper-responsiveness in asthma
ep damage exposes nerve endings leads to increased hypersensitivity
42
in regards to hypersensitivity and hyper activity which is associated with mild and severe
mild= hyperS, severe = hyperS and hyperA
43
in a non atopic individual what would happen in response to an allergen
low Th1 response
44
in as asthmatic individual what immune changes happen
strong Th2 response, dendritic cells present to CD4+ T cells
45
what doCD4+T cells release
IL4 which causes B cells to release IgE, this binds to FcE receptors in Mast cells and eisonophils
46
what do eisonphils and mast cells release
histamine, leukotrienes, chemokines
47
what immune cells are involved in COPD
neutrophils
48
what causes occupational asthma
isocynataes, platinum salts, soldering, flour, epoxy

My1 Resp (16 decks)

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