obstrutive airway diseases

Question 1

what are three obstructive airway diseases?

Answer 1

chronic bronchitis
emphysema
asthma

Question 2

what is FEV1

Answer 2

FEV1 is the Forced Expiratory Volume of air exiting the lung in the first second of this exercise

Question 3

what is FVC

Answer 3

the Final Total amount or air expired

Question 4

what is the normal ratio of FEV1:FVC

Answer 4

0.7-0.8

Question 5

is COPD more common in females or males

Answer 5

males

Question 6

what are 4 risk factors of COPD

Answer 6

SMOKING
Atmospheric Pollution
Occupation : dust

Alpha-1-antiprotease (antitrypsin) deficiency is an extremely rare cause of emphysema

Question 7

what is the clinical definition of chronic bronchitis?

Answer 7

Cough productive of sputum most days
in at least 3 consecutive months
for 2 or more consecutive years

Question 8

what are the morphological changes in chronic bronchitis in large airways?

Answer 8

Mucous gland hyperplasia
Goblet cell hyperplasia
Inflammation and fibrosis is a minor component

Question 9

what are the morphological changes in chronic bronchitis in small airways?

Answer 9

Goblet cells appear

Inflammation and fibrosis in long standing disease

Question 10

whats the definition of emphysema?

Answer 10

Increase beyond the normal in the size of airspaces distal to the terminal bronchiole arising either from dilatation or from destruction of their walls and without obvious fibrosis.

Question 11

what are the forms of emphysema?

Answer 11

CENTRIACINAR
PANACINAR
PERIACINAR
SCAR  ‘ irregular’
‘Bullous emphysema

Question 12

what happens in centriacinar?

Answer 12

Begins with bronchiolar dilatation

Then alveolar tissue is lost

Question 13

what is a bulla?

Answer 13

an
emphysematous
space
greater than 1cm

Question 14

what are bullas and blebs related to?

Answer 14

peri acinar

Question 15

what is the predicted FVC

Answer 15

4.95

Question 16

what is the normal range for peak expiratory flow rate?

Answer 16

400-600 litres/min

Question 17

what is more likely to be reduced in obstructive lung disease? FEV1 or FVC?

Answer 17

FEV1 is defos reduced and FVC may be reduced?

Question 18

in hyperventilation which falls and rises? PO2 and PCO2?

Answer 18

PCO2 reduces and PO2 rises

Question 19

in hypoventilation which falls and rises? PO2 and PCO2?

Answer 19

PO2 falls

PCO2 rises

Question 20

true or false, in obstructive lung disease: FEV1 is less than 70% of FVC

Answer 20

true

Question 21

is bronchial asthma reversible?

Answer 21

yes

Question 22

aetiology of COPD

Answer 22

smoking
atmospheric pollution
occupation: dust
alpha 1 antiprotease deficiency

Question 23

whts the difference between PA and Pa

Answer 23

PA is partial pressure off gas in alveolar air

Pa is partial pressure of gas in arterial blood

Question 24

what is the four abnormal states associated with hypoaemia?

Answer 24

Ventilation / Perfusion imbalance - V/Q
Diffusion impairment
Alveolar Hypoventilation
Shunt

Question 25

why does COPD cause hypoxaemia?

Answer 25

``` Airway Obstruction Alveolar Hypoventilation Reduced Respiratory Drive Diffusion Impairment Loss of Alveolar Surface Area Shunt Only during acute infective exacerbation ```

Question 26

what is the commonest cause of hypoxaemia

Answer 26

low V/Q

Question 27

true or false: | Fall in PaO2 due to hypoventilation is corrected by raising FIO2

Answer 27

true

Question 28

what is FIO2

Answer 28

the Fraction of Inspired air which is Oxygen

Question 29

what happens when pulmonary vascular changes in hypoxia?

Answer 29

Physiological pulmonary arteriolar vasoconstriction When alveolar oxygen tension falls Can be localised effect All vessels constrict if there is hypoxaemia A protective mechanism Do not send blood to alveoli short of oxygen!

Question 30

what is chronic cor pulmonale?

Answer 30

Hypertrophy of the Right Ventricle resulting from disease affecting the function and/or the structure of the lung