Flashcards in Resp 9 - Asthma + COPD Deck (21):
Chronic inflammatory disorder of the airways, resulting in reversible airway obstruction, via inflammation, bronchoconstriction and increased mucous
List some environmental triggers of Asthma:
- Cold air
- Dust mites faeces
- Emotional distress
- Car fumes
- Cigarette smoke
- Isocyanates (varnish)
- Acid anhydrase (paint)
During an Asthmatic response to an environmental trigger, which cell process the trigger and present antigens to T lymphocytes?
Which TH cells are activated in an Asthmatic response?
What are the signs and symptoms of asthma?
- Chest tightness
- Dry cough (worse at night, exercise-induced)
Is asthma a restrictive or obstructive deficit?
Explain the proper way to use an inhaler:
- Shake well
- Breathe in
- Hold for 10 seconds
What is the treatment for mild, intermittent asthmatic episodes?
SABA as required
What is the treatment for an Asthma attack?
- Salbutamol + Atrovent via nebuliser/IV
Chronic Obstructive Pulmonary Disorder:
Progressive airway obstruction, not fully reversible. Predominantly caused by smoking.
What genetic deficiency can cause COPD?
What are the pathological changes in COPD?
- Enlargement of mucous-secreting glands of central airways
- Increased number of goblet cells
- Ciliary dysfunction
- Elastin breakdown = destruction of alveolar walls + loss of elastic recoil
- Formation of large air spaces = decreased SA for gas-exchange
- Vascular bed changes = pulmonary hypertension
What type f heart failure are COPD patients most likely to develop?
- Right heart failure due to pulmonary hypertension
(Cor pulmonale as caused by lung disease)
List some signs/symptoms of COPD:
- Shortness of breath
- Pursed lip breathing
- Use of accessory muscles when breathing
- Hyper-resonance on percussion
- Distant breath sounds
- Reduced air entry
- Central cyanosis (late COPD)
- Flapping tremors (late COPD)
What is the symptom of lung hyperinflation?
What lung disease is this usually seen in?
What are the signs of this on an X-Ray?
Flattened diaphragm, hyperlucent lungs, ^ AP diameter
Why should patients with COPD have an ABG?
To be assessed for respiratory failure
What genetic test might you perform on a non-smoker who has developed COPD?
alpha-1 antitrypsin deficiency test
List some pharmaceutical agents used to treat COPD:
- Bronchodilators ie Salbutamol
- Inhaled Corticosteroids
- Mucolytics ie Carbocysteine
What vaccines may you give to a patient with COPD?
What type of O2 would you give a hypoxic patient with COPD? Why?
24% or 28% O2
If higher % given, would lower respiratory drive, worsening hypoxia. This is due to modified 'normal' PO2 due to chronic hypoxia, by central chemoreceptors.