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Flashcards in Resp 9 - Asthma + COPD Deck (21):
1

Define Asthma:

Chronic inflammatory disorder of the airways, resulting in reversible airway obstruction, via inflammation, bronchoconstriction and increased mucous

2

List some environmental triggers of Asthma:

- Cold air
- Pollen
- Dust mites faeces
- Animals
- Exercise
- Perfume
- Emotional distress
- Car fumes
- Cigarette smoke
- NSAIDs/Beta-blockers
- Isocyanates (varnish)
- Acid anhydrase (paint)

3

During an Asthmatic response to an environmental trigger, which cell process the trigger and present antigens to T lymphocytes?

Macrophages

4

Which TH cells are activated in an Asthmatic response?

TH2

5

What are the signs and symptoms of asthma?

- Wheeze
- Breathlessness
- Chest tightness
- Dry cough (worse at night, exercise-induced)

6

Is asthma a restrictive or obstructive deficit?

Obstructive

7

Explain the proper way to use an inhaler:

- Shake well
- Breathe in
- Hold for 10 seconds

8

What is the treatment for mild, intermittent asthmatic episodes?

SABA as required

9

What is the treatment for an Asthma attack?

- O2
- Salbutamol + Atrovent via nebuliser/IV

10

Define COPD:

Chronic Obstructive Pulmonary Disorder:
Progressive airway obstruction, not fully reversible. Predominantly caused by smoking.

11

What genetic deficiency can cause COPD?

alpha-1-antitrypsin deficiency

12

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

13

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)

14

List some signs/symptoms of COPD:

- Cough
- Shortness of breath
- Pursed lip breathing
- Tachypnoea
- Use of accessory muscles when breathing
- Barrel-chest
- Hyper-resonance on percussion
- Distant breath sounds
- Reduced air entry
- Wheezing
- Central cyanosis (late COPD)
- Flapping tremors (late COPD)

15

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?

Barrel-chest
COPD
Flattened diaphragm, hyperlucent lungs, ^ AP diameter

16

Why should patients with COPD have an ABG?

To be assessed for respiratory failure

17

What genetic test might you perform on a non-smoker who has developed COPD?

alpha-1 antitrypsin deficiency test

18

List some pharmaceutical agents used to treat COPD:

- Bronchodilators ie Salbutamol
- Antimuscarinics
- Inhaled Corticosteroids
- Mucolytics ie Carbocysteine
- Theophylline

19

What vaccines may you give to a patient with COPD?

Pneumococcal vaccine
Influenza vaccine

20

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.

21

Name some common complications of COPD:

- Recurrent pneumonia
- Pneumothorac
- Respiratory failure
- Cor pulmonale