The Respiratory System

Question 1

COPD stands for

Characterised by…

What are the examples

Answer 1

Chronic Obstructive Pulmonary Disease

airflow that is not fully reversible

Examples: Emphysema (lung disease), chronic bronchitis and asthma

Question 2

Aetiology of COPD

Answer 2

Smoking, Infection, Alpha1-antitrypsin deficiency

Question 3

Pathophysiology- Emphysema

(hint: 3)

Answer 3

1. Destruction of the alveolar wall by proteases
   - Loss of surface area (Breakdown of alveoli walls and septae) = Less gaseous exchange
   - Loss of pulmonary capillaries ((affecting perfusion and diffusion)
   - Elastase (breaks down elastic fibres in the alveoli essential for elastic recoil
2. Fibrosis and thickening of bronchial walls (repeated inflammation, infections and mucous production)
   - Narrowed airways
   - Weakened Walls
   - Altered passive expiratory flow
3. Progressive expiratory difficulty leads to
   - Air trapping and increased residual volume
   - Overinflation of the lungs
   - Thorax remodelling- barrel chest
   - Flattened diaphragm

Question 4

Pathophysiology- Chronic Bronchitis

(name at least 3)

Answer 4

Constant irritation (smoking/pollution)
Increase mucus producing goblet cells
Decreased ciliated epithelium
Acute and chronic inflammation
Leading to chronic bronchitis
Chronic inflammation leads to scarring and fibrosis of the small airways

Question 5

Signs & Symptoms

(name at least 3)

Answer 5

Dyspnoea exertion (shortness of breath) at rest
Hyperventilation prolonged expiratory phase
Accessory muscle use, barrel chest, tripod position
Poor chest expansion
Hyperinflated lungs
Weight loss and fatigue
Clubbing of fingers
Polycythemia (increased RBC)
Productive cough- white or clear sputum
LRTIs
Cor pulmonale (causes the right side of the heart to fail)

Question 6

Treatments

Answer 6

Smoking cessation/ irritant avoidance
Drug therapies aimed at long-term management of symptoms or short-term management of exacerbations
Bronchodilators (Beta-adrenoreceptor agonists or antimuscarinics)
Steroids (inhaled and oral)
Antibiotics
Mucolytic agents
Oxygen therapy

Question 7

Definition of Asthma

Affects how many people? Common in?

Answer 7

A chronic inflammatory disorder of the lungs causing bronchi and bronchioles to inflame and constrict

Affects more than 300 million people worldwide

More common in boys, but by adulthood the sex ratio is reversed

Question 8

Aetiology of Asthma

(hint: 3)

Answer 8

Atopy and allergy: atopy is a tendency to develop allergic diseases/disorders including asthma, hay fever, eczema and this appears to run in families

Genetic factors: no single gene, but several genes increase production of cytokines and immunoglobulins (IgE)

Environmental factors: early exposure to allergens and maternal smoking, or ‘clean’ environment increases IgE response to allergens