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COPD/COLD
| Question | Answer |
|---|---|
| What are some chronic, progressive and recurrent obstructions of airflow? (types of copd) | Emphysema, chronic bronchitis |
| What is the 4th leading cause of death in the US? | COPD |
| Why does COPD occur? | Inflammation and fibrosis of bronchial wall, Hypertrophy of submucosal glands and hypersecretion of mucous, loss of aveolar tissue and elastic lung fibers. |
| What is emphysema? | Enlargement of air spaces and destruction of lung tissue. Loss of lung elasticity. Abnormal enlargement of air spaces distal to terminal bronchioles. Hyperinflation of lungs. Destruction of alveolar walls and capillary beds. |
| What are some causes of emphysema? | Smoking, inherited deficiency of a1-antitrypsin (antiprotese enzyme which protects lung from injury), breakdown of elastin by protesases |
| What is centracinar? | Affects bronchioles with preservation of alveolar ducts/sacs Most common type of emphysema Predominant in male smokers |
| What is paracinar? | Includes alveoli – initially peripheral then central bronchioles and alveoli More common with a1-antitrypsin deficiency |
| What is chronic bronchitis? | Obstruction of major and small airways. |
| Chronic bronchitis is associated with what irritant? | Associated with chronic irritation from smoking and recurrent infections. |
| What cough represents chronic bronchitis? | Productive cough for at least 3 consecutive months in at least 2 consecutive years. |
| Chronic bronchitis is hypersecretion of mucus in large airways associated with... | hypertrophy of submucosal glands in trachea and bronchi. |
| Chronic bronchitis is Inflammatory infiltration and fibrosis of... | Bronchiolar wall. |
| What is an example of a pink puffer? | Emphysema with dypsnea, lungs collapse during inspiration, air trapped (barrel chest), pursed lip breathing helps to prevent airway collapse by increased airway pressure. |
| What is an example of a blue bloater? | Chronic bronchitis with SOB, unable to maintain O2 levels, pulmonary HTN causes R sided HF with peripheral edema. |
| How do you diagnose COPD? | Lab tests (ABG's), Lung volume measurement in pulmonary function tests (spirometry) reveal marked increase in RV, and increase in TLC and elevation of the RV to TLC ratio |
| How do you treat COPD? | Smoking cessation, avoid exposure to RTIs, Immunizations, O2 therapy (90%), bronchodialators |
| What is cystic fibrosis? | Autosomal recessive disorder involving fluid secretion in exocrine glands in epithelial lining of respiratory, GI and reproductive tracts |
| Cystic fibrosis is a cause of what in children? | Chronic respiratory disease. |
| Cystic fibrosis is caused by a mutation of what gene? | Long arm of chromosome 7 that regulates for CFTR. |
| What does CFTR function as? | CFTR functions as chloride channel in epithelial cell membranes. |
| Mutations render epithelial membrane relatively impermeable to what? | Chloride ion. |
| The mutation leads to a series of events that includes increased absorption of what? | Na+ and H2O from airway lumen causing more viscid respiratory secretions. |
| The mutation causes airway obstruction and predisposition to what? | Recurrent pulmonary infections |
| What do you treat cystic fibrosis infections with? | Treat infections to limit lung damage and perform chest PT (mucolytic agents) |
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