Shared Flashcard Set

Details

COPD Pathophys
COPD Pathophys
21
Pharmacology
Graduate
09/04/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Chronic Bronchitis
Definition

Anatomic Site: Bronchus

Major Pathologic changes: Mucous gland hyperpalasia, Hypersecretion

Etiology: Tobacco Smoke, Air polutants

SxS - Cough, sputum production

Term
Emphysema (Spectrum)
Definition

Anatomic Site: Acinus

Major changes: Airspace enlargement; wall destruction

Etiology: Tobacco Smoke

SxS: Dyspnea

Term
COPD effects:
Definition
women and african americans more
Term
2 Catergories of COPD
Definition
  • Centiacinar: 95% of cases
  • Panacinar
  • Paraseptal and irregular. Only first 2 cause clinically significant airflow
Term
Centriacinar Emphysema
Definition
  • Central or proximal parts are effected.
  • More common and severe in upper lobes
  • Occurs mostly in heavy smokers
Term
Panacinar Emphysema
Definition
  • The acini are uniformly enlarged
  • More common in lower zones
  • Most severe at bases
  • Associate with Alpha1-antitrypsin Deficiency
Term
Paraseptal Emphysema
Definition
  • Affect distal part of acinus
  • Severe in upper lobes, enlarged airspaces
  • Cause of pneumothorax in young adults
Term
Irregular Emphysema
Definition
  • Associates with scarring, likely the most common form
  • is asymptomatic and clinically insignificant
Term
COPD Inflammation is caused by increased number of:
Definition
  • Macrophages, Neutrophils and both T-lymphocytes
  • Inflam cells release proteases and mediators
  • LKT b4, IL-8, TNF, etc that damange lung structures
Term
Emphysema Risk Factors
Definition
  • Environmental: 

Functional deficiency of alpha1-antitrypsin, CIG SMOKING, AIR POLLUTION

  • Genetic (1 in 3000)

Congenital deficiency of alpha1-antitrypsin, polymorphism in proteinase inhib on chrom 14.

Term
A1-Antitrypsin normally present in
Definition
Serum, tissue fluids, and macrophages
Term

Emphysema: Mechanism of obstruction

(3)

Definition
  • Loss of elastic tissue/recoil CARDINAL FEATURE

1. decreased radial traction. 2. alveoli distention with trapped air

  • Goblet cell metaplasia - mucus plugging lumen
  • Thickening of Bronchiolar wall

Smooth muscle hypertrophy, Neutro, macro, B&T

Term
Emphysema Clinical Course
Definition
  • Dyspnea
  • Cough/wheezing/weight loss/barrel-chested
  • sits forward in hunched position
  • expiratory airflow limitation (diagnostic key)
Term

Eventually Emphysema patients develop

 

Definition
  • cor pulmonale and CHF due to secondary pulmonary vascular hypertension
Term
Death in Emphysema occurs mainly due to:
Definition
  • Respiratory acidosis and Coma
  • RIght sided heart failure
  • massive collpase of the lungs secondary to pneumothorax
Term
Chronic Bronchitis initiating risk factors
Definition
  • Tobacco smoke (90%), dust from grain, cotton, silica
Term
Early feature (Large airways)
Definition
  • Hypertrophy of submucosal glands
  • Hypersecretion of mucus
  • Activation of neutrophils that inturn stimulate mucus hypersecretion
Term
CHRONIC BRONCHITIS Next step (small airways, small bronchi, and bronchioles)
Definition
  • Goblet cell hyperplasia

Leading to excessive mucus production (cardinal feature) and airway obstruction

Term
Cigarette smoke predispose
Definition
  • Direct damage to airway epi
  • interferes with ciliary action
  • inhibits bronchial and alveolar leukocytes to clear bacteria
Term
CB Clinical Course
Definition
  • Cardinal symptom: Persistent n productive cough
  • later on: hypercapnia, hypoxemia, mild cyanosis
  • over the years: Cor pulmonale and heart failure, cancer
Term
Pre dominate Emphysema
Definition
  • Older, severe and early dyspnea
  • Late coughing, low sputum
  • Occasional infections, terminal respiratory insuff
  • rare cor pulmonale, but terminal
  • normal or slightly increased airway resistance
  • low elastic recoil
  • Hyperinflation; small radiograph
Supporting users have an ad free experience!