Chronic Obstructive Pulmonary Disease- Exam Questions and Answers Latest Update () Already Passed

Chronic Obstructive Pulmonary Disease- Exam Questions and Answers Latest Update () Already Passed Define COPD: - Answers a disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases What two conditions characterise CODP? - Answers 1) chronic bronchitis 2) emphysema What is the most common cause of COPD? - Answers smoking (90%) What is chronic bronchitis? - Answers long-term inflammation of the bronchi causing cough and sputum production What is emphysema? - Answers damage and dilatation of the alveolar sacs and alveoli, decreasing the surface area for gas exchange Describe 5 histiological features of chronic bronchitis: - Answers 1) mucous gland hyperplasia 2) squamous metaplasia 3) increased epithelial mucous cells 4) infiltration with neutrophils and CD8+ lymphocytes 5) loss of stromal support Name the three distributional classifications of emphysema: - Answers 1) centri-acinar emphysema 2) pan-acinar emphysema 3) irregular emphysema What is an acinus? (in context of respiratory medicine) - Answers an alveolar unit comprised of a bronchiole opening into alveoli What is centri-acinar emphysema? - Answers distension and damage of lung tissue is concentrated around the respiratory bronchioles while more distal alveolar ducts and alveoli tend to be well preserved What is pan-acinar emphysema? - Answers distension and destruction affecting the whole acinus What genetic condition is pan-acinar emphysema associated with? - Answers alpha 1 antitrypsin deficiency What is irregular emphysema? - Answers scarring and damage that affects the lung parenchyma patchily, independent of acinar structure How does emphysema result in an increase in total lung capacity? - Answers the destruction and dilatation of alveoli causes a loss of elastic recoil Describe how smoking causes COPD: (2) - Answers 1) smoking irritates the lung, increasing numbers of neutrophil granulocytes which release elastases and proteases (which breakdown alveolar tissue) 2) irritation also causes mucous gland hypertrophy, with mucous obstructive the airways What is the role of alpha 1 antitrypsin in the lungs? - Answers it is a proteinase inhibitor which acts to inhibit neutrophil elastase in the lungs, preventing alveolar destruction Where is alpha 1 antitrypsin produced? - Answers liver What % of emphysema cases are caused by alpha 1 antitrypsin deficiency? - Answers 2% Give 5 respiratory symptoms of COPD: - Answers 1) shortness of breath 2) cough 3) sputum 4) wheeze 5) recurrent respiratory infections Give 6 systemic symptoms of COPD: - Answers 1) hypertension 2) osteoporosis 3) depression 4) weight loss 5) right ventricular heart failure 6) reduced muscle mass Give 3 observational signs associated with COPD: - Answers 1) tachypnoea 2) use of accessory muscles 3) pursing of lips on exertion What percussion finding is associated with COPD? - Answers loss of liver and cardiac dullness due to lung hyperinflation Describe the pink puffer COPD presentation: (2) - Answers 1) the patient is responsive to CO2 2) the patient is breathless but not cyanosed Describe the blue bloater COPD presentation: (2) - Answers 1) the patient has become insensitive to CO2 2) the patient appears oedematous, cyanosed but not breathless Give 3 clinical signs of hypercapnia (CO2 retention): - Answers 1) bounding pulse 2) CO2 hand flap 3) peripheral vasodilation How is COPD diagnosed? (2) - Answers 1) clinical presentation 2) spirometry What spirometry result confirms as diagnosis of COPD? - Answers obstructive picture: FEV1: FVC ratio of less than 70% with no response to variability testing with beta-2 agonists such as salbutamol