3: COPD Pathophysiology

Question 1

Pulmonary HTN in COPD leads to what?

Answer 1

Right ventricular HF

Question 2

Chronic bronchitis is a condition associated with excessive _____ production.

Answer 2

Chronic bronchitis is a condition associated with excessive tracheobronchial mucus production.

Question 3

Why is there increased residual volume (RV) and functional residual capacity (FRC) with elevated total lung capacity (TLC) in COPD?

Answer 3

Loss of elastic recoil pressure of the lung

Question 4

Is asthma considered COPD?

Answer 4

It does have crossover and can lead to COPD especially in asthma patients who smoke.

Question 5

What are the systemic consequences of COPD?

Answer 5

1. Weight loss with decreased fat-free mass
2. Muscle wasting and weakness
3. Cardiac comorbidity
4. Osteoporosis
5. Anemia
6. Depression

Question 6

Emphysema is permanent, abnormal distention of the air spaces distal to the terminal bronchiole with destruction of the _____.

Answer 6

Emphysema is permanent, abnormal distention of the air spaces distal to the terminal bronchiole with destruction of the alveolar septa.

Question 7

Name 4 principles of pathophysiology of COPD.

Answer 7

1. Reduced FEV1.
2. Chronically reduced FEV1/FVC ratio.
3. Hyperinflation (large chest d/t air trapping).
4. Impaired gas exchange (ventilation/perfusion mismatch).

Question 8

Chronic bronchitis causes cough with expectoration that is present for at least _____ of the year for more than _____ years.

Answer 8

Chronic bronchitis causes cough with expectoration that is present for at least 3 months of the year for more than 2 years.

Question 9

What happens to the diaphragm in COPD?

Answer 9

Flattening

Question 10

Why is expiration prolonged in COPD?

Answer 10

Airway narrowing

Question 11

What small airway changes occur in chronic bronchitis?

Answer 11

1. Goblet cell hyperplasia
2. Inflammation
3. Edematous changes
4. Peribronchial fibrosis
5. Intraluminal mucus plugs
6. Increased smooth muscle

Question 12

Maldistribution of gas and blood flow leads to what?

Answer 12

1. Abnormal arterial blood gases
2. Elevated CO₂ levels
3. Decreased O₂ levels

Question 13

Chronic mucopurulent bronchitis indicates what?

Answer 13

Infection

Question 14

Disturbed pressure-flow relationships lead to what?

Answer 14

Mild to severe pulmonary HTN at rest and with exercise.

Question 15

Chronic bronchitis with obstruction is caused by _____ obstructing the airway.

Answer 15

Chronic bronchitis with obstruction is caused by mucus obstructing the airway.