Answers
A. Cor pulmonale
B. Congestive cardiac failure
C. Airway hyper-responsiveness
D. Extrinsic allergic alveolitis
E. Eosinophilic bronchitis
F. Airway remodelling
G. Bronchiectasis
H. Emphysema
From the list below please select the most appropriate terminology for each of the statements below
1. Prolonged airway inflammation producing irreversible airway obstruction in asthmatic patients results in the condition known as
F- Airway remodelling. This is a complex series of events including mast cell migration, smooth muscle cell hyerplasia, basement layer thickening, and ultimately epithelial restructuring that occurs throughout the life of patients who have uncontrolled airway inflammation in COPD, and in particular, asthma. The pathogenesis of airway remodelling is not yet fully understood, but we see this phenomenon frequently in clinical practice.
2. In asthma the exaggerated airway bronchoconstrictor response to various exogenous stimuli is known as
C- Airway hyper-responsiveness. Also known as bronchial hyper-responsiveness, and sometimes as hyper-reactivity. Normal airway epilthelium responds to a number of stimuli, such as histamine, to produce a bronchosconstrictor response. In asthmatic airways the airway response is exaggerated, producing significant bronchoconstriction in response to minimal stimuli, usually with naturally occurring antigens (house dust mite, grasses, pollen, animal dander, trees). The response is due to degranulation of mast cells, and to a lesser degree basophils, resulting in the release of histamine, and leukotrienes. Steroids act to prevent the degranulation of the mast cells, and leukotriene receptor blockers, such as montelukast, block the effects of leukotriene release.
3. Prolonged hypoxemia in COPD results in the condition known as
A – Cor Pulmonale. This is right heart failure due to a pulmonary condition. We know that in the majority of cases right ventricular failure is predated by secondary pulmonary arterial hypertension; both conditions are untreatable, irreversible, end stage complications of COPD. We know that secondary pulmonary hypertension increases the risk of pulmonary thrombosis, so we give these patients warfarin; they are also usually hypoxaemic, so we give them long term oxygen therapy, if safe to do so.
