PAT 20A/B Lecture Notes - Lecture 7: Gastroesophageal Reflux Disease, Bronchial Hyperresponsiveness, Airway Obstruction
6 Nov 2018
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Document Summary
Copd overlap [aco]: recurrent and reversible shortness of breath, resulting from narrowing of the bronchi and bronchioles. Key characteristics are inflammation, bronchial smooth muscle spasticity, and sputum production; inflammation is the most important characteristics (lilley, p. 719) Irritants (smoke, smog, occupational irritants & strong odors (perfume): nsaids & asa affect some who have the clinical triad of asthma, chronic rhinosinusitis with nasal polyps, emotional factors (stress, hormones, gerd, temperature extremes. Allergen exposure triggers ige-mediated release of chemical mediators from sensitized mast cells. Results in: opening mucosal intercellular junctions with exposure of submucosal mast cells to antigen, bronchospasm. Late-phase response: (4-8 hrs after exposure, may last days, weeks) Increased airway responsiveness: epithelial cell injury; decreased muco-ciliary function, mucus accumulates. Inflammatory mediators (neutrophils, eosinophils, basophils) released from mast cells, macrophages and epithelial cells. Increased vascular permeability & edema: changes in muco-ciliary function and decreased clearance of secretions, bronchospasm, chronic inflammation leads to remodelling.
