Question

D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35mmHg and mild CHF.

What is pulmonary hypertension and how could D. D. have developed PH?

How does her history fit in with her new diagnosis?

1. How many patients are suffering from COPD in the US? Do COPD sufferers die of respiratory causes or other causes? (be sure to cite the data)
2. What are the two separate diseases that are the main COPD diseases? Give background on each disease.
3. How does COPD correlate with left ventricular pressure and primary heart failure?
4. What are the three types of bronchodilators, and how do they function to alleviate the symptoms of COPD? What are other possible treatments for COPD?
5. Through what mechanism does bronchiolitis cause destruction of alveoli? Is emphysema genetic? Can environmental factors increase the risk of emphysema, why or why not?
6. Is lung transplantation a solution for emphysema? Can new technology be useful in the treatment of emphysema? Why or why not?

Answer 1

#. Pulmonary Hypertension: Mean pulmonary artery pressure 12 to 16 mm Hg above normal or about 20 mm Hg creates chronic pressure overload in the right ventricle causing R ventricle hypertrophy and failure. Bronchiolitis, hyperinflated lungs, pulmonary edema, and mild CHF as a result of her chronic smoking has lead to development of PH .

#. Her history fit in with the diagnosis of PH because her history of disease are the causative factor for development of PH

#. More than 16.4 million people have been diagnosed with COPD, but millions more may have the disease without even knowing it.

Yes , as COPD severity increases sufferers die of respiratory causes

Source : Mortality in COPD : causes ,risk , factors and prevention .

#. COPD definition

characterized by airflow obstruction that is not fully reversible and is progressive; emphysema + chronic bronchitis

Chronic bronchitis :

presence of chronic productive cough lasting more than 3 consecutive months of the year for two consecutive years w/o underlying etiology of bronchiectasis or tuberculosis

Emphysema :

results from pathological destruction of the alveolar walls and septae from long-term exposure to irritants