Asthma vs COPD

• What onset is asthma most common in?

  Childhood
• Asthma is most common in those with a family history of atopy (hayfever, eczema & asthma).
• COPD tends to occur as people get older. The more you smoke, the more likely you are to develop COPD.
• Can you differentiate between asthma & COPD based on symptoms alone?

  No, but…

  Asthma is usually intermittant, returning to normal between events

  COPD is a chronic progressive decline with no relief
• What is the sputum like in asthma?

  Pellets of luminous green sputum (due to IgE)
• Fill in the blanks

  A) Mostly

  B) Possibly

  C) Rare

  D) Often

  E) Uncommon

  F) Common

  G) Common

  H) Uncommon

  I) Presistent

  J) progressive

  K) Variable

  L) Uncommon]

  M) Common

  N) Uncommon

  O) Common

  
• What are the risk factors of COPD?

  Smoking

  Air pollution

  Occupational exposures

  Low birth weight

  Low socioeconomic status

  Childhood infection

  Asthma
• 60% of continuous smokers have normal lung function at 25 years.
• Asthma is a mix between genetics, epigenetics & environmental exposures.
• What is the difference between asthma & COPD on imaging?

  CXR in asthma is most often normal, but may be hyperexpanded

  COPD - hyperinflation is comon

  • loss of height of convexity of hemidiaphragm
• What is the prodominant cell type in asthma vs COPD?

  Asthma - eosinophilic

  COPD - neutrophilic
• What is neutrophilic asthma?

  Very severe & persistent

  Frequent exacerbations

  Fixed airway obstruction
• Fill in the blanks

  A) Normal

  B) Obstructive

  
• Asthma & COPD are both due to airway obstruction. What is the mechanism behind each one?

  Asthma

  • airway obstruction from constriction of bronchial smooth muscle, airway hyperreactivitiy to allergens & inflammation + increased eosinophils & activated T cells
  • Intermittent & reversible

  COPD

  • airway smooth muscle is NOT constricted, mainly due to mucoud hypersecretion & mucosal infiltration by inflammatory cells -> cellular damage & loss of alveolar structure
  • Associated cellular destruction & structural changes in COPD -> interferes with oxygenation & pulmonary circulation
• Fill in the blanks

  A) ICS

  B) SABA

  C) LABA

  D) LTRA

  E) Specialist care

  
• Can you have both asthma & COPD?

  Yes
• What is ACOS?

  Asthma COPD Overlap Syndrome