Emphysema is a lung disease that interferes with normal breathing. It's one of a group of lung diseases known collectively as chronic obstructive pulmonary disease (COPD). Other diseases in this group include asthma and chronic bronchitis. More than 12 million Americans suffer from emphysema. To learn more about this lung disease, take this quiz.
1. Cigarette smoking is the usual cause of emphysema.
The correct answer is A. True .
Cigarette smoking is the cause in up to 90 percent of emphysema cases. A smoker is 10 times more likely to die of COPD than a nonsmoker. Scientists believe that, in addition to smoking-related processes, other factors are involved in the disease, because only 15 to 20 percent of smokers develop emphysema. The nature and role of these other factors in smokers' emphysema are not yet clear. Other factors that may contribute to emphysema include air pollution and fumes and dust in the workplace. There is also a form of emphysema that runs in families. People with this form of the disease have a deficiency of a blood component called alpha-l-protease inhibitor, also called alpha-l-antitrypsin (AAT). A blood test can detect this deficiency.
2. The main symptom of emphysema is shortness of breath.
The correct answer is A. True .
At first, shortness of breath occurs during a physical activity. As the disease progresses, shortness of breath is present all the time, even while sitting quietly.
3. In emphysema, shortness of breath is caused by permanent damage to the small air sacs (alveoli) and small airways in the lungs.
The correct answer is A. True .
In emphysema, the alveoli (tiny, elastic air sacs of the lung) are permanently destroyed. This occurs because of the irreversible destruction of a protein in the lungs called elastin, which helps maintain the strength of the alveolar walls. The loss of elastin also causes the collapse or narrowing of the smallest air passages, called bronchioles, which in turn limits airflow out of the lungs. Air continues to get into alveoli when the lungs expand during inhalation, but it is often unable to escape during exhalation because the air passages tend to collapse during exhalation, trapping the "stale" air in the lungs. The passageways become plugged with mucus.
4. Lung function—the ability to move air into and out of the lungs—declines with age.
The correct answer is A. True .
The decline is gradual in healthy nonsmokers. Because healthy nonsmokers have excess lung capacity when younger, the slow loss of lung function isn't noticeable. The decline in smokers, however, is rapid and significant. If a smoker quits before COPD develops, the decline levels off until it is nearly normal for the person's age.
5. Emphysema affects only the lungs.
The correct answer is B. False .
Emphysema and other forms of COPD make the heart work harder. The right ventricle enlarges and thickens because it must force blood into the lungs, which have been damaged or destroyed by the disease. Blood vessels in the lungs constrict because COPD reduces the amount of oxygen in the blood. The right ventricle works harder and harder to pump blood into these narrow vessels. An enlarged heart can cause abnormal heartbeats, which disturb the normal heart rhythm. People with this condition get tired easily and have chest pains and palpitations. The poor oxygen supply characteristic of emphysema also affects the brain, causing headaches, sleep problems, and irritability.
6. Swelling of the ankles can be caused by heart problems, which in turn have been caused by emphysema.
The correct answer is A. True .
A person with emphysema or other forms of COPD usually has an enlarged heart because of damaged lungs. If the heart is put under extra strain because of a minor illness, it may not be able to supply enough blood to the liver and kidneys. If these organs can't carry out their functions, the person may develop swelling of the ankles, legs, and abdomen. Because of poor oxygen supply, a person with emphysema may have a bluish tinge to skin, lips, and nails.
7. If you have emphysema, you should get a yearly flu shot.
The correct answer is A. True .
You should also get a pneumonia vaccination. If you have emphysema or other forms of COPD, you are less able to tolerate the flu and pneumonia. Complications of these illnesses can be fatal in a person with COPD. Other ways you can cope: Stop smoking. Avoid air pollution and cut back on physical activities during any air pollution alerts. Stay away from dust and fumes at work and people with respiratory infections. Avoid extreme hot and extreme cold, as well as very high altitudes. (Supplemental oxygen may be required for flying on commercial aircraft.) Drink plenty of fluids to keep sputum (mucous material in your lungs) loose.
8. A doctor diagnoses emphysema with a chest X-ray.
The correct answer is B. False .
A chest X-ray can show if the lungs overinflate, which can suggest emphysema, but it is not used to diagnose this disease. Instead, a doctor diagnoses emphysema through a physical exam and medical history. He or she will listen to the patient's breathing and measure lung capacity. The doctor also may order a high-resolution CT scan to help with diagnosis.
