110714 copd and cases Flashcards

1
Q

acinus

A

distal to terminal bronchiole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

airways prxoimal to respiratory bronchioles are lined by what kind of epithelium

A

pseudostratified ciliated columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

definition of COPD

A

diseases that cause obstruction to airflow out of lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

types of obstructive lung disease

A

emphysema
chronic bronchitis
asthma
bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

obstructive disease is located where

A

airway disorder–trachea to terminal bronchiole (although in emphysema you see changes with alveoli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

restrictive disease is located where

A

parenchymal disorder-respiratory bronchiole, alveoli and alveolar ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

obstructive lung disease

A

increased resistance to air flow and limited expiratory rates on forced expiartion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

restrictive lung disease

A

decreased expansion with reduced total lung capacity, O2 diffusing capacity, lung volumes and compliance

can have similar to normal or increased FEV1/FVC ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

emphysema

A

permanent enlargement of all or part of the respiratory unit (respiratory bronchioles, alveolar ducts, alveoli) accompanied by wall destruction WITHOUT obvious fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

causes of emphysema

A

smoking
air pollution
alpha1 antitrypsin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

types of emphysema

A

centriacinar (centrilobular)-95% of cases–associated with smoking

panacinar-associated with alpha1 antitrypsin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pathogenesis of emphysema

A

increased numbers of macrophages, CD8 T cells and neutrophils

neutrophils and macrophages are activated by tissue damage from cigarette smoke

neutrophils make elastase
macrophages make free radicals

destruction of elastic tissue
increased compliance and decreased elasticity

elastic tissue normally keeps airway lumens open by applying traction. destruction of elastic tissue causes COLLAPSE of airways on expiration and prevention of air exit, causing trapped air distending repiratory unit and destruction of alveoli and alveolar ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

panacinar emphysema

A

alpha1 antitrypsin deficiency that’s genetic or acquired (acquired from things like cigarette smoke)

lower lobes (as opposed to upper for centriacinar emphysema)

all parts of respiratory unit are affected by elastic tissue destruc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical findings of emphysema

A

severe and early onset of dyspnea
pink puffers
coexistence w chronic bronchitis (smokers’ emphysema)
cor pulmonale (less common)
diminished breath sounds due to hyperinflation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CXR of emphysema

A

increased AP diameter (barrel chest)
hyperlucent lung fields
vertical heart
depressed diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

chronic bronchitis

A

productive cough for at least 3 months for 2 consecutive years

17
Q

causes of chronic bronchitis

A

smoking

cystic fibrosis

18
Q

pathogenesis of chronic bronchitis

A

inhaled smoke causes mucous hypersecretion in bronchi, leading to airflow osbruction in terminal bronchioles. in long standing cases, leads to irreversible fibrosis of terminal bronchioles

exacerbated by infection

another contributing factor is bronchospasm resulting in narrowed airway

19
Q

clinical findings of chronic bronchitis

A
PRODUCTIVE COUGH (due to mucus secretion)
cyanosis (due to decreased O2 saturation from hypoxemia)

blue bloaters
dyspnea
expiratory wheezing and rhonchi
cor pulmonale

20
Q

CXR of chronic bronchitis

A

enlarged heart, horizontally oriented

increased bronchial markings

21
Q

histology of chronic bronchitis

A

chronic inflam cells in airway wall
increased mucous glands-hyperplasia
thickening of walls (narrowing of bronchiolar lumen)

22
Q

reid index

A

ratio of thickness of mucous gland layer to thickness of wall btwn epithelium and cartilage

23
Q

compare emphysema and chronic bronchitis

A

see slide 35

24
Q

bronchoectasis

A

permanent destruction and dilatation of bronchi and bronchioles

destruction involves cartilage and elastic tissue (entire wall)

25
causes of bronchiectasis
``` cystic fibrosis infections bronchial obstruction (tumor) primary ciliary dyskinesia allergic bronchopumonary aspergillosis ```
26
clinical findings of bronchiectasis
copious sputum hemoptysis digital clubbing cor pulmonale
27
CXR of bronchiectasis
bronchial markings (from dilatation) extending to the periphery of lungs
28
gross findings of bronchiectasis
bilateral lower lobes distal bronchi and bronchioles dilated airways on cut surface dilated bronchi appear as cysts filled with mucopurulent secretions
29
history of SOB as child
asthma
30
what would productive cough mean?
chronic bronchitis
31
what causes decreased FEV1 in chronic bronchitis?
mucous secretion
32
what causes decreases FEV1 in emphysema
alveolar walls lost and elasticity lost
33
would beta agonist help for emphysema?
no, because beta agonist only works for sm musc contraction
34
clubbin is a sign of
chronic impaired air exchange, hypoxia
35
COPD
usually related to smoking obstruction not reversible with beta agonist reduced gas exchange
36
associated diseases of COPD
right heart failure | lung cancer
37
asthma
usually develops early in life (exacerbated by smoke but not caused by it) associated with allergies obstruction reversible with beta agonist no defect in gas exchange