16 Copd

Question 0

Elastic tissue function in the lungs

Answer 0

Pulls open airways during inspiration- destruction causes air trapping

Question 1

Emphysema pathogenesis

Answer 1

• ^ Macs, CTLS, PMNS
• Tissue damage cigarette smoke activates Macs and Neuts
  
  • Elastase increases decrease in antielastase
  • increased oxidants

Question 2

Centriacina emphysema

Answer 2

Smokers emphysema- respiratory bronchiole

• oxidative injury to the respiratory bronchiole
• oxidizers destroy anti trypsin
• upper lobes

Question 3

Panacinar emphysema

Answer 3

Genetic or acquired antitripsyn deficiency
Autosomal dominant
Lower lobes.

Question 4

Emphysema findings

Answer 4

Diminished breath sounds 22 hyperinflation
Increased AP diameter
Hyperlucent lung feilds
Vertical heart
Depressed diaphraghm

Question 5

Paraseptal emphysema

Answer 5

subpleural involvement with spontaneous pneumthorax- no COPD

Question 6

Irregular emphysema

Answer 6

Arround lung scarred tissue.

No COPD

Question 7

Chronic bronchitis criteria and etiology

Answer 7

Productive cough for 3 months fo 2 consecutive years

*Smoking or CF

• Irritant–> mucous—>obstruction –>fibrosis of terminal bronchioles
• infection
• bronchospasm
• Smooth muscle hyperplasia

Question 8

Chronic bronchitis clinical findings

Answer 8

Hypoxemic
productive cough
expiratory wheezing and rhonchi
early COR PULMONALE

CXR: Enlarged horizontal heart and increased bronchial markings

Question 9

Chronic bronchitis histo

Answer 9

Mucinous/mucopurulent secretions
hyperemia swelling
Chronic inflammation of airways
Increased mucous glands (measured by reid index as percentage of mucous gland thickness to wall between epithelum and perichondrium.

Question 10

Bronchiectasis definition and causes

Answer 10

• Destruction and dilation of bronchi and bronchiles
• destroyed cartilage and elastic tissue

Causes:
CF, TB, adenovirus, H influenzae, staph A, bronchial obstruction, Primary ciliary dyskenesia, allergic bronchiopulmonary aspergillosis

Question 11

Bronchiectasis findings

Answer 11

sputum
hemoptysis
clubbing
corr pulmonale

CXR
Bronchial markings extending to the periphery of lungs

Question 12

CF pathoogenesis

Answer 12

• Chromosome 7 deletion blocking chloridde transporter.
• decreased CL secretin- thicker secretions
• dehydrated body secretions- Bronchioles, pancreas, bile, meconium, seminalfluid

Question 13

CF findings

Answer 13

Nasal polyps
Respiratory infections and failure
Malabsorption
DM I
Male infertility
Meconium ileus
2ndary biliary cirrhosis

Question 14

CF morphology

Answer 14

Dilated airways

cut surface with mucopurulent cysts

Question 15

Bronchiectasis morphology

Answer 15

Necratizing ulceration and intense inflammatory exudate
Squamous metaplasia of bronchial epithelium
lung abscess
fibrosis of bronchial walls/ bronchiolitis obliterans
Positive lung cultures