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Path Block 2 > 9- Obstructive Lung Disorder > Flashcards

9- Obstructive Lung Disorder Flashcards

0
Q

Obstructive lung disease functional lung test presents , and physical how?

A 
TLC ^
RV^
Percussion bilateral hyper resonant 
Auscultation faint
Barrel chest
Fev1/fvc= decreased
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1
Q

How does the diaphragm present in Ob LD

A

Pushed down

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2
Q

What mind of diagnosis is emphysema

A

Anatomical

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3
Q

What kind of diagnosis is chronic bronchitis?

A

Clinical

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4
Q

What is the cause of airflow obstruction in chronic bronchitis

A

Edema ,fibrosis and recurring infections of bronchial tree

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5
Q

What is the cause of airflow obstruction in emphysema

A

Loss of elastic recoil so small respiratory acini collapse

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6
Q

Second cause for Emphysema after cigarette smoke

A

A1 anti trypsin deficiency

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7
Q

What protease damages the elastic tissue of the lung ?

A

Serine protease

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8
Q

Destruction of elastic tissue causes what?

A

Loss of radial traction
Small airways collapse
Air gets trapped

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9
Q

What airways does centriacinar involve

A

Only dilation of respiratory bronchial

Alveoli normal

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10
Q

The other name for centriacinar

A

Centri lobar emphysema

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11
Q

What is the mc type of emphysema

A

Centriacinar

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12
Q

What part of lungs does centriacinar involve

A

Apical segment of upper lobes where smoke goes up to

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13
Q

Who is centriacinar mostly seen in

A

Smokers and CWP

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14
Q

Who is panacinar emphysema seen in ?

A

Patients with AAT deficiency

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15
Q

What organ makes AAT

A

Liver

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16
Q

Two problems in AAT deficiency ?

A

Lungs have decreased anti trypsin and liver has accumulation of misfolded ATT - cirrhosis of liver

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17
Q

What does accumulation of misfolded AAT lead to in panacinar emphysema

A

Cirrhosis of liver cells

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18
Q

What is the thee other name for paraseptal emphysema

A

Distal acinar

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19
Q

Does paraseptal emphysema cause obstruction

A

No

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20
Q

What does distal acinar paraseptal emphysema MC lead to

A

Spontaneous pneumothorax from rupture of sub pleural bullae

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21
Q

What does the thinking and destruction of large air spaces and alveolar capillaries lead to in emphysema

A

Pulmonary hypertension

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22
Q

3 symptoms of emphysema

A

Dyspnea
Dec exercise tolerance
Tachypnea– hyperventilation

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23
Q

What does pursing lips in emphysema do and what are these people called

A

Creates positive backwards pressure- over oxygenated skin so PINK BUFFERS

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24
Q

WhAt develops late in emphysema from PH

A

COR pulmonary

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25
Q

How does X-ray look in emphysema

A

Hyperlucent lung fields
Depressed diaphragm
Increased ap diameter
Vertically orientated hidden heart

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26
Q

Mc type of COPD

A

Chronic bronchitis

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27
Q

Clinical requirement of chronic bronchitis

A

3 months for two years of cough and sputum

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28
Q

What airways does chronic bronchitis affect

A

Large-trachea and bronchi

and small airways -terminal bronchi

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29
Q

What do the large airways in chronic bronchitis produce

A

Mucous gland hyperplasia

Excess mucous

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30
Q

In chronic bronchitis what happens in the small airways

A

There is goblet cell metaplasia and mucous plugs with smc hypertrophy causing obstruction

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31
Q

What does mucous plug in chronic bronchitis cause

A

Hypoxemia- acidosis - constriction -cyanosis -PH- COR pulmonale

32
Q

In chronic bronchitis what does mucous gland

Hypertrophy lead to

A

Increased Reid index more than .40

33
Q

What is the reid index

A

Is the thickness of mucosal gland to entire wall thickness

34
Q

What do patient with chronic bronchitis look like

A

Blue bloaters with peripheral edema from RVF

35
Q

What does late stage chronic bronchitis lead to

A

Severe hypoxia from broncoconstriction
Pulmonary HT
COR pulomonale

36
Q

PH in COPD develops from what combination of things

A

Pulmonary vasoconstriction -Hypoxia

Increased blood viscosity

-polycythemia

Loss of pulmonary vasculature surface area

37
Q

Why does COPD develop increased lung viscosity

A

Due to polycythemia from chronic hypoxia

38
Q

What kind of lung disease is Asthma

A

Obstructive

39
Q

What kind of lung disease is bronchiectasis

A

Obstructive

40
Q

What airways do bronchiectasis involve

A

Medium dialated airways extending to pleura

41
Q

What does inflammation in bronchiectasis cause

A

Destruction of cartilage muscle And elastic tissue which cause weakness and permanent and irreversible dilatation

42
Q

Mc cause of bronchiectasis in America

A

CF

43
Q

Mc agents causing bronchiectasis in CF patients

A

Pseudomonas aeruginosa

44
Q

Mc cause of bronchiectasis in the world

A

Tb

45
Q

What causes bronchiectasis

A

Obstruction from mucous from infection

Chronic persistent infection

46
Q

Organism that cause bronchiectasis in children

A

H. Influenza

47
Q

Common organism that cause bronchiectasis

A

Strep pneumo
Staph aureus
Pneumococci
Pseudomonas aeroginosa

48
Q

Causes for bronchiectasis

A

CF
TB
Broncogenic Carcinoma
Kartagners*

49
Q

What are the bronchioles In bronchiectasis filled with

A

Pus

50
Q

Bronchiectasis clinical findings

A

Digital clubbing

Cupfull sputum

51
Q

How does the X-ray of bronchiectasis look

A

Bronchial markings toward periphery

52
Q

Obstruction pattern in emphysema

A

Airway collapse

53
Q

Obstruction pattern in bronchiectasis

A

Functional obstruction

54
Q

Obstruction pattern in chronic bronchitis

A

Mucous plug

55
Q

In bronchiectasis what do you find In ct scan of lung

A

Signet ring and dialated bronchi with thickened walls

56
Q

Bronchiectasis is reversible or irreversible ?

A

Irreversible

57
Q

Asthma is reversible or irreversible

A

Reversible

58
Q

What cause obstruction in asthma

A

Broncospasm

Mucosal inflammation-edema

Excessive secretion of mucous

59
Q

What airways does asthma involve

A

Bronchi and terminal bronchioles

Not resp unit

60
Q

What is the most common cause of children absence in school from respiratory disease

A

Asthma

61
Q

Other name for idiosyncratic asthma

A

Intrinsic asthma

Non allergic asthma

62
Q

What kind is asthma is aspirin induced asthma

A

Intrinsic non immune

63
Q

What kind of asthma is virus induced asthma

A

Intrinsic

64
Q

What mind of asthma is ozone produced asthma

A

Intrinsic

65
Q

When’re do you see nasal polyps in adults

A

Aspirin produced asthma

66
Q

Where do you see nasal polyps in children

A

CF

67
Q

In early phase of extrinsic Asthma what is The signal for mast cells to degenerate

A

Cross link of igE on them

68
Q

Asthma early stage IL-4 Cause

A

IgE production

69
Q

Early stage asthma what cells secrete IL -4 and IL-5

A

CD 4 TH2 cells

70
Q

What mind of hypersensitivity is asthma

A

1

71
Q

Does does il-5 do in asthma

A

Chemo tactic for activation of eosinophils

72
Q

At what time is the late phase of asthma

A

4-8 hours later

73
Q

What cells are involved in late phase in Asthma

A

Neutrophils mononucleosis cells and eosinophils

74
Q

What is the important mediator in late stage asthma

A

Leukotrienes cde4

75
Q

In late phase asthma what do eosinophils release

A

Mbp- damage epithelial cells

Cationic protein- damage epithelial and cause constriction

76
Q

What histology changes happen in the cells in asthma

A

Hyperplasia of mucous glands
Hypertrophy of smc
Edema
Eosinophils infiltrate

77
Q

What are asthma curshmann spirals

A

Shed epithelial cells in spiral

Shaped mucous plugs

78
Q

In asthma What are crystalline granules in eosinophils fuses to form ?

A

Spear shaped Charcot Leyden crystals

Path Block 2 (19 decks)

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