B4-057 Obstructive Lung Disease

Question 1

increase in resistance to airflow due to diffuse airway disease

Answer 1

obstructive

Question 2

reduced expansion of lung parenchyma and decreased TLC

Answer 2

restrictive lung disease

Question 3

obstructive lung disease: FEV1/FVC is

Answer 3

less than 0.7

Question 4

restrictive lung disease: FEV1/FVC is

Answer 4

normal

Question 5

2 diseases under COPD

Answer 5

• emphysema
• chronic bronchitis

Question 6

if theres a reversible component, patient may have COPD and

Answer 6

asthma

Question 7

primary risk factor for COPD

Answer 7

smoking

Question 8

• affects proximal acinus
• respiratory bronchioles are enlarged, distal alveoli are spared
• upper lobe predominant

Answer 8

centriacinar

Question 9

• affects entire acinus
• uniform enlargement from respiratory bronchiole to alveoli
• lower lobe predominant

Answer 9

panacinar

Question 10

what type of emphysema is associated with heavy smoking?

Answer 10

centriacinar

Question 11

what type of empysema is associated with alpha1-antitrypsin deficiency?

Answer 11

panacinar

Question 12

Answer 12

centriacinar emphysema

Question 13

Answer 13

panacinar emphysema

Question 14

Answer 14

emphysema

Question 15

an increase in […] damages the elastic fibers of the alveoli septa, causing emphysema

Answer 15

neutrophil elastase

Question 16

loss of […] in the alveolar walls allows the respiratory bronchioles to collapse during expiration

Answer 16

elastic tissue

Question 17

in emphysema, hyperinflation is caused by

Answer 17

air being trapped in alveoli and dilation of distal airspaces

Question 18

A1AT deficiency + smoking causes

Answer 18

increased severity and earlier age of onset of emphysema

Question 19

A1AT deficiency can also cause

Answer 19

liver cirrhosis

Question 20

• increased bronchovascular markings with bronchial cuffing
• cardiomegaly

Answer 20

chronic bronchitis

Question 21

hyperinflation
* low diaphragm
* dark lung fields with reduced vascular markings

Answer 21

emphysema

Question 22

caused by exposure to noxious inhaled substances

Answer 22

chronic bronchitis

smoke, grain/cotton/silica dust

Question 23

mucus hypersecretion in airway

Answer 23

chronic bronchitis

Question 24

acquired CTFR dysfunction from smoking

Answer 24

chronic bronchitis

Question 25

* goblet cell hyperplasia * basement membrane thickening * smooth muscle hyperplasia

Answer 25

chronic bronchitis

Question 26

complications of COPD | 3

Answer 26

* pneumothorax * pneumonia * pulmonary hypertension

Question 27

due to increased airway sensitivity to a variety of stimuli

Answer 27

episodic bronchoconstriction | asthma

Question 28

wheezing, dyspnea, chest tightness, cough

Answer 28

asthma

Question 29

* triggered by exposure to allergens * associated with rhinitis, eczema, urticaria, family hx

Answer 29

atopic asthma

Question 30

chronic airway inflammation and hyperreactivity but no evidence of sensitization to allergen

Answer 30

non-atopic asthma

Question 31

an exaggerated Th2-mediated IgE response to enviornmental allergens in genetically predisposed individuals

Answer 31

atopic asthma

Question 32

stimulates B cells to produce IgE

Answer 32

IL4

Question 33

activates eosinophils

Answer 33

IL5

Question 34

stimulates mucus secretion and increases IgE

Answer 34

IL13

Question 35

binds Fc receptors on mast cells

Answer 35

IgE

Question 36

re-exposure to antigen results in

Answer 36

immediate IgE cross-linking on mast cells | immediate hypersensitivity reaction

Question 37

cause bronchoconstriction, vascular permeability, and mucus production

Answer 37

leukotrienes

Question 38

cause bronchoconstriction via muscarinic receptors

Answer 38

acetylcholine

Question 39

forms charcot-leyden crystals, inflammation and mucus production

Answer 39

galectin-10

Question 40

young children who develop lower respiratory tract infections have increased risk of developing

Answer 40

severe/persistent asthma

Question 41

Answer 41

charcot leyden crystals | tons of eosinophils

Question 42

destruction of smooth muscle and elastic tissue causing irreversible dilation of bronchi and bronchioles

Answer 42

bronchiectasis

Question 43

Answer 43

bronchiectasis

Question 44

Answer 44

bronchiolectasis

Question 45

* severe, persistent, productive cough * purulent, foul smelling sputum * dyspnea * hemoptysis

Answer 45

bronchiectasis

Question 46

* impaired mucociliary clearance * organ laterality defects

Answer 46

primary ciliary dyskinesia

Question 47

defect in dynein

Answer 47

primary ciliary dyskinesia

Question 48

situs inversus, sinusitis, bronchiectasis

Answer 48

kartagener syndrome | primary ciliary dyskinesia

Question 49

caused by aspergillus

Answer 49

ABPA

Question 50

* high serum IgE * Charcot-Leyden crytals * IgG to aspergillus

Answer 50

ABPA

Question 51

treatment bronchiectasis

Answer 51

* antibiotics * chest physical therapy

Question 52

* barrel shaped chest * prolonged expiration * pursed lips breathing

Answer 52

emphysema

Question 53

CXR * increased AP diameter * flattened diaphragm * increased field lucency

Answer 53

emphysema

Question 54

* wheezing, crackles * cyanosis * dyspnea * CO2 retention

Answer 54

chronic bronchitis

Question 55

hypertrophy and hyperplasia of mucus secreting glands in bronchi

Answer 55

chronic bronchitis

Question 56

productive cough > 3months in two years

Answer 56

chronic bronchitis ## Footnote this is from FA, not sure she mentioned it

Question 57

* asymptomatic baseline * intermittent coughing, wheezing, dyspnea, hypoxemia * mucus plugging

Answer 57

asthma

Question 58

* hyperresponsive bronchi * reversible bronchoconstriction * smooth muscle hypertrophy and hyperplasia

Answer 58

asthma

Question 59

* daily purulent sputum * recurrent infections (P. aeruginosa) * hemoptysis * digital clubbing

Answer 59

bronchiectasis

Question 60

chronic necrotizing infection of bronchi or obstruction leading to permanently dilated airways

Answer 60

bronchiectasis