Benign Resp Path

Question 1

what is the definition of asthma

Answer 1

chronic inflammatory disorder of airways - paroxysmal bronchospasm causing wheeze and cough - partially reversible

Question 2

what is the pathogenesis of asthma

Answer 2

mucosal inflammation and oedema, hypertrophic mucous glands and mucus plugs in bronchi - hyperinflated lungs

Question 3

what are the different types of asthma

Answer 3

atopic (extrinsic) non-atopic (intrinsic) allergic bronchopulmonary aspergillosis (ABPA)

Question 4

describe an atopic asthma attack

Answer 4

type 1 hypersensitivity reaction
dust and pollen or animal products
exacerbated by cold, exercise, infection
bronchiolar smooth wall hypertrophy and mucous gland hyperplasia

Question 5

what is the most common occupational lung disease

Answer 5

asthma

Question 6

what are the two distinct pathological entities of COPD

Answer 6

chronic bronchitis (cough with sputum for 3 months in 2 years) 
emphysema - caused by chronic bronchitis, large alveolar spaces

Question 7

what is the pathogenesis of COPD

Answer 7

bronchitis - cell damage - inflammation, scar and mucous infection - wall thickening
emphysema - increased elastase - alveolar wall loss - deceased gas exchange

Question 8

what are the three classes of emphysema

Answer 8

centrilobular (centiacinar) - most associated with smoking and coal dust

pan lobular (panacinar) - severest lower lobe bases

paraseptal (distal acing) - can rupture and lead to pneumothorax

Question 9

what are the clinical features of COPD

Answer 9

dyspnoea 
cough 
sputum 
infection 
right heart signs - increased work load - pulmonary hypertension and right ventricular hypertension

Question 10

define bronchiectasis

Answer 10

permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue

Question 11

what is the pathogenesis of bronchiectasis

Answer 11

bronchiole damage due to infection or autoimmune condition which lead to inflammation and scarring

Question 12

what is a major complication of bronchiectasis

Answer 12

abscess formation

Question 13

which syndromes and diseases are associated with bronchiectasis

Answer 13

CF, primary colliery dyskinesia, kartagener syndrome, RA

Question 14

what are the clinical features of bronciectaiss

Answer 14

cough, fever, foul smelling sputum, abscesses

pneumonia, septicaemia

Question 15

what is the definition of ILD (interstitial lung disease)

Answer 15

group and diffuse and chronic conditions of pulmonary connective tissue such as alveolar walls or bronchioles

Question 16

what is the pathogenesis of ILD

Answer 16

idiopathic trigger causes inflammation and fibrosis in bronchioles and or alveolar walls = thickening and deceased lung compliance and reduced gas diffusion

Question 17

what are the two types of clinical features of ILD

Answer 17

acute - damage to lung parenchyma (type 1 pneumocytes) causing ARDS - repsiarory alkalosis

chronic - clubbing, fine crackles, dry cough, honey comb lung

Question 18

what is another name for idiopathic pulmonary fibrosis

Answer 18

cryptogenic fibbing alveolitis

Question 19

what is the pathogenesis of idiopathic lung fibrosis

Answer 19

interstitial chronic inflammation - fibrous tissue with normal alveolar walls - cobblestone pleural surface

Question 20

what is the pathogenesis of sarcoidosis

Answer 20

red, swollen, granulomas in lymph nodes of the lung usually hilariously nodes - can infect other organs

Question 21

what are the key clinical features of sarcoidosis

Answer 21

hypercalcaemia and elevated serum ACE

Question 22

what is pneumoconiosis

Answer 22

dust diseases which is occupational - inflation of fibrogenis mineral dust sin the workplace or vapours

Question 23

what is coal worker pneumoconiosis

Answer 23

black lung disease
inhalation of coal dust - biros and necrosis - restrictive disease
simple - macular or nodular lesion
complication - progressive massive fibrosis

Question 24

what is silicosis and the key clinical features

Answer 24

inhalation of silicotic noduli which leads to granulomatous chronic inflammation
possible reactivation of TB
increased risk of lung carcinoma
mixed dust pneumoconiosis

Question 25

what is hypersensitivity pneumonitis and what is the pathogenesis

Answer 25

extrinsic alergic alveolitis - framer slung, pigeon fanciers lung

inhaled allergy - hypersensitivity 3 - peribroncioalr inflammation - interstitial fibrosis

Question 26

what is the definition of cystic fibrosis

Answer 26

inherited multiorgan disorder or epithelial cells affecting fluid secretion in exocrine glands and epithelial lining of repository, GI and reproductive organs

Question 27

what is the causes and pathoegeniss of CF

Answer 27

AR inheritence, CFTR mutation chromosome 7
lack of chloride ion transport out of cells so w water can’t follow and bronchioles or tubes become sticky and blocked - recurrent infection
severe respiratory diseases and hyperplasia of secreting glands

Question 28

what are the key clinical features of CF

Answer 28

pancreatic problems, atrophy and fibrosis
impaired fat absorption and meconium ileum
cirrhosis
salivary problems
infertility in males