Chronic Bronchitis

Question 1

What is the clinical definition of chronic bronchitis?

Answer 1

Persistent cough production of sputum for at least 3 months in 2 consecutive years, with no other cause

Question 2

Describe the pathogenesis of chronic bronchitis

Answer 2

Chronic irritation by inhaled substances (e.g. cigarette smoke) results in increased mucus production in larger airways, and inflammation, scarring and narrowing of smaller airways

Question 3

What 6 histological changes are seen with chronic bronchitis?

Answer 3

Hypertrophy of mucus secreting glands (resulting in thickening of the bronchial wall)
Increased goblet cells
Mild increase in lymphocytes, macrophages and plasma cells
Mild oedema
Peribronchial fibrosis in small airways
+/- squamous metaplasia

Question 4

List 3 complications of chronic bronchitis

Answer 4

Superimposed infective exacerbations
Chronic hypoxia, leading to pulmonary hypertension and cor pulmonale
Squamous metaplasia and dysplasia (pre-malignant)