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Pathology > COPD > Flashcards

COPD Flashcards

1
Q

COPD defined

A

Chronic airway obstruction + Increased flow resistance

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2
Q

4 diseases of COPD

A
  1. Chronic bronchitis
  2. Emphysema
  3. Bronchial asthma
  4. Bronchiectasis
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3
Q

Bronchitis definition

A

Chronic cough + sputum

> 3 mo, >2 years consecutively

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4
Q

Bronchitis etiology

A
  1. Smoking (>90%)
    Cessation improves, related to pack/year
  2. Other: air pollution, toxic fumes, pneumonias
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5
Q

Bronchitis pathology

A
  1. Increased goblet cells & hypertrophy of mucus glands
  2. Thickening of walls + lumen filled with mucus
  3. Mucosa infiltrated with lymphocytes, macrophages & plasma cells
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6
Q

Bronchitis over time patho

A

Ulcer/Metaplasia of epithelium

Pulmonary vasculature compressed by peribronchial fibrosis–Pulm HTN–Cor pulmonale

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7
Q

Bronchitis symptoms

A
  1. Prolonged coughing + thick tenacious/purulent sputum
  2. Dyspnea
  3. Hypoxia
  4. Cor pulmonale leads to peripheral venous stagnation
    BLUE BLOATER
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8
Q

Bronchitis CXR findings

A
  1. Increased bronchovascular markings

2. Enlarged heart

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9
Q

Emphysema Definition

A

Enlarged airpace distal to terminal bronchioles

& Alveolar wall destruction

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10
Q

Emphysema etiology

A
  1. Smoking

2. Non-smokers rare, except Alpha-1-Antitrypsin deficiency

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11
Q

Emphysema pathology

A
  1. Smoke irritant increase inflammatory cells in alveoli
  2. WBC release proteolytic enzymes (elastases)
  3. Alveolar wall damage, decreased elastin fibers
  4. Alveolar space enlarges
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12
Q

Emphysema gross pathology

A
  1. Enlarged, billowy, white lungs (don’t collapse)
  2. Touch at midline
  3. Blebs: subpleural, pneumothorax if rupture into pleural cavity
  4. Bullae: parenchymal, >1 cm
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13
Q

Emphysema Symptoms

A
  1. NO cough/sputum
  2. Tachypnea (compensate for decreased resp surface)
  3. Chest over-expanded= “barrel shaped”
  4. Leaning forward to use auxiliary muscles
  5. Hyperventilate–
    PINK PUFFERS
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14
Q

Emphysema CXR

A
  1. Clear lung fields
  2. Barrel-shaped/over inflation
    A lot of space between ribs, low diaphragm, increased
    AP diameter
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15
Q

Asthma definition

A

Stimuli increases responsiveness of bronchial tree

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16
Q

Asthma epidemiology/age

A
  1. 10% of children, 5% of adults
  2. M 2X F
  3. 50% in childhood, 30% after 40, 20% old age
17
Q

Asthma forms

A
  1. Extrinsic: Exogenous allergen, children with hay fever
  2. Intrinsic: non-immune mechanisms, due to persistent inflammation of bronchial mucosa
    Ex: Heat/cold, stress, exercise, pollution, infection
18
Q

Asthma pathophysiology

A
  1. Allergen binds to IgE on Mast cell
  2. Mast cell degranulates, releases histamine
  3. Macrophages, lymphocytes, basophils, eosinophils, plasma cell release mediators:
    Histamine, bradykinin, PG
  4. Effects: Vasodilate, Bronchoconstrict, Mucus secretion
19
Q

Asthma histologic findings

A
  1. Bronchi: chronic inflammation
  2. Gland hyperplasia & increased mucus
  3. Eosinophil/Inflammatory cell infiltrate in mucosa
  4. Curschmann spirals: whorls of epithelial cells
  5. Smooth muscle cell increase in size & number (due to frequent spasm)
20
Q

Asthma gross features

A
  1. Lungs: large, pink, touch in midline

2. Mucus plugs–turn into casts

21
Q

Bronchiectasis definition

A

Permanent bronchi dilation

22
Q

Bronchiectasis etiology

A

MC complication of chronic bronchitis

Also caused by lobar pneumonia

23
Q

Bronchiectasis pathophysiology

A
  1. Dilated bronchi/bronchioles
  2. Fill with mucopurulent material
  3. Material stagnates, can’t clear with cough–Halitosis
  4. Infection results
  5. Adhesions may occur between lobes
24
Q

Bronchiectasis infection characteristics

A
  1. Spreads to alveoli
  2. Recurren pneumonia
  3. Hematogenic spread to other organs
25
Q

Bronchiectasis CXR

A

Increased vascular markings (due to dilation)

Pathology (11 decks)

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