CP6 Benign lung pathology

Question 1

What are important factors for a good airway?

Answer 1

Good support
Good wall strength
Appropriate size lumen

Question 2

What can affect the amount of air transported in gas exchange?

Answer 2

More airflow
The size and number of the areas for gas exchange

Question 3

What is the key aspect of inflammation that leads to narrowing of lumen?

Answer 3

Swelling due to leaky fluid from the vessels.

Question 4

What are released by neutrophils in acute inflammation?

Answer 4

Proteases and active oxygen species

Question 5

How does the releases of chemicals by neutrophils affect local tissues?

Answer 5

Non specific so can damage healthy cells leading to more inflammation

Question 6

What is a swelling in the lungs or arteries due to fluid known as?

Answer 6

Ectasia

Question 7

How do tissues respond after an episode of acute inflammation?

Answer 7

Complete resolution
Chronic inflammation
Loss of tissue
Scarring

Question 8

What consequences of inflammation can affect gas exchange in the lung tissue?

Answer 8

Scarring, loss of tissue and chronic inflammation (least effect of the 3)

Question 9

What is an example of a disease associated with loss of lung tissue?

Answer 9

Emphysema

Question 10

What happens when pressure increases in areas of the lung affected by emphysema?

Answer 10

The area of the lung collapses obstructing the passage of air

Question 11

What is a consequence of emphysema?

Answer 11

Reduction in capillary beds increasing capillary resistance making the right side of the heart pump harder leading to right ventricular hypertrophy

Question 12

What is scarring in the lung known as?

Answer 12

Fibrosis

Question 13

What is a consequence of lung fibrosis?

Answer 13

Reduces elasticity of the lungs

Question 14

How is asthma triggered?

Answer 14

Sensitisation to trigger followed by a re-exposure to trigger causing airway narrowing

Question 15

How does asthma affect the lungs?

Answer 15

Thickens alveolar walls due to inflammation and tissue hyperplasia, contraction of smooth muscle in the airways and increased production of mucus in the lumen

Question 16

How does asthma present clinically?

Answer 16

SOB, wheeze, cough and hyperinflation

Question 17

What are 3 common triggers of asthma?

Answer 17

Allergens, NSAIDs, cold

Question 18

What occurs in the lungs with bronchitis?

Answer 18

Inflammation and increased goblet cells and overlying luminal mucus

Question 19

Most common cause of chronic bronchitis is….

Answer 19

Smoking

Question 20

What two conditions are encompassed in COPD?

Answer 20

Emphysema and chronic bronchitis

Question 21

How is COPD triggered?

Answer 21

Chemical and heat trigger inflammation in bronchitis and lung parenchyma. In the bronchi there is persistent inflammation, scarring and mucus hyperplasia. In the parenchyma, inflammation leads to emphysema.

Question 22

How are the lungs affected in bronchiectasis?

Answer 22

Dilated bronchus and muco-purulent debris in lumen

Question 23

What is bronchiectasis?

Answer 23

Permenant dilation if the bronchi and bronchioles due to wall damage secondary to chronic necrotising infection.

Question 24

What triggers bronchiectasis?

Answer 24

Mainly obstruction leading to infection - usually by a tumour or thick mucus in CF patients - and also de novo infections, leading to inflammation damaging wall tissues leading to dilation containing inflammatory debris and muscles.

Question 25

What are symptoms and signs of bronchiectasis?

Answer 25

Productive cough +/- haemoptysis
Recurrent infections
Obstructive ventilatory defects

Question 26

What is chronic ILD?

Answer 26

Reduction of lung compliance due to scarring +/- inflammation

Question 27

What are examples of diseases classes as chronic ILDs?

Answer 27

Idiopathic pulmonary fibrosis (IPF)
Pneumoconiosis
Sarcoidosis
Hypersensitivity pneumonitis (HP)

Question 28

What does the lung look like in chronic IPF diesease?

Answer 28

Lung mixed with areas of fibrosis and areas of normal alveoli

Question 29

What part of the lungs is mainly affected by chronic IPF?

Answer 29

Lower zones of both lungs

Question 30

What is the mean survival time for people with chronic IPF?

Answer 30

3 years

Question 31

What are the triggers for chronic IPF?

Answer 31

Idiopathic

Question 32

What is the lung like in pneumoconiosis?

Answer 32

Contains coal dust and areas of fibrosis

Question 33

What happens to a scar over time?

Answer 33

The affected tissue contracts

Question 34

What causes pneumoconiosis?

Answer 34

Lung damage secondary to partial inhalation (most commonly coal, asbestos or silica) from occupational exposure. Damage is a result of the particles being ingested by macrophages causing fibrosis

Question 35

What are present in the lungs in sarcoid?

Answer 35

Granulomas

Question 36

How does sarcoid trigger issues in the lung?

Answer 36

Non-caseating granulomas trigger scarring aka fibrosis

Question 37

What body parts are affected by sarcoid?

Answer 37

Lungs and lymph nodes

Question 38

Who is most likely to get sarcoid?

Answer 38

Those aged 20-60, more in North Africa and Europe and in non smokers

Question 39

How does HP affect the lungs?

Answer 39

Interstitium widened by inflammatory infiltrate leading to fibrosis

Question 40

What causes hypersensitivity pneumonitis (HP)?

Answer 40

Inhaled organic antigens (e.g. mould, hay, animal faeces, paint fumes etc..) triggering a hypersensitivity response leading to inflammation and fibrosis (if the antigen isn’t removed)

Question 41

How does CF affect the lungs?

Answer 41

Production of abnormally thick mucus and pus blocking the lumina leading to infections, inflammation and scarring.

Question 42

How does CF affect the pancreas?

Answer 42

Exocrine atrophy leading to malabsorption