CSIM1.71 Respiratory D/z 2 Flashcards
What kind of lung disease is emphysema?
Obstructive lung disease
Describe emphysema?
Permanent enlargement of airpsace distal to terminal bronchioles with destruction of walls.
Describe centri-acinar emphysema?
Alveoli in the middle, proximal to terminal alveoli, are enlarged and destroyed.
More common in upper lobes and commonly seen in smokers.
Takes many years to be symptomatic.
Clinical features of centriacinar emphysema?
“Pink puffer” appearance.
raised RR, normal O2.
Breathlessness
Heart failure
Pneumothorax possible
What is panacinar emphysema?
Destruction of all alveoli air sacs including distal and proximal alveoli.
Common in lower lobes.
More likely genetic defect and younger patients.
Smoking makes it worse.
Describe paraseptal/irregular emphysema
Happens due to reduced blood flow in the portion of the lung, especially upper lobes.
Causes wakening of alolvar walls which leads to destruction.
Happens more in young tall and thin adults
Often presents with spontaenous pneumothorax.
Clinical features of asthma
Excessive mucus production, pulmonary edema, smooth muscle constriction and eosinophilic infiltrates sometimes.
What happens in chronic asthma?
Airway remodellingm, thickening bronchials and increase in basement membrane. Mucus gland hypertrophy and smooth muscle hypertrophy.
+/- fibrosis of bronchial walls.
What is chronic bronchitis?
Persistent bronchus inflammation with sputum production.
What is ther cycle in chronic bronchitis?
Inhalation of irritants causing inflammation and damage to defences, leads to trapping of organisms causing infections which causes more damage to airways≥
Clinical features of chronic bronchitis?
“Blue bloater” presentation.
Lower O2 saturation
Cyanosis of lips and skin
What is bronchiectasis?
Caused by chronic bronchi infection, causing permanent dilatation creating reservoir of organisms causing persistent infections.
Clinical features of bronchiectasis?
Cough, fever, foul purulent sputum and persistent infection
Causes of lung cancer?
Environmental and genetic influence
Smoking, occupational exposure, air pollution are some environmental causes.
Some symptoms of lung cancer?
Very non-specific
Coughing, weight loss, dyspnoea, chest discomfort.
Hormone imbalances due to neoplastic secretions - hypocalcaemia, myopathy, neuropathy
Symptoms depend on spread of cancer.
Describe adenocarcinomas of the lung
Common histological cause of lung cancer
Peripheral cancer with mucus production
Aggressive, spreads to lymph nodes and pleura
Describe squamous cell carcinoma of the lung
Central cancer
High smoking association
Histology shows keratin and some differentiation
Presents early and does not spread quickly.
Describe small cell carcinoma of the lung
High association with smoking
Aggressive, central cancer
Rapid spread, cells show poor differentiation
Describe bronchial carcinoids
Rare neuroendocrine tumors
Benign and can be treated with surgery
Prone to relapses.
