Developmental aspects of lung disease

Question 1

when does embryonic lung morphogenesis take place? is it part of organogenesis or lung differentiation?

Answer 1

3-8 weeks of gestation

Question 2

when does pseudo-glandular lung morphogenesis take place? is it part of organogenesis or lung differentiation?

Answer 2

5-17 weeks of gestation

Question 3

when does canalicular lung morphogenesis take place? is it part of organogenesis or lung differentiation?

Answer 3

16-26 weeks of gestation

Question 4

when does saccular lung morphogenesis take place? is it part of organogenesis or lung differentiation?

Answer 4

24-38 weeks of gestation

Question 5

when does alveolar lung morphogenesis take place? is it part of organogenesis or lung differentiation?

Answer 5

36 weeks of gestation -2/3 years after birth

Question 6

what happens during embryonic lung morphogenesis?

Answer 6

formation of major airways (appearance of trachea and main bronchi), formation of bronchial tree and portions of respiratory parenchyma, birth of the acinus (appearance of lung buds), appearance of main pulmonary arteries

Question 7

what happens during pseudo-glandular lung morphogenesis?

Answer 7

same as embryonic lung morphogenesis + all conducting airways and accompanying blood vessels form, wall structure and epithelial cells differentiate, bronchi 8-13 generation, bronchioli 3-10 generation

Question 8

what happens during canalicular lung morphogenesis?

Answer 8

last generations of the lung periphery formed (respiratory airways form), epithelial differentiation, air-blood barrier formed and thins, surfactant appears, bronchioli 3-5 generation, alveolar ducts 2-3 generation

Question 9

what happens during alveolar lung morphogenesis?

Answer 9

secondary septation (cysts are divided in segments)

Question 10

how do alveoli/airways keep developing after birth? how many are there at birth/ after development?

Answer 10

increased alveolar dimensions, increased alveolar separation (100-150 million at birth to 200-600 million at 3/8 years), airways double in size

Question 11

when does the embryonic period end and the fetal period starts?

Answer 11

8 weeks

Question 12

what happens during saccular lung morphogenesis?

Answer 12

expansion of air spaces (= saccules), surfactant detectable in amnionic fluid,

Question 13

what congenital lung diseases can appear in the embryonic sage of lung morphogenesis?

Answer 13

tracheal stenosis, laryngeal stenosis, pulmonary agenesis, tracheo-oesophageal fistula

Question 14

what pseudoglandular lung diseases can appear in the embryonic sage of lung morphogenesis?

Answer 14

pulmonary sequestration, cystadenomatoid malformation, cyst formation

Question 15

diaphragm development- when does the diaphragm close?

Answer 15

about 18 weeks

Question 16

diaphragm development- which primitive tissues (membranes) combine to form closed diaphragm?

Answer 16

septum transversum (Ant.), mesoesophagus (Post., where everything come through), 2 membrana-pleuro peritonealis (Lat.)

Question 17

what diaphragmatic abnormalities can take place (before birth?)?

Answer 17

diaphragmatic hernia (L>R, pulmonary hypoplasia (not enough cells), persistent pulmonary hypertension), eventration

Question 18

at birth, what functional changes occur in the lung?

Answer 18

change from fluid secretion to fluid absorption, pulmonary vasodilation

Question 19

what composes surfactant?

Answer 19

detergent (phospholipids and lipophilic proteins), SP (surfactant protein) appear 12-14 weeks

Question 20

what produces surfactant?

Answer 20

type 2 pneumocytes (lamellar bodies)

Question 21

is surfactant deficiency a prenatal or postnatal lung disease?

Answer 21

postnatal

Question 22

what is the disease caused by surfactant deficiency called?

Answer 22

hyaline membrane disease (RDS)

Question 23

how do you treat RDS?

Answer 23

antenatal glucocorticoids, surfactant replacement, oxygen, CPAP (continuous positive airway pressure, no closing of alveoli)), mechanical ventilation

Question 24

which 2 chronic neonatal lung disease is there?

Answer 24

BPD and CLDP

Question 25

what does chronic neonatal lung disease do?

Answer 25

increased severity bronchiolitis, “asthma”, maybe future COPD

Question 26

what are the antenatal origins of adult lung disease (COPD)?

Answer 26

in utero nicotine exposure, nutrition, low birth weight/ prematurity (antenatal steroids), micronutrients/ vitamins

Question 27

what are the post-natal origins of adult lung disease (COPD)?

Answer 27

infection (Barker hypothesis), growth, ETS (+/- alpha1 AT deficiency), environmental pollution, micronutrients/ vitamins

Question 28

are all origins of adult COPD influenced by gene-environment interactions?

Answer 28

yes

Question 29

does lung function vary during life?

Answer 29

yes, low lung function tracks throughout life increasing the risk of future COPD

Question 30

what is the Fletcher Peto diagram?

Answer 30

variation of FEV1 % after age of 25 according to age

Question 31

according to the Fletcher Peto diagram, below what percentage of FEV1 (value at age 25) is there an onset of respiratory symptoms?

Answer 31

slightly above 50%

Question 32

according to the Fletcher Peto diagram, below what percentage of FEV1 (value at age 25) is there severe disability?

Answer 32

about 30%

Question 33

according to the Fletcher Peto diagram, below what percentage of FEV1 (value at age 25) do you die?

Answer 33

about 10%

Question 34

COPD is the Xth leading cause of death in the world. X= ?

Answer 34

3rd

Question 35

what is the major cause of autism?

Answer 35

vaping

Question 36

what is the major cause of COPD?

Answer 36

heavy smoking