Diseases of Airways

Question 1

Obstructive airway diseases M/C affect which pop’n?

Answer 1

infants and very young

Question 2

List 5 causes of upper airway obstruction.

Answer 2

FFIRE

1. Foreign body aspiration
2. Faulty placement of endotracheal tube
3. Infection
4. Retropharyngeal hemorrhage
5. Edema

Question 3

What is saber sheath trachea and which condition is it most strongly associated with?

Answer 3

Trachea is flattened in the left to right dimension (sagittal diameter is larger) in the INTRATHORACIC region.

lateral film:frontal film = 1.5x larger

Associated with COPD

Question 4

How often is the respiratory tract involved in relapsing polychondritis?

Answer 4

approx. 50% of patients (life threatening causing airway obstruction)

Question 5

What is the cause for permanent airway stenosis in relapsing polychondritis?

Answer 5

Inflammatory episodes cause the cartilages to dissolve and be replaced by fibrotic tissue.

Question 6

Which of the following is false about asthma?

a. Increase vital capacity
b. Increased airway resistance
c. Increased total lung capacity
d. Increased residual volume

Answer 6

a. Increase vital capacity

Vital capacity = maximum amount of air a person can expel (This is decreased in asthma b/c air is trapped d/t mucus plugs.)

Question 7

What are the radiographic signs of asthma?

Answer 7

• hyperinflation
• hemidiaphragms slightly less domed
• bronchial wall thickening

Question 8

What is the most important etiologic factor in emphysema?

Answer 8

cigarette smoking

Question 9

What is the pathogenesis of emphysema?

Answer 9

Smoke activates macrophages –> neutrophils –> release elastase –> cleaves collagen and elastase in bronchi.
Tobacco smoke also interferes with function of alpha-1-antitrypsin which protects the elastin in lung.

Question 10

What are the 3 types of emphysema?

Answer 10

a) centrilobular
b) panlobular
c) paraseptal

Question 11

What is vanishing lung?

Answer 11

Large, progressive, upper lobe bullae in young men.

Question 12

Which location does centrilobular emphysema M/C affect and what is their common presentation?

Answer 12

Upper and lower lung zones.

Present with bullae (>1cm)

Question 13

Which type of emphysema is often associated with spontaneous pneumothorax?

Answer 13

Paraseptal (b/c it involves the alveolar ducts and sacs in the lung periphery)

Question 14

Which type of emphysema is classically associated with alpha-1-antitrypsin deficiency?

Answer 14

Panlobular

Question 15

Which type of emphysema is most widespread and severe?

Answer 15

Panlobular

Question 16

What is the most reliable sign of emphysema?

Answer 16

Hyperinflation

Question 17

What are some radiographic signs for emphysema?

Answer 17

• hyperinflation
• low diaphragm
• flat diaphragm
• increased retrosternal airspace

Question 18

What does the presence of an air-fluid level in a bulla indicate?

Answer 18

Infection, hemorrhage or neoplasm of the bulla

Question 19

What is James-Swyer-MCleod syndrome?

Answer 19

Unilateral hyperlucent, small lung.

Form of obliterative bronchiolitis d/t a viral insult to the developing lung.

Question 20

What is the triad of Kartagener syndrome and what subset of disease does it belong to?

Answer 20

a. situs inversus
b. chronic sinusitis
c. bronchiectasis

Subset to primary ciliary dyskinesia (infertility in males).

Question 21

What is the triad associated with yellow nail syndrome?

Answer 21

a. yellow nails
b. lymphedema
c. pleural effusions

Question 22

What are the main clinical manifestations of cystic fibrosis?

Answer 22

• abnormal sweat electrolytes
• sinus and pulmonary disease
• exocrine pancreatic insufficiency
• male infertility

Question 23

What are the radiographic findings of cystic fibrosis?

Answer 23

• bronchial wall thickening & bronchiectasis
• pulmonary hyperinflation
• fingered glove appearance