Emphysema

Question 1

Patho 5

Answer 1

structural and functional abnormalities in the respiratory system, primarily affecting the alveoli and the terminal bronchioles

Permanent destruction of alveolar walls. Destruction occurs due to an imbalance between proteolytic enzymes and their inhibitors

Alveoli’s elastic fibres degrade leading to impaired recoil and reduced ability to expel air from lungs

Alveolar destruction and capillary damage cause a mismatch between ventilation and perfusion

Reduced surface area for gas exchange, Decreased lung compliance, Airway obstruction due to dynamic collapse during exhalation.

Question 2

Causes 3

Answer 2

Cigarette Smoking: The most common cause; smoke-induced inflammation promotes elastase activity and inhibits protective enzymes.

o Alpha-1 Antitrypsin Deficiency: A genetic condition predisposing individuals to unopposed elastase activity and early-onset emphysema.

o Environmental Pollutants: Prolonged exposure to pollutants and occupational irritants can contribute to lung damage

Question 3

Symptoms

Answer 3

Shortness of Breath: Persistent and progressive, worsened by activity, due to air trapping and poor gas exchange.

· Prolonged Expiration: Noticeably longer exhalation from loss of elastic recoil.

· Barrel Chest: Increased chest diameter caused by chronic lung hyperinflation.

· Use of Accessory Muscles: Neck and shoulder muscles visibly assist breathing due to increased effort.

· Decreased Breath Sounds: Reduced airflow causes diminished sounds during auscultation.

Question 4

Diagnosis

Answer 4

History of smoking or exposure to environmental irritants

o Pulmonary Function Tests: Reduced FVC ratio confirms obstructive lung disease. Increased residual volume and total lung capacity indicate air trapping and hyperinflation

o Imaging studies: Chest X-ray or CT scan to identify hyperinflated lungs, flattened diaphragm and Bullae

o Assesses oxygen and carbon dioxide levels, especially in severe cases. May show hypoxemia and hypercapnia in advanced stages

Question 5

Treatments 4

Answer 5

No Cure: Focus on symptom management and slowing progression.

o Smoking Cessation: Most effective measure.

o Medications: Bronchodilators (albuterol, tiotropium). Inhaled corticosteroids (fluticasone). Phosphodiesterase-4 inhibitors (roflumilast). Oxygen therapy for hypoxemia.

o Pulmonary Rehab: Improves breathing and exercise tolerance.