Lung Histopathology

Question 1

What is the FEV1:FVC ratio in obstructive lung disease

Answer 1

Reduced FEV1:FVC ratio (FEV1 is lower, but FVC remains similar)

Question 2

Give the site, aetiology and pathology of chronic bronchitis

Answer 2

chronic bronchitis

site: bronchus
aetiology: tobacco smoke, pollution
pathology: airway dilation, excessive mucus production

Question 3

Give the site, aetiology and pathology of bronchiectesis

Answer 3

bronchiectesis

site: bronchus
aetiology: inflammatory (e.g. post-infectious, asthma), congential (e.g. CysFib, primary ciliary dyskinesia)
pathology: airway dilation and scarring

Question 4

Give the site, aetiology and pathology of asthma

Answer 4

asthma

site: bronchus
aetiology: immunological: allergens, cold air, exercise, drug interactions
pathology: Inflammation, SM cell hyperplasia, excess mucus production

Question 5

Give the site, aetiology and pathology of emphysema

Answer 5

emphysema

site: acini
aetiology: tobacco smoke, a1-AT defiency (reduced production from tissue degrading enzymes)
pathology: Airspace enlargement (reduced alveolar emptying), wall destruction

Question 6

Give the site, aetiology and pathology of small airway disease/bronchiolitis

Answer 6

small airway disease/bronchiolitis

site: bronchiole
aetiology: tobacco smoke, air pollutants
pathology: inflammatory scarring/obliteration

Question 7

Give the clinical features, histological features and complications of chronic bronchitis

Answer 7

chronic bronchitis
clinical features: cough and sputum on most days in 3 month periods ongoing for over 2 years
histological features: airway dilation, goblet cell hyperplasia, mucus gland hypertrophy
complications: recurrent infections, chronic hypoxia, pulmonary htn

Question 8

Give the clinical features, histological features and complications of bronchiectesis

Answer 8

bronchiectesis
clinical features: cough, purulent sputum, fever
histological features:
complications: recurrent infection, pulmonary htn, haemoptysis, amyloidosis

Question 9

Give the clinical features, histological features and complications of asthma

Answer 9

asthma
clinical features: dyspynoea, wheezing, episodic cough
histological features: eosinophils, curschman spirals (shed epithelium), Charcot-Leyden crystals
complications: Chronic asthma, other atopy, anaphylaxis

Question 10

Give the clinical features, histological features and complications of emphysema

Answer 10

emphysema
clinical features: dyspnoea, cough
histological features: loss of alveolar parenchyma distal to the terminal bronchiole (acinar).
complications: pulmonary htm, pneumothorax, respiratory failure

Question 11

Name 3 inflammatory and 3 congenital cause of bronchiectesis

Answer 11

Inflammatory:
Post infectious (esp kids)
Post-inflammatory (aspiration)
Asthma
Connective tissue diseases
Ciliary dyskineasia (kartageners)
Obstruction 

Congenital
CysFib
Primary ciliary dyskinesia (also inflam)
Hypogammaglobulinemia (also inflam)

Question 12

What is the FEV1:FVC ratio in interstitial (restrictive) lung disease?

Answer 12

Relatively normal ratio, reduced FVC,

Question 13

Describe 3 features of interstitial lung disease on spirometry

Answer 13

restrictive (decreased CO diffusion capacity, decreased lung volume, decreased compliance).

Question 14

Describe 5 clinical features of interstitial lung disease presentation

Answer 14

SOB, End inspiratory crackles, cyanois, pulmonary htn, cor pulmonale

Question 15

What are the 4 main categories of interstitial lung disease?

Answer 15

Fibrosing,
Granulomatous,
Eosinophillic,
Smoking related

Question 16

What are the 6 types of Fibrosing ILD?

Answer 16

Idiopathic pulmonary fibrosis
Pneumoconiosis
Cryptogenic organizing pneumonia
Connective tissue disease associated
Drug induced
Radiation pneumonitis

Question 17

What are the 3 types of granulomatous ILD?

Answer 17

Sarcoid
Extrinsic allergic alveolits
Associated with vasculitides (wegeners, churg strauss, microscopic polyangiitis etc.)

Question 18

What histological feature is present in end stage ILD?

Answer 18

Honey-combing

makes it difficult to find initial cause in end stage disease.