,mn,mn Flashcards
*****What stereotype characterizes Chronic Bronchitis?
Blue Bloaters:
• Overweight and Cyanotic people with Elevated Hbg (because they’re hypoxic) peripheral edema and rhonchi and wheezing.
*****What disease is characterized by pink puffers?
• why do we call them pink puffers?
Emphysema = pink puffers
• Older and Thin (because they burn so much energy breathing) with severe dyspnea and quiet chest sounds
*****Differentiate the methods of Dx for chronic bronchitis and emphysema.
Chronic Bronchitis:
• CLINICAL dx. characterized by 3 mo. of daily productive cough for 2 consecutive years
Emphysema:
• PATHOLOGIC dx. characterized by destruction of the airspace distal to the terminal bronchioles
**Why would you seen an abundance of the cells pointed out by the black arrows?
Black arrows:
• Type II pneumocytes: these are hobnail shaped and are seen in abundance following destruction of type I pneumocytes
*****What are Clara Cells and what is their role in the lungs?
• where are they found?
Clara cells = CLUB CELLS - these are dome shaped cells with short microvilli found in small airways (BRONCHIOLES) of the lungs
ROLE: PROTECTION
**What is being pointed out by the back arrows in this electron microscopy image?
Surfactant - Lamellar Bodies - that are found in type II pneumocytes
**What most likely accounts for the changes seen in the cells on the left and on the right?
• what cells are being pointed out?
Left side reprsents alveolar macrophages in someone who is a non-smoker while the right side shows a crack cocaine user note the increased number of particles in the macrophages
*ANY PARTICLE this is 1-5µm in size have the potential to make it to an alveolus
What are the 3 types of Atelectasis?
• differentiate their common causes.
• which way does the mediastinum shift in response?
3 types = Resorption, Compression, Contraction
Resorption:
• Airway obstruciton by mucous plugs or tumor, this acts as a valve that allows air out but not back in leading to suction so the mediastium shifts toward the affected side
Compression:
•Filling of pleural cavity bytumor, blood, air,this acts tocompression of tissuepushing the mediastinumaway from the affected side.
Contraction:
•Fibrotic lung pleura this is just a shrinking of the lung tissue there is no mediastinal shift
**Which of these phenomena is irreversible?
Contraction - caused by fibrosis is irreversible
**What is happening here?
Resorption Atelectasis - a tumor affecting the right mainstem bronchus has resulted in markedly reduced right lung volume and rightward mediastinal shift
**what is happening here?
compression atelectasis - left pneumothorax from chest wall trauma is resulting in left lung collapse and right mediastinal shift
What is the only Obstructive lung disease that is caused by loss of elastic recoil of the lung?
Emphysema, all of the others (chronic bronchitis, asthma, and bronchietasis) result from airway obstruction and narrowing
# Define Emphysema? • is fibrosis typically a feature of this disease?
Emphysema:
• Abnormal permanent enlargement of airspaces accompanied by destruction of their walls
• Fibrosis is not a significant feature of emphysema
A previously healthy young adult man pressents with unknown respiratory disease developes spontaneous pneumothorax. Biopsy indicates a type of underlying obstructive disease. What is this diseas?
PARASEPTAL emphysema - causes pneumothorax in young adults
Differentiate locations and causes of centriacinar and panacinar emphysema.
Centriacinar:
• Typically found in heavy smokers => causes XS inflammation and overactivation of proteases
• Predominates in the upper lobes
Panacinar:
• Associated the A1AT deficiency => is not present to prevent proteases from breaking down our own tissue
• Found in the lower lobes
*****What do you expect to see on the liver biopsy of a patient with A1AT deficiency?
- what causes this appearance?
- Genetics of this person?
Liver biopsy shows pink PAS positive hyaline globules that results from misfolded A1AT accumulating in the endoplasmic reticulum of hepatocytes - notice red blobs
What disease is a person with a PiMZ mutation at risk of developing?
• what factors would increase their risk of developing disease?
This is a mutant heterozygote for A1AT deficiency.
• these patients are asyptomatic unless they smoke
**Remember Z indicates mutation - homozygote = PiZZ => they will have disease