MP324 - LUNG DISEASES + IMMUNOSUPPRESSION

Question 1

upper respiratory tract infections

Answer 1

affect approximately above the bronchi

common cold etc.

Question 2

acute bronchitis

Answer 2

a persistent (2-3 weeks but can be longer) infection (usually viral) in the lower respiratory tract

Question 3

chronic bronchitis

Answer 3

prolonged inflammation of the bronchial airways which lead to cough and mucus production

Question 4

pneumonia

Answer 4

infection of the lung parenchyma (alveolar structures)

Question 5

pleuritis

Answer 5

inflammation of the pleural membranes
can have many causes, including pulmonary embolism and viral or bacterial infections

Question 6

symptoms of bronchiectasis

Answer 6

chronic cough + sputum
SOB
coughing up blood
wheeze
chest pain
frequent lung infections

Question 7

causes of bronchiectasis

Answer 7

• cystic fibrosis
• lung infections
• impaired host defences
• immunosuppressive drugs
• aspergillosis
• lung injury/obstruction

Question 8

diagnosing bronchiectasis

Answer 8

HRCT scan
showing persistent dilation of the airways

Question 9

CT features of bronchiectasis

Answer 9

• internal diameter of a bronchus is >1.5x the diameter of the pulmonary artery
• bronchial wall thickening
• ‘tree-in-bud’ appearance
• failure of bronchial tapering

Question 10

treatment options for bronchiectasis

Answer 10

• no smoking
• exercise to clear mucus
• airway clearance therapy
• antibiotics if required (mucolytics) and sometimes bronchodilators (salbutamol) for acute exacerbations
• vaccinations against common airway infections
• may eventually need lung transplant

Question 11

bronchiectasis - process of inflammation

Answer 11

inflammation dominated by neutrophils that, when activated, released neutrophil serine proteases including neutrophil elastase

Question 12

brensocatib

Answer 12

oral
selective
competitive and reversible inhibitor of DPD-1 that has been shown to inhibit neutrophil serine protease activity in the blood

Question 13

pneumonia causes

Answer 13

viral
fungal
bacteria
mycoplasma

RAPID ONSET 24-48 HOURS

Question 14

pneumonia - infection process

Answer 14

• infection reaches the alveoli and causes an inflammatory response
• alveoli fill with fluid, WBCs, proteins and RBCs
• micro accesses filled with pus
• compromised gas exchange and presence of viscous fluid cases the lung tissue to become firm

Question 15

symptoms of pneumonia

Answer 15

dyspnoea
cough
fever
chest pain

Question 16

'’consolidation” in pneumonia

Answer 16

occurs when the airspaces of the lungs are filled with something other than air

Question 17

treatment of pneumonia

Answer 17

• treat the infectious agents e.g. anti-bacterials
• rest, fluids
• oxygen therapy

Question 18

acute Respiratory distress syndrome

Answer 18

• form of severe hypoxemic respiratory failure
• inflammation injury to the alveolar/capillary barrier
• extravasation of protein-rich oedema fluid into the airspaces
• triggered by septic shock and pneumonia

Question 19

cystic fibrosis

Answer 19

• mutations in the gene encoding the CF transmembrane conductance regulator (CFTR)
• CFTR protein is a chloride/thiocyanate channel found in cells lining the lungs, and other organs

Question 20

chloride channel in normal vs CF lungs

Answer 20

in normal lungs, Cl-