Obstructive airway disease

Question 1

Name some localised airway obstructions

Answer 1

cancer and tumours
Inhaling foreign bodies
bronchiectasis

Question 2

Name the 3 obstructive airway diseases

Answer 2

Chronic bronchitis
emphysema
asthma

Question 3

Which two of these make up COPD/

Answer 3

chronic bronchitis and emphysema

Question 4

What are predicted spirometry values based on?

Answer 4

Age sex and height

Question 5

Is bronchial asthma reversible?

Answer 5

Yes with time and treatment

Question 6

Aetiology of bronchitis and emphysema

Answer 6

Smoking
Atmospheric pollution and dust
Age and susceptibility
Antitrypsin deficiency

Question 7

Clinical definition of chronic bronchitis

Answer 7

Cough productive of sputum most days in at least 3 consecutive months for 2 or more consecutive years

Question 8

What are the morphological changes in chronic bronchitis aimed towards/

Answer 8

Increasing mucous production

Question 9

Emphysema definition

Answer 9

Increase beyond the normal in the size of airspaces distal to the terminal bronchiole arising either from dilatation or from destruction of their walls without obvious fibrosis

Question 10

State the 4 forms of emphysema

Answer 10

Centriacinar
panacinar
periacinar
scar “bullous emphysema”

Question 11

Why is centriacinar the most common type?

Answer 11

Most at risk as most material inhaled

Question 12

Where is centriacinar emphysema the greatest and why?

Answer 12

At apex and upper lobe as less blood supply carrying macrophages

Question 13

Panacinar - where does it occur?

Answer 13

Massive destruction

Question 14

Periacinar - where does it occur?

Answer 14

Pleura

Question 15

What is a bulla?

Answer 15

Emphysematous space greater than 1cm

Question 16

What is a bleb?

Answer 16

A bulla just underneath the pleura

Question 17

Pathogenesis of emphysema?

Answer 17

Smoking and protease-anti protease imbalance

Question 18

In COPD small airways which factors respond to pharmaceutical intervention?

Answer 18

Smooth muscle tone and inflammation

Question 19

In emphysema there is loss of what kind of attachment?

Answer 19

Alveolar

Question 20

Why is there diffusion impairment in COPD?

Answer 20

Loss of alveolar surface area

Question 21

A fall in PaO2 due to hypoventilation is corrected by doing what?

Answer 21

Raising FIO2

Question 22

What is chronic cor pulmonale?

Answer 22

Hypertrophy of the right ventricle due to disease

Question 23

What is the main reason there is pulmonary hypertension in chronic cor pulmonale?

Answer 23

Pulmonary vasoconstriction