Obstructive airway diseases Flashcards

1
Q

What is the normal predicted value of FVC

A

4.95L

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2
Q

How can COPD be detected

A

Airflow limitaiton
PEFR reduced (Peak Expiratory Flow Rate)
FEV1 reduced
FVC may be reduced
FEV1/FVC less than 70%

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3
Q

What would the values of obstructive lung disease look like compared to normal:
FEV1 = 4 l
FVC = 4.9 l
FEV1/FVC = 0.81

A

FEV1 = 1.8L
FVC = 3.4L
FEV1/FVC = 0.53

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4
Q

What is bronchial asthma

A

Type 1 hypersensitivity in airways
Reversable Airway obstruction

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5
Q

What is the aetiology of Chronic bronchitis & Emphysema

A

Smoking
Pollution
Dust
Age & Susceptability

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6
Q

What does alpha-1-antiprotease (antitrypsin) deficiency cause

A

Rare cause of emphysema

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7
Q

What is chronic bronchitis defined as clinically

A

Sputum cough in 3 consecutive months for 2 or more consecutive years

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8
Q

When does complicated chronic broncitis occur

A

Sputum turns mucopurulent (contains mucous and pus)
FEV1 falls

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9
Q

What are the morphological changes in chronic bronchitis in the Large Airways

A

Mucouse gland hyperplasia
Goblet cell hyperplasia
Inflammation& fibrosis

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10
Q

What are the morphological changes in chronic bronchitis

Small airways

A

Goblet cells appear
Inflam. & fibrosis

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11
Q

Describe the image

A

Goblet cell hyperplasia
Small airway inflamed with fibrosis

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12
Q

What is the pathological definition of Emphysema

A

Increase beyond normal in size of airspaces distal to the terminal bronchiole
Arises from dilatation/destruction of their walls and without obvious fibrosis

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13
Q

Describe the image

A

Increase size of airspaces
Destruction of alveoli walls

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14
Q

What are the different forms of Emphysema

A

Centracinar
Panacinar
Periacinar
SCAR (irregular, bullous emphysema)

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15
Q

What is an asinus

A
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16
Q

What is centracinar

A

Begins as bronchiolar dilation
Then alveolar tissue lost
Occurs in upper regions of lungs

Most important clinically

17
Q

What is panacinar

A

Uniform enlargement of airspaces in acinar
Usually occurs in lower region of lungs

18
Q

What is periacinar

A

Contains a Bulla

19
Q

What is a bulla

A

emphysematous space greater than 1cm

20
Q

What is a bleb

A

Bulla formed underneath the plura

21
Q

What is an identifyable trait of COPD on X-ray

A

Hyperinfalted Lungs

22
Q

what does bullous emphysema look like on MRI

A
23
Q

What is chronic Cor pulmonale

A

Hypertrophy of Right Ventricle resulting from disease affecting function and/or structure of the lung

24
Q

What negative effects does smoking have

A
25
Q

How does alpha-1-antitrypsin deficiency affect elastase
what type of Emphysema is it seen in

A

Panacinar

26
Q

What are the mechanisms of airway obstruction in COPD

A

LArge airways- little contribution
Small airways:
[Smooth muscle tone
Inflammation] respond to Pharmalogical intervention
Fibrosis

Loss of alveolar attachments important in emphysema

27
Q

What is the most common cause of cor pulmonale

A

Pulmonary hypertension
Cos it causes:
Pulmonary vasoconstriction
Pulmonary arterioles- muscle hypertrophy & intimal fibrosis
Loss of capillary bed
Secondary polycythaemia