Obstructive airway diseases Flashcards

1
Q

What are the three main obstructive airway diseases?

A

Chronic bronchitis
Emphysema
Asthma

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2
Q

Whats is chronic bronchitis and emphysema better know as?

A

COPD (chronic obstructive pulmonary disease)

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3
Q

What is PEFR ?

A

Peak expiratory flow rate

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4
Q

What are the characeristics of an obstructive lung disease?

A
  • Airflow limitation
  • Peak expiratory flow rateis reduced
  • FEV1 reduced
  • FVC may be reduced
  • FEV1 is less than 70% of FVC
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5
Q

Describe bronchial asthma?

A

Type 1 hypersensitivity in the airways.
Degranulation of mast cells causing smooth muscle contraction and inflammation.
CONSIDERED REVERSIBLE

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6
Q

Name the aetiology of chronic bronchitis and emphysema:

A
  • Smoking
  • Atmospheric Pollution
  • Occupation eg dust

Higher prevalence in men

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7
Q

Define chronic bronchitis clinically

A

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

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8
Q

What is “complicated” Bronchitis?

A

If mucous is yellow or green - infection present. or FEV1 falls

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9
Q

What are the morphological changes in chronic broncitis in the large airways?

A
  • Mucous gland hyperplasia
  • Goblet cell hyperplasia
  • Inflammation and fibrosis is a minor component.
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10
Q

What are the morphological changes in chronic broncitis in the small airways?

A
  • Goblet cells appear

- Inflammation and fibrosis if disease is long standing.

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11
Q

What is the pathological definition of emphysema?

A

Increase beyond the normal size of airspaces distal to the terminal bronchiole arising either from dilation or from destruction of there walls without any obvious fibrosis.

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12
Q

What is the acinus?

A

After terminal bronchiole no longer completely lined in respiratory epithelium. (1-2cm in diameter)

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13
Q

What are the forms of emphysema?

A
  • Centriacinar
  • Panacinar
  • Scar “irregular”
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14
Q

Describe centiacinar emphsema

A

Patchy diffusion in central acinus. Tends to happen in upper lobes

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15
Q

Describe panacinar emphysema?

A

Through out acinar.

Most in lower lobes

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16
Q

What is a bulla?

A

A bulla is an emphysematous space greater than 1 cm.

17
Q

How many ribs should you be able to see in a normal chest x ray?

A

Normally 9-10

18
Q

Describe the unlikely cause of emphysema

A

Alpha-1-antitrypsin deficiency

19
Q

What does alpha-1-antitrypisin stop?

A

Healthy lung tissues being digested.

20
Q

What does smoking cause?

A
  • Increase in neutophils, macrophages
  • Increase elastease/ Proteases
  • Decreases Anti-elastase
  • Decrease repair mechanisms
21
Q

What aprts of emphysema respond to pharmacological intervention?

A
  • Smooth muscle tone

- Inflammation

22
Q

What is MOST important in emhysema?

A

Loss of alveolar attachments( like guy ropes for tent)

23
Q

What do alveolar attachments do?

A

Pull small alveolar airways open.

Stop airways shutting too soon.