Obstructive Airway Diseases

Question 1

What is the normal FEV1

Answer 1

3.5-4 litres

Question 2

What is the normal FVC

Answer 2

5 litres

Question 3

What is the normal ration of FEV1/FVC

Answer 3

0.7-0.8

Question 4

What is the predicted FVC based on

Answer 4

age, sex and height

Question 5

Except for FEV1 and FVC how else can obstructive lung disease be demonstrated

Answer 5

PEFR

Question 6

What is PEFR

Answer 6

How fast an individual can exhale

Question 7

What is a normal PEFR

Answer 7

400-600 litres/min

Question 8

Below what percentage is a marked fall of PEFR

Answer 8

<50%

Question 9

What are the features of Obstructive Lung Disease (5)

Answer 9

Airflow limitation
PEFR is reduced
FEV1 is reduced
FVC may be reduced
FEV1 is less than 70% of FVC

Question 10

What type of hypersensitivity is bronchial asthma

Answer 10

Type 1

Question 11

Aetiology of Chronic Bronchitis and Emphysema (5)

Answer 11

Smoking
Atmospheric pollution
Occupation
Alpha-1-antitrypsin deficiency 
Effect of age and susceptibility

Question 12

Chronic Bronchitis large airways

Answer 12

Mucous glands and goblet cell hyperplasia
Inflammation
Fibrosis (minor component)

Question 13

Chronic Bronchitis small airways

Answer 13

Goblet cells appear
Inflammation
Fibrosis (long standing disease)

Question 14

What is Emphysema

Answer 14

Increase of alveolar space distal to terminal bronchiole arising from dilation or destruction and without obvious fibrosis

Question 15

Forms of Emphysema

Answer 15

Centri-acinar
Pan-acinar
Bulla

Question 16

Where is Centri-acinar emphysema more common

Answer 16

Around a central bronchiole and Upper part of the lung as there is more ventilation there

Question 17

Where is Pan-acinar most common

Answer 17

Lower part of the lungs and causes huge areas of tissue loss

Question 18

What is a bulla

Answer 18

Emphysematous space greater than 1cm

Question 19

What can happen if a bulla bursts

Answer 19

It can cause a pneumothorax

Question 20

What type of emphysema can individuals with alpha-1-antitrypsin get

Answer 20

Bulla

Question 21

Pathogenesis of Emphysema

Answer 21

Smoking
Protease-antiprotease imbalance
Ageing
A1A deficiency

Question 22

What is the purpose of anti-elastase (anti-protease)

Answer 22

Counteracts the effects of neutrophils and macrophages when there is a foreign body within the respiratory system

Question 23

What effect does smoking have on the production of anti-protease

Answer 23

it reduces it and impairs the repair mechanism involved in elastin synthesis

Question 24

Is emphysema reversible (Y/N)

Answer 24

No

Question 25

Why does emphysema lead to an increase on CO2 and decrease in O1

Answer 25

Increase in CO2 means 1 O2 molecule cannot occupy the same space so the O2 level drops

Question 26

What does the high level of CO2 retention cause

Answer 26

Chemoreceptors become less sensitive to the effects of CO2

Question 27

What does the the decrease in sensitivity to CO2 mean?

Answer 27

The body does not rely on CO2 concentration as the respiration drive but Hypoxia

Question 28

Those that don't respond to hypoxia are known as

Answer 28

Blue bloaters