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Respiratory Pathology > Obstructive Airway Diseases > Flashcards

Obstructive Airway Diseases Flashcards

1
Q

What are the obstructive airway diseases?

A

Chronic bronchitis
Emphysema
Asthma

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2
Q

What are chronic bronchitis and emphysema known as?

A

COPD

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3
Q

What is FEV1?

A

Forced expiratory volume of air exiting the lung in the first second

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4
Q

What is FVC?

A

Final total amount expired

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5
Q

FEV vs FVC

A

FEV1 usually about 70 - 80% of FVC
FEV 1 - 3.5 - 4 litres
FVC - 5 litres

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6
Q

Normal FEV1:FVC ratio

A

0.7- 0.8

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7
Q

What is predicted FVC based on?

A

Age
Sex
Height

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8
Q

What does PEFR stand for?

A

Peak expiratory flow rate

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9
Q

What is PEFR used to monitor at home?

A

Bronchial asthmatics respiratory function

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10
Q

Normal PEFR

A

400 - 600 L/min

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11
Q

Normal range of PEFR

A

80 - 100% of best value

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12
Q

What is a moderate fall of PEFR?

A

50 - 80%

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13
Q

What is a marked fall of PEFR?

A

< 50%

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14
Q

Features of obstructive lung disease

A 
Airflow limitation 
PEFR reduced
FEV1 reduced
FVC reduced 
FEV1 less than 70% of FVC
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15
Q

Pathology of bronchial asthma

A

Type 1 hypersensitivity in the airway
Allergic (associated) reactions
Constriction of bronchial smooth muscle
Inflammation response

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16
Q

What type of obstruction is bronchial asthma? In response to what?

A

Reversible
In response to
- spontaneously
- pharmacological intervention

17
Q

Causes of chronic bronchitis / emphysema

A

Any chronic irritant being inhaled into the lungs
Smoking
Atmospheric pollution
Occupation (dust)
Alpha 1 antiprotease (antitrypsin) deficiency (emphysema)

18
Q

Which gender gets chronic bronchitis /emphysema?

A

M > F

19
Q

Definition of chronic bronchitis

A

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

20
Q

What does chronic bronchitis result in?

A

Natural decline in FEV1

21
Q

What is complicated bronchitis?

A

Mucopurulent (mucus and pus) in an acute infective exacerbation
FEV1 falls

22
Q

Morphological changes in chronic bronchitis

A 
Large airways
- mucous gland hyperplasia
- goblet cells hyperplasia 
- inflammation and fibrosis
Smaller airways
- goblet cells appear 
- inflammation and fibrosis in long standing disease
23
Q

Definition of emphysema

A

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

24
Q

What is the terminal bronchiole?

A

Last conducting airway of sub mm in size which is completely lined by respiratory epithelium

25
Q

Pathology of emphysema

A

Increase in size of airspaces distal to terminal bronchiole
Loss of alveolar tissue (making spaces bigger)
Loss of alveolar walls may take place in the acinus

26
Q

What is the acinus?

A

The region of the lung supplied with air from one of the terminal bronchioles

27
Q

Types of emphysema

A

Centriacinar
Paracinar
Periacinar
Bullous

28
Q

What is centriacinar emphysema?

A

Begins with bronchiolar dilatation
Gough wentworth section of the lung
Upper regions of the lung

29
Q

What is paracinar emphysema?

A

Lower regions of the lung
Massive destruction
All gas tissue disappears and left with tubes and airways suspended in space

30
Q

What is periacinar emphysema?

A

Enlarged air spaces along the edge of the acinar unit but only where it abuts against a fixed structure such as pleura or a vessel

31
Q

What is a bulla?

A

Emphysematous space greater than 1cm

32
Q

What is used to describe bullae under the pleura?

A

Bleb

33
Q

Causes of emphysema

A

Smoking
Ageing
Alpha - 1 - antitrypsin deficiency

34
Q

Pathology of smoking causing emphysema

A

Protease : antiprotease imbalance
Leads to malfunction of alpha 1 antitrypsin and similar enzymes
Causes inflammation in the lungs which also causes damage
These enzymes try to repair the damaged tissue but they cant so the tissue damage occurs and stays

35
Q

Most important factor in the pathology of emphysema

A

Loss of alveolar attachments

36
Q

Causes of respiratory alkalosis

A 
PE
Anxiety leading to hyperventilation 
CNS disorders e.g. stroke, SAH, encephalitis
Altitude
Pregnancy
37
Q

Causes of respiratory acidosis

A 
COPD
Opiate overdose
Life threating decompensated asthma
NM disease
Obesity hypoventilation syndrome
Benzodiazepines overdose

Respiratory Pathology (16 decks)

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