Obstructive and Restrictive Pulm Disease

Question 1

What is emphysema

Answer 1

A lung disease where the lungs increase in size beyond normal.

Question 2

What is this increase in airway size caused from basically

Answer 2

Either destrucition of alveolar walls or dilation of alveoli

Question 3

What pattern of emphysema is most characteristic of smoking

Answer 3

Centrilobular pattern

Question 4

Panlobular pattern of emphysema development is characteristic of

Answer 4

alpha-1-antitrypsin deficiency

Question 5

Whats an Acinus

Answer 5

All the alveoli served by one terminal bronchiole. The functional unit of the lung

Question 6

Centriacinar emphysema

Answer 6

Initially affects the respiratory bronchioles

Question 7

Panacinar emphysema

Answer 7

Initially affects the peripheral structures (the alveolus and alveolar duct) then moves to the resp bronchiloes

Question 8

The other type of emphysema you may need to know

Answer 8

Bullous…Damaged alveoli that form huge airspaces especially in the UPPERMOST portions of the lungs. Can happen in healthy young adults. Airspace may rupture and leak into pleural space causing the lung to collapse.

Question 9

Clinical definition of chronic bronchitis

Answer 9

Persistant productive cough for at least 3 months over 2 consecutive years.
Buckets of mucous, usually smoking associated

Question 10

Bronchiectasis

Answer 10

Permanant abnormal dilation of airways

Question 11

Bronchial asthma definition

Answer 11

Chronic INFLAMMATORY disorder caused by bronchospasm/constriction due to hyperactive airways.

Question 12

Gross pathology

Answer 12

Pulmonary hyperexpansion and bronchial mucus plugs

Question 13

Microscopic pathology

Answer 13

Bronchial mucus, eosinophils, neutrophils
Creola bodies, Cruschman spirals, Charcot Leyden Crystals, Airway remodelling includes smooth muscle hyperplasia, hypertrophy, submucosal gland expansion, Thick BM, fibrosis

Question 14

Pneumoconioses

Answer 14

Non-neoplastic lung reaction to inhalation of mineral dusts, organic and inorganic particulates, chem fumes and vapors

Question 15

Common types of pneumoconioses

Answer 15

coal miner’s lung, asbestos, silicosis

Question 16

Most common chronic occupational disease is silicoses

Answer 16

true

Question 17

Inhaled asbestos particles usually ingested by…

Answer 17

macrophages…become encrusted with iron salts and form ferruginous bodies which show up in sputum.

Question 18

Sarcoidosis characterized by what>

Answer 18

Noncaseating granulomas in many tissues and organs.

Question 19

Sarcoid girl looks like

Answer 19

Young- middle age black female

Question 20

Can affect any organ, but in 90%, sarcoidosis effects

Answer 20

intrathoracic lymph nodes, pulm involvement, skin or ocular signs or symptoms, or some combo….so lymph, lungs, skin or eyes. This distribution suggests that something in the environment causes it

Question 21

What macrophage alleles contribute to sarcoid susceptibility

Answer 21

HLA and BTNL2…these are involved in antigen presentation, processing, and cytokine realease…three processes believed to be at the core of sarcoidosis

Question 22

What other type of immune cell is important in sarcoidosis

Answer 22

CD4 T cells….interact with antigen presenters to initiate the formation and maintenance of granulomas

Question 23

SARCOIDOSIS = NONCASEATING GRANULOMAS

Answer 23

.

Question 24

What is one big difference between emphysema and bronchitis

Answer 24

minimal sputum in emphysema.

other differences: very thin, not cyanotic because they can exhale with pursed lips to retain oxygenation and exhale completely. This leads to the wt. loss b/c they are basically exercising.