Obstructive disease Flashcards
Two main characteristics of obstructive lung disease
Increased lung volumes (air trapping, overexpansion) and decreased flow in airways (usually)
In what types of disease do you see honeycomb lungs
end stage restrictive
floating septae are characteristic of what dz?
emphysema
What is the pathogenesis of emphysema
protease/antiprotease imbalance. proteases made by inflammatory cells. Usually due to increase in proteases but ~1% due to A1AT deficiency (autosomal recessive)
how are proteases normally inactivated?
alpha 1 antitrypsin made in liver (can be deficient in liver dz)
what type of emphysema results from smoking? from A1AT deficiency? From scarring?
cenriacinar, panacinar, distal acinar
Diagnosis of chronic bronchitis
productive cough for most days in 3 consecutive months in 2 consecutive years
what is the reid index?
Ratio of mucus gland size to distance from epithelium to cartilage (>0.4 means bronchitis)
two characteristics of chronic bronchitis
significant inflammation of large airways, hypertrophy of mucus glands
Bronchiectasis
irreversible dilation of airways. Cycle of obstruction>infection>bronchial wall destruction. Most common cause is cystic fibrosis. Foul smelling sputum.
Three main themes of asthma
Reverisble episodic obstruction, airway hyperreactivity, chronic inflammation
Two main types of asthma
Atopic-type 1 (IgE) hypersensitivity. Allergens.
Nonatopic-irritants and infection
Samter’s triad
Asthma, aspirin allergy, nasal polyps
Four histologic and gross findings of asthma
BM thickening, Charcot-Leyden Crystals (eosinophils), Mucus plugging, Churchman’s spirals
