OBSTRUCTIVE DISEASES

Question 1

1) Asthma

Answer 1

chronic inflammatory disorder of the bronchial mucosa.
*causs bronchial hyper-resposiveness, constriction of the airways, variable airflow obstruction that is reversible
IMPORTANT: IgE causes the mast cells to degranulate, releasing a large number of inflammatory mediators. Activates the neutrophils

SSS (swelling, secretions, spasms)

Question 2

2) Chronic bronchitis

Answer 2

hyper section of mucus and chronic productive cough that last at least 3 months of the year and for at least 2 consecutive years.

Question 3

3) Emphysema

Answer 3

abnormal permanent enlargement of the gas-exchange airways accompanied by the destruction of the alveolar walls without obvious fibrosis.
*loss of elastic recoil

Question 4

Chronic Bronchitis: pathophysiology

Answer 4

• Inspired irritants increase mucous production, size and number of mucous glands, and bronchial edema; mucus is thicker than normal
• Hypertrophied bronchial smooth muscle
• Hypoxemia and hypercapnia
• Airways collapse early in expiration, trapping gas in the lung

Question 5

Chronic Bronchitis: clinical manifestations

Answer 5

Decreased exercise tolerance
Wheezing and shortness of breath
Productive cough (“smoker’s cough”) becomes copious
Polycythemia
Decreased FEV1

Question 6

Chronic Bronchitis: treatment

Answer 6

Smoking cessation: Disease progression can be halted
Bronchodilators
Expectorants
Chest physical therapy
Antibiotics
Steroids
Mechanical ventilation, if needed
Oxygen therapy

Question 7

Types of Emphysema : Primary & Secondary

Answer 7

1. Primary: inherited deficiency of the enzyme a1-antirypsin
2. Secondary: main cause= cigarette smoke;( air pollution, occupational exposures, child respiratory infections are possible contributors)

Question 8

Emphysema: pathophysiology

Answer 8

Destruction of the alveoli occurs through the breakdown of elastin in the septa as a result of an imbalance between proteases and antiproteases, oxidative stress, and apoptosis of the lung’s structural cells.
Alveolar destruction also produces large air spaces within the lung parenchyma (bullae) and air spaces adjacent to pleurae (blebs).

Question 9

Emphysema: clinical manifestations

Answer 9

Clinical manifestations
Dyspnea on exertion
Later progresses to marked dyspnea, even at rest
Little coughing and very little sputum
Tachypnea with prolonged expiration; use of accessory muscles for ventilation; pursed lips
Increased anteroposterior diameter of the chest (barrel chest)

Question 10

Emphysema: treatment

Answer 10

Smoking cessation
Pulmonary rehabilitation
Improved nutrition
Breathing

Question 11

Acute Bronchitis

Answer 11

Is an acute infection or inflammation of airways or bronchi; commonly follows a viral illness.
Causes symptoms similar to pneumonia but does not demonstrate pulmonary consolidation and chest infiltrates.
Clinical manifestations: Nonproductive cough occurs in paroxysms and is aggravated by cold, dry, or dusty air.
Treatment: Rest, aspirin, humidity, and cough suppressant (codeine).