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S3B1 Pathology > Obstructive Lung Disease > Flashcards

Obstructive Lung Disease Flashcards

1
Q

What is emphysema?

A

irreversitble airspace enlargement distal to terminal bronchiole with destrubtion of airspace walls

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2
Q

What is the definiton of the acinus?

A

portion from respiratory bronhiole ot the alveoli

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3
Q

What is the difference in pathological location of centriacinar emphysema vs. panacinar emphysema?

A
  • centriacinar: proximal aspect of acinus - not including alveoli
  • panacinar: from respiratory bronchioles to alveolar sac
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4
Q

What lobe is it most common to see centriacinar emphysema?

A

upper lobe apices

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5
Q

What type of obstructive lung disease commonly occurs in heavy smokers?

A

centriacinar emphysema

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6
Q

What type of emphysema are shown in the provided images?

A
  • Left: centriacinar emphysema
    • can see some normal lung tissue (patchy emphysematous changes)
  • Right: panacinar emphysema
    • involving entire pulmonary lobule
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7
Q

What area of lung is most commonly affected by panacinar emphysema?

A

lower lungs & anterior margins

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8
Q

Panacina emphysema is associated with what disease?

A

anlph-1-antitrypsin deficiency

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9
Q

Describe the general pathogenesis of emphysema

A
  • Inflammatory mediators increase inflammation & induce structural changes
  • Proteases released from inflammatory cells breakdown tissue
  • oxidative stess results in even more inflammation & damage
    • NRF2 upregulates other genes that protect from oxidative damage
  • Infections may exacerbate the process
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10
Q

What is the role of alpha-1-antitrypsin?

What chromosome is its gene located on?

A

inhibits elastase (protease) secreted by neutrophils

chromosome 14

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11
Q

What is the normal alpha-1-antitrypsin allele?

What is the allele that leads to a deficiency?

A

PiMM is homozygous normal

PiZZ is homozygous for deficiency

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12
Q

What is the difference between a bleb and a bullae?

A

bleb: enlarge airspace up to 1 cm
bullae: enlarged airspace over 1cm

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13
Q

What gross findings would you expect to seen in lungs with emphysema?

A
  • Large lungs
  • Upper portion of lung most affected
    • pical blebs & bullae
  • cut sections of parenchyma will show enlarged air spaces
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14
Q

What pathology do you see with the lungs in the provided image?

A

Emphysema

  • lumpy in the apical lobes & anterior portion
    • bullae
  • anthracosis
    • dark carbon pigment
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15
Q

What disease is characteristic of the provided microscpic finding?

A

emphysema

  • enlarged alveoli
  • thin septa
  • loss of attachments of aleoli to small ariways
  • septa look like they end blindly inot alveolar spaces
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16
Q

What pathology is shown in the provided image?

A

Centrilobular (Centriacinar) Emphysema

  • enlarged airspaces
  • patchy
  • dark lymph nodes (also pick up carbon pigment)
17
Q

What pathology is shown in the provided image?

A

emphysema

  • enlarged & normal alveli
  • more normal in background - probably centriacinar emphysema
18
Q

What is the clinical definiton of chronic bornchitis?

A

persistent cough with sputum, at least 3 months in 2 consective years with no other cause

19
Q

Describe the general pathogenesis of chronic bronchitis

A
  • Mucus hypersecretion
  • inflammation
    • acute & chronic
  • infection results in acute exacerbation
20
Q

What gross findings would you expect to see on lungs with chronic bronchitis?

A
  • hyperemia (excess blood in the vessels), swelling, edema of mucosa
  • increased mucinous secretions
    • sometimes mucopurulent
21
Q

What is the major microscopic findings associated with chronic bronchitis?

A
  • submucosal mucus gland hyperplasia
  • increased number goblet cells
  • chronic inflammation of airways (lymphocytes)
  • thickened basement membrane
  • squamous metaplasia or dysplasia
22
Q

What is the Reid index?

What is a normal score on it?

A
  • Reid index: ratio of thickness of mucus gland layer to thickness of tissue between epithelium and cartilage
    • bc : ad
  • normal is 0.4
    • higher in bronchitis

thicker the glands, the worse it is

23
Q

What pathology is shown in the provided image?

A

chronic bronchitis

chronic inflammation, goblet cells, mucus in lumen with neutrophils

24
Q

What pathology is shown in the provided image?

A

chornic bronchitis

thick eosinophilc basemement membrane consistent with chronic inflammation

25
Q

What is asthma?

A

chronic disorder with episodic bronchocontriction, bronchial wall inflammation and increased mucus secretion

episodes of wheezing, dyspnea, chest tightness, cough

at least partly reversible

26
Q

What is unusual about the lungs shown in this autopsy?

This is consistent with what pathology?

A

notice lungs are overlapping at the pericardium

asthma

27
Q

What microscopic findings would you expect to see in an asthma case?

A
  • thickend airway with increased vessels
  • goblet hyperplasia & increased size of submucosal glands
  • thickened basement membrane
  • submucosal inflammation (eosinophils)
  • Smooth muscle hypertrophy
  • Charcot-Leyden crystals
  • Sputum with Curschmann spirals (extruded mucus plugs)
28
Q

What pathology is shown in the provided image?

A

Asthma

  • lot of normal alveolar lung
  • bronchioles filled with mucus
29
Q

What pathology is showni n the provided image?

A

Asthma

  • lots goblet cells
  • thick, prominent basement membrane
  • lots of inflammation w/ eosinophils
30
Q

The provided histological finding is indicative of what disease?

A

Curschmann’s spiral

Astham

31
Q

The provided histological finding is indicative of what disease?

A

Charcot-Layden crystals

from eosinophil degranulation

Asthma

32
Q

Describe the reversible vs. irreversible components of asthma

A
  • Reversible
    • muscular bronchoconstriction, edema, mucus plugs
  • Irriversible
    • fibrosis, submucosal gland & smooth muscle hypertrophy
33
Q

What is bronchiectasis?

A

chronic infections that lead to destruction of smooth muscle & elastic tissue causepermanent dilatin of bronchi and bronchioles

34
Q

What gross findings do you expect to see on a lung with bronchiectasis?

Where in the lung is this pathology most commonly located?

A
  • Severely dilatd airways, may appear cystic with mucopurulent secretions
    • usually lower lobes
    • more severe in bronchi & bronchioles
35
Q

What pathology is shown in the provided image?

A

bronchiectasis

notice dilated bronchi extending to visceral pleura

S3B1 Pathology (7 decks)

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