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Otitis Externa > Obstructive lung Disease > Flashcards

Obstructive lung Disease Flashcards

1
Q

In obstructive lung disease there is an increase resistance to what?

A

Air flow

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2
Q

Obstructive lung disease can be what?

A

Partial or complete

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3
Q

What are some examples of obstructive lung disease?

A

Emphysema, chronic bronchitis, bronchiectasis, asthma

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4
Q

The FEV1 in obstructive lung disease is what?

Forced expiratory volume

A

Decreased

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5
Q

The total lung capacity in obstructive lung disease is?

A

Normal

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6
Q

The forced viral capacity in obstructive lung disease is?

A

Normal

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7
Q

In chronic bronchitis we have airway inflammation with a…

A

Productive cough

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8
Q

COPD is heavily associated with what lifestyle choice?

A

Smoking

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9
Q

Which race is slightly more affected by COPD?

A

African Americans

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10
Q

What is one cardinal symptom of COPD?

A

Dysnea that gets worse with exertion

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11
Q

What are some physical findings in someone suffering from COPD?

A
  1. Barrel chest
  2. Cyanosis
  3. Decreased air entry= distant breath sounds
  4. Wheezes or Rhonchi
  5. Cor pulmonale= pulmonary hypertension
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12
Q

What is emphysema?

A

Irreversible enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls without obvious fibrosis

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13
Q

What is centriacinar or centrilobar emphysema?

A

central or proximal parts of the acini, formed by the respiratory bronchioles are affected. The distal alveoli are sparred

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14
Q

Centriacinar emphysema is most common and usually more severe in…

A

the upper lobes

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15
Q

Centriacinar emphysema is most predominant in …

A

Heavy smokers and often exists in association with chronic bronchitis

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16
Q

What happens in panacinar emphysema?

A

acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli

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17
Q

Panacinar or panlobular emphysema is more commonly found in the…

A

lower zones and in the anterior margins of the lung

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18
Q

What deficiency is associated with panacinar or panlobular emphysema?

A

alpha-1 antitrypsin deficiency

19
Q

What parts of the respiratory system are affected in paraseptal emphysema? or distal acinar?

A

proximal portion of the acinus is normal but the distal part is involved

20
Q

Distal acinar or paraseptal emphysema can provoke what?

A

spontaneous pneumothorax in young patients

21
Q

What is irregular emphysema?

A

Airspace enlargement with fibrosis

22
Q

What are some characteristics of irregular emphysema?

A
  1. Acinus is irregularly involved
  2. Almost invariably associated with scaring
  3. Occurs in small foci and is clinically insignificant
23
Q

Alpha -1 antitrypsin inhibits what?

A

Elastase which is a protease

24
Q

Which cells secret proteasas?

A

Neutrophils

25
Q

Smoking inhibits what?

A

alpha-1 antitrypsin

Can also be due to a genetic defect

26
Q

Why is there obstruction in emphysema?

A

There is a loss of elastic tissue which causes the respiratory bronchioles to collapse during expiration

27
Q

What other things that cause airflow obstruction?

A

Goblet cell hyperplasia with mucus plugging of the lumen, inflammatory infiltrates in bronchial walls, thickening of the bronchial wall due to smooth muscle hyper trophy and peribronchial fibrosis

28
Q

What are some histo logic characteristics of emphysema?

A
  1. Destruction of acinar walls and dilatation of the airspaces
  2. Bronchial metaplasia is often present
  3. Usually not associated with significant inflammation or fibrosis
29
Q

What X ray findings can we observe in a patient with emphysema?

A
  1. Compressed and verticalized heart

2. Wall of bleb

30
Q

What are some clinical symptoms of emphysema?

A

Symptoms appear after age 50, dyspnea, no cough, respiratory rate increases with use of accessory respiratory muscles, barrel chest, decreased breath sounds, hyper resonance on percussion, prolonged inspiration, reduced FEV1

31
Q

Emphysema and severe chronic bronchitis may lead to…

A

Respiratory failure or cause pulmonary hypertension with the latter leading to increased strain on the right ventricle

32
Q

Chronic bronchitis is defined as…

A

Clinically persistent cough with sputum production for at least 3 months in at least 2 consecutive years in the absence of any other identifiable cause

33
Q

What is the epidemiology of chronic bronchitis?

A

Affects habitual smokers and inhabitants of smog laden cities
More females are affected
Most affected individuals are more than 45 years of age

34
Q

The airways of a patient with chronic bronchitis are filled with?

A

abundant mucus or mucopurulent secretions

35
Q

What is asthma?

A

An inflammatory disease of the small airways

36
Q

Inflammation of the airways leads to what?

A

Mucus production and bronchospasm leading to reversible obstructive lung disease

37
Q

Asthma is most prevalent in…

A

children (may have a higher prevalence in African American children)

38
Q

Many asthma patients will have known precipitants such as…

A

Allergen exposure, viral, upper respiratory tract infections

39
Q

What is atopic asthma?

A

when there is evidence of allergen sensitization and immune activation often in patient with allergic rhinitis or eczema

40
Q

What is non atopic asthma?

A

When there is asthma but with no evidence of allergen sensitization

41
Q

What are some causes of atopic asthma?

A

Respiratory infections due to viruses, inhaled pollutants such as tobacco smoke, sulfur dioxide, nitrogen dioxide, exposure to cold, excercise

42
Q

What can be appreciated in the sputum or bronchoalveolar lavage specimens of patients with atopic asthma?

A

Curschmann spirals

43
Q

What are Charcot Leyden crystals?

A

Crystals that can be appreciated in asthma patients that are composed of eosinophil derived protein galectin-10

Otitis Externa (5 decks)

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