Obstructive lung disease

Question 1

Obstructive lung diseases, what happens to RV and FVC?

Answer 1

Air trapping in the lung
Airways close prematurely at high lung volume,
resulting in high RV and low FVC

Question 2

Obstructive lung disease: PFT

Answer 2

PFT: low low FEV1, low FVC, which results in
Low FEV1/FVC ratio (hallmark)
V/Q mismatch

Question 3

Obstructive lung diseases: 4 types

Answer 3

1) Chronic bronchitis (blue bloater)
2) Emphysema (pink puffer, barrel chested)
3) Asthma
4) Bronchiectasis

Question 4

Obstructive lung diseases:

Chronic Bronchitis 2 findings

Answer 4

“Blue bloater”

1) Hypertrophy of mucus secreting glands in the bronchi
2) Reid index (thickness of gland layer/total thickness of bronchial wall)> 50%

Question 5

Obstructive lung diseases:

Chronic Bronchitis finding

Answer 5

Cyanosis (early-onset hypoxemia due to shunting)

Late onset dyspnea

Question 6

Obstructive lung diseases:

Chronic Bronchitis: dx

Answer 6

Productive cough for > 3 months per year (not nec consecutive) for > 2 years
Disease of small airways

Question 7

Obstructive lung diseases:

Emphysema:

Answer 7

“Pink puffer, barrel chested”

1) enlargement of airspaces and reduced recoil from destruction of alveolar walls
2) high compliance

Question 8

Obstructive lung diseases:

Emphysema types

Answer 8

1) centriacinar: associated with smoking

2) panacinar: associated with alpha 1 antitrypsin deficiency

Question 9

Obstructive lung diseases:

Emphysema finding

Answer 9

Exhalation through pursed lips to increase airway pressure and prevent airway collapse during respiration

Question 10

Obstructive lung diseases:

Asthma 4 changes

Answer 10

1) Bronchial hyperresponsiveness cause reversible bonchoconstrictions
2) SM hypertrophy
3) Curschman’n’s spiral (shed epithelium forms mucus plug)
4) Charcot-Leyden crystals (from breakdown of eosinophils in sputum)

Question 11

Obstructive lung diseases:

Asthma 3 findings

Answer 11

Low I/E ratio
Pulsus paradoxus,
Mucus plugging

Question 12

Obstructive lung diseases:

Bronchiectasis (5 things)

Answer 12

1) Chronic necrotizing infection of bronchi
2) Permanently dilated airways
3) purulent sputum
4) recurrent infections
5) hemoptysis.

Question 13

Obstructive lung diseases:

Bronchiectasis; diseases associated with

Answer 13

1) Bronchial obstruction,
2) Poor ciliary motility (smoking)
3) Kartagener’s syndrome
4) CF
5) Allergic bronchopulmonary aspergillosis (ABPA).