Obstructive Lung Disease

Question 1

Are obstructive lung disease reversible or irreversible?

Answer 1

Irreversible

Question 2

Which populations are most susceptible to obstructive diseases?

Answer 2

Women

AA

Question 3

Irreversible enlargement of the airspaces distal to the terminal bronchioles with accompanying fibrosis

Answer 3

Emphysema

Question 4

Type of emphysema where proximal parts of acini are affected but distal alveoli are spared

Answer 4

Centriacinar emphysema

Question 5

Which lobes is centriacinar emphysema most common in?

Answer 5

Upper/Apical lobes

Question 6

Type of emphysema where acini are uniformly enlarged from bronchiole to terminal alveoli

Answer 6

Panacinar emphysema

Question 7

Which lobes is panacinar emphysema most common in?

Answer 7

Lower lobes

Question 8

Which emphysema type is associated with A1AT in children?

Answer 8

Panacinar emphysema

Question 9

The pathogenesis of emphysema is?

Answer 9

Noxious particles irritate lungs –> epithelial damage/inflammation –> parenchymal destruction and airway disease

Question 10

Which enzyme activity is deficient in pts with emphysema?

Answer 10

Protective antiproteases

Question 11

Tobacco smoke produces oxidants the inhibit transcription of which gene?

Answer 11

NRF2

Question 12

What are the presenting Sx’s of emphysema?

Answer 12

Dyspnea
Cough/Wheezing
Weight loss

Question 13

What will be seen on CXR?

Answer 13

Hyperinflated lungs with possible blebs

Question 14

Barrel-chested, prolonged expiration, hunched over posture, breathing through pursed lips =

Answer 14

Pink Puffer –> Emphysema

Question 15

Which pt population is at highest risk for interstitial emphysema?

Answer 15

Premature children on + pressure ventilation

Adults on artificial ventilation

Question 16

What is interstitial emphysema?

Answer 16

When alveolar tears allow air into the interstitium allowing fibrosis to ensue

Question 17

What is the criteria to be diagnosed with chronic bronchitis?

Answer 17

Productive cough for at least 3 consecutive months over 2 years

Question 18

What is the initiating event for chronic bronchitis?

Answer 18

Exposure to noxious/irritating inhaled substances

Question 19

DOE, hypercapnia, hypoxemia, mild cyanosis =

Answer 19

Blue Bloater –> Bronchitis

Question 20

Long-standing chronic bronchitis can lead to…?

Answer 20

Cor pulmonale

Question 21

Which disease is defined as an IgE-mediated type 1 hypersensitivity rxn?

Answer 21

Atopic asthma

Question 22

What presentation will a skin test show in an asthmatic pt?

Answer 22

Wheel-and-flare

Question 23

What is the pathogenesis of ASA-induced asthma?

Answer 23

ASA ingestion –> COX inhibition –> PDE synthesis inhibition –> inhibition of inhibition of proinflammatory mediators

Question 24

Astma is associated with which type of T cell and which cytokines?

Answer 24

Th2

IL-4, IL-5, IL-13

Question 25

Mutations of IL-13 on chrom 5q are associated with which disease?

Answer 25

Asthma

Question 26

Mutations of ADAM33 are associated with which disease?

Answer 26

Asthma

Question 27

Variations of Chitinase are associated with which disease?

Answer 27

Asthma

Question 28

Serum levels of ___ correlate with asthma severity?

Answer 28

YKL-40

Question 29

Disease with destruction of SM and elastic tissue by chronic necrotizing infections leads to permanent dilation of bronchi and bronchioles

Answer 29

Bronchiectasis

Question 30

What are the major cause of Bronchiectasis?

Answer 30

Rhinitis Sinusitis Kartagener syndrome (situs inversus)

Question 31

Bronchiectasis can be cause by which congenital diseases?

Answer 31

Cystic fibrosis | Primary Ciliary Dyskinesia

Question 32

Which organism can cause bronchiectasis in pts with CF and asthma?

Answer 32

Aspergillus

Question 33

Which disease has a characteristic cough when the pt awakens in the morning?

Answer 33

Bronchiectasis

Question 34

What are some complications of bronchiectasis?

Answer 34

Cor Pulmonale Brain abscesses Amyloidosis