Obstructive Lung Disease Flashcards
Are obstructive lung disease reversible or irreversible?
Irreversible
Which populations are most susceptible to obstructive diseases?
Women
AA
Irreversible enlargement of the airspaces distal to the terminal bronchioles with accompanying fibrosis
Emphysema
Type of emphysema where proximal parts of acini are affected but distal alveoli are spared
Centriacinar emphysema
Which lobes is centriacinar emphysema most common in?
Upper/Apical lobes
Type of emphysema where acini are uniformly enlarged from bronchiole to terminal alveoli
Panacinar emphysema
Which lobes is panacinar emphysema most common in?
Lower lobes
Which emphysema type is associated with A1AT in children?
Panacinar emphysema
The pathogenesis of emphysema is?
Noxious particles irritate lungs –> epithelial damage/inflammation –> parenchymal destruction and airway disease
Which enzyme activity is deficient in pts with emphysema?
Protective antiproteases
Tobacco smoke produces oxidants the inhibit transcription of which gene?
NRF2
What are the presenting Sx’s of emphysema?
Dyspnea
Cough/Wheezing
Weight loss
What will be seen on CXR?
Hyperinflated lungs with possible blebs
Barrel-chested, prolonged expiration, hunched over posture, breathing through pursed lips =
Pink Puffer –> Emphysema
Which pt population is at highest risk for interstitial emphysema?
Premature children on + pressure ventilation
Adults on artificial ventilation
What is interstitial emphysema?
When alveolar tears allow air into the interstitium allowing fibrosis to ensue
What is the criteria to be diagnosed with chronic bronchitis?
Productive cough for at least 3 consecutive months over 2 years
What is the initiating event for chronic bronchitis?
Exposure to noxious/irritating inhaled substances
DOE, hypercapnia, hypoxemia, mild cyanosis =
Blue Bloater –> Bronchitis
Long-standing chronic bronchitis can lead to…?
Cor pulmonale
Which disease is defined as an IgE-mediated type 1 hypersensitivity rxn?
Atopic asthma
What presentation will a skin test show in an asthmatic pt?
Wheel-and-flare
What is the pathogenesis of ASA-induced asthma?
ASA ingestion –> COX inhibition –> PDE synthesis inhibition –> inhibition of inhibition of proinflammatory mediators
Astma is associated with which type of T cell and which cytokines?
Th2
IL-4, IL-5, IL-13
Mutations of IL-13 on chrom 5q are associated with which disease?
Asthma
Mutations of ADAM33 are associated with which disease?
Asthma
Variations of Chitinase are associated with which disease?
Asthma
Serum levels of ___ correlate with asthma severity?
YKL-40
Disease with destruction of SM and elastic tissue by chronic necrotizing infections leads to permanent dilation of bronchi and bronchioles
Bronchiectasis
What are the major cause of Bronchiectasis?
Rhinitis
Sinusitis
Kartagener syndrome (situs inversus)
Bronchiectasis can be cause by which congenital diseases?
Cystic fibrosis
Primary Ciliary Dyskinesia
Which organism can cause bronchiectasis in pts with CF and asthma?
Aspergillus
Which disease has a characteristic cough when the pt awakens in the morning?
Bronchiectasis
What are some complications of bronchiectasis?
Cor Pulmonale
Brain abscesses
Amyloidosis
