Obstructive lung diseases

Question 1

What is chronic bronchitis and emphysema known as

Answer 1

Chronic Obstructive Pulmonary Disease

Question 2

What are the two ways obstructive lung disease be demonstrated

Answer 2

Peak Expiratory Flow Rate (PEFR)
-airflow obstruction = < 50%

Spirometry

• reduced FEV1/FVC ratio
• FEV1 is less than 70% of FVC
• bronchial asthma is normal between attacks

Question 3

What are three examples of obstructive lung diseases - what do they all have in common

Answer 3

Asthma
Emphysema
Chronic bronchitis

AIR FLOW LIMITATION

Question 4

What is the mechanism of bronchial asthma

Answer 4

inflammation in the airways with the degranulation of mast cells due to bronchial sensitivity

Question 5

How can the effect Inflammation and smooth muscle contraction in asthma be reversed

Answer 5

Inflammation and smooth muscle contraction can be revered by pharmacological drugs but can also reverse spontaneously

Question 6

What is the aetiology of bronchitis and emphysema

Answer 6

Smoking 
Occupation 
ageing  
atmospheric pollution 
chronic asthma

Question 7

What is an extremely rare cause of emphysema

Answer 7

Alpha-1-antiprotease (antitrypsin) deficiency

Question 8

True or false our FEV1 remains constant throughout our life?

What contributes to the biggest decline in FEV1

Answer 8

False, FEV1 decreases with age

Smoking

Question 9

What is the clinical definition signs of chronic bronchitis

Answer 9

Cough productive of sputum most days
in at least 3 consecutive months
for 2 or more consecutive years

Question 10

When does bronchitis become complicated

Answer 10

When FEV1 falls

When there is pus - mucopurulent

Question 11

What morphologies occur on the airways of chronic bronchitis

Answer 11

Mucous gland hyperplasia (enlarge) and Goblet cell hyperplasia/appear increasing mucus production
This leads to Inflammation and fibrosis and an over all narrowing of the airways

Question 12

if the airways are irritated by something what are they most likely to produce

Answer 12

More mucus

Question 13

What is the pathology of emphysema

Answer 13

Loss of elastin by destruction or dilation of alveoli wall
Leading to thickening of airways by inflammation and fibrosis

Inflammation triggers neutrophils causing further damage, triggering elastase for further break down of elastin

Loss of alveolar attachment

Question 14

What part in the respiratory tract is last linked with respiratory epithelium

Answer 14

Respiratory bronchil

Question 15

What is the overall alveoli and alveolar duct called?

Answer 15

Acinus

Question 16

What are the different form of emphysema

Answer 16

CENTRIACINAR
PANACINAR
PERIACINAR

Question 17

What is centriacinar emphysema

Answer 17

Emphysema that occurs at the beginning of the bronchiolar dilation (in-between alveoli branches)

Question 18

Why is centriacinar emphysema mostly linked to environmental factor emphysema

What is it mostly likely linked to then

Answer 18

The upper zone of the lungs as are less effiecent at clearing due to decreased bloody supply compared to the lower region of the lungs and is more likely to be affected by environmental factors as reach upper airways first

Smoking

Question 19

What is panacinar emphysema primarily characterised by and where is it most likely to be seen

Answer 19

relatively uniform enlargement of air spaces throughout the terminal bronchioles and alveoli

Located all over the lung

Question 20

What is periacinar emphysema characterised by

Answer 20

A bulla -emphysematous abnormal airspaces greater than 1cm resulting from the destruction of normal airspace

Located underneath the pleura is called bleb

Question 21

What is one of the noticeable characteristics of emphysema

Answer 21

Hyperinflation of the chest

Question 22

What is smokings affect on emphysema

Answer 22

Leads to malfunction of Alpha-1-antitrypsin which increases the production elastase therefore increasing breakdown of elastin
As well causes inflammation recruiting neutrophils which increase elastase, resulting in further breakdown of elastin
= alveoli wall destruction

Question 23

What is the most important factor in emphysema

Answer 23

LOSS OF ALVEOLAR ATTACHMENTS

Question 24

Although alveolar attachment can not be reinstated what is possible reversible in COPD cases with pharmacological intervention

Answer 24

smooth muscle tone

inflammation

Question 25

What aetiology is panacinar emphysema most likely linked to

Answer 25

alpha 1 antitrypsin deficiency