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Pathology > Obstructive Lung Disorders > Flashcards

Obstructive Lung Disorders Flashcards

1
Q

Which side of lung have more tendency of foreign body to enter

A

Right lung

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2
Q

Most common location of lung abscess

A

Right lower lobe

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3
Q

Most common cause of Lung abscess

A

Aspiration of foreign body

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4
Q

Most common aspirated foreign body

A

Food particles

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5
Q

Most common causative organism of Lung abscess

A

Anaerobes

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6
Q

If lung abscess seen in elderly patients, what should we rule out first

A

Ruleout lung cancer

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7
Q

If presence of multiple of lung abscesses we should rule out

A

Staph. Aureus Septicimea

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8
Q

Respiratory Epithelial lining

A

Pseudostratified ciliated columnar epithelium except Vocal cords

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9
Q

Epithelial lining of vocal cords

A

Stratified Squamous epithelium

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10
Q

Epithelial lining of vocal cords

A

Stratified Squamous epithelium

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11
Q

Cilia + Mucus are

A

Protective in nature

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12
Q

Decreased activity of cilia and mucus clearance can leads to

A

Increased risk of infection

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13
Q

Congenital disease leading to cilia dysfunction

A

Kartagener Syndrome

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14
Q

In Kartagener Syndrome, there is defect of

A

Dynein

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15
Q

Classical triad seen in Kartagener Syndrome

A

Bronchiectasis
Sinusitis
Situs inversus (Dextrocardia)

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16
Q

Acquired cause which affects cilia activity

A

Smoking

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17
Q

In Cystic fibrosis there is problem of which gene

A

CFTR Gene

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18
Q

Problem of CFTR gene in Cystic fibrosis can leads to

A

Chloride channel defect - Cl, Na, H20 Can’t move properly - mucus dries - mucus can’t move - increased risk of infection

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19
Q

Important parameters of lung

A

Ventilation
Perfusion
Ventilation perfusion ratio

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20
Q

Ventilation is most in which part of lung

A

Base

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21
Q

Perfusion is most in which part of lungs

A

Base

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22
Q

Ventilation perfusion ratio is most in which part of lungs

A

Apex

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23
Q

Normal range of Ventilation perfusion ratio

A

0.8
Can’t exceed 1

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24
Q

Wall of respiratory tract consist of

A

Epithelial lining
Smooth muscle
Mucus secreting cells
Cartilage

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25
Q

In Bronchioles there is absence of

A

Cartilage
Submucous glands

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26
Q

Reid’s index =

A

A/B where,
A- thickness of mucus glands
B- distance between epithelium and cartilage

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27
Q

Normal value of Reid’s index

A

0.4

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28
Q

Functional unit of lungs

A

Acinus

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29
Q

Types of Pneumocytes

A

Type 1 and
Type 2

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30
Q

Function of Type 1 Pneumocytes

A

Lines the alveolar cells and increases surface area

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31
Q

Function of Type 2 Pneumocytes

A

More in number
Secrets surfactants - decreases surface tension - important at time of expiration - prevents collapse of alveoli
Reparative function - play important role in replacement of type 1 Pneumocytes

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32
Q

Spirometry findings in case of Obstructive lung disorders

A

FEV1 <80%
FVC - Normal
FEV1/FVC - <0.7%
TLC - Normal or slightly increased

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33
Q

Spirometry findings in Restrictive lung disorders

A

FEV1 - Normal or Slightly decreased
FVC decreases
FEV1/FVC - >0.7
TLC - Decreases

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34
Q

Examples of Obstructive lung disorders

A

Emphysema
Chronic bronchitis
Bronchiectasis
Bronchial asthma
Small airway disease

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35
Q

Emphysema usually involves which part of lung

A

Disorder of acinus

36
Q

Emphysema means

A

Abnormal permanent enlargement of air spaces distal to terminal bronchioles

37
Q

Fibrosis in Emphysema

A

Minimal fibrosis
Alveolar wall destruction

38
Q

Damaging factor of lungs in case of Emphysema

A

Elastase - damages elastin fibers in lungs

39
Q

Protective factors of lungs in case of Emphysema

A

Anti-elastases - Alpha-antitrypsin, Alpha 1 macroglobulin - neutralizes Elastase

40
Q

Risk factors of Emphysema

A

Smoking
Air pollution
Occupational hazards (Pneumoconiosis)

41
Q

How Smoking can lead to emphysema

A

Smoking - inflammation in airways - neutrophils and macrophages increases - elastase secretion increases - damage elastin fibers of lungs - increased risk of Emphysema
Also smoking leads to formation of free radicals - decreases activity of Anti-elastase

42
Q

If there is protein misfoldings in alpha 1 antitrypsin

A

Liver doesn’t release it in circulation - doesn’t able to reach lungs (No protective mechanism) - high risk of Emphysema or chronic bronchitis

43
Q

Accumulation of misfolded proteins in liver can leads to

A

Micronodular Cirrhosis

44
Q

Anatomical classification of Emphysema

A

Centriacinar emphysema
Panacinar emphysema
Distal acinar emphysema
Irregular Emphysema

45
Q

Centriacinar emphysema involves which part of acinus

A

Involves central or proximal part of acinus

46
Q

Most common cause of Centriacinar emphysema

A

Smoking

47
Q

Clinically most common type of Emphysema

A

Centriacinar emphysema

48
Q

Centriacinar emphysema predominantly damages which lobe of lungs

A

Upper lobe

49
Q

Which part of acinus is affected in Panacinar emphysema

A

Complete acinus is affected

50
Q

Panacinar emphysema is most commonly associated with

A

Alpha-1 anti trypsin deficiency

51
Q

In Panacinar emphysema which part of lung is commonly affected

A

Base of lung

52
Q

Which part of acinus usually affected in Distal acinar emphysema

A

Distal part of acinus

53
Q

Distal acinar emphysema commonly affected which lobe of lungs

A

Upper lobe

54
Q

Enlarged air spaces in emphysema can leads to

A

Air trapping - BLEB formation - Pneumothorax

55
Q

Clinical features of Emphysema

A

Elderly patients (60-70 years)
Earliest complaint - Dyspnea
Use of accessory muscles
Weight loss
Pink puffers
Advanced - decreased O2 in blood - can lead to pulmonary Hypertension - Right heart failure

56
Q

“Pink puffers” are referred to patients with which disease

A

Emphysema

57
Q

Most common risk factor of Chronic bronchitis

A

Smoking

58
Q

How Smoking can leads to Chronic bronchitis

A

Smoking - inflammation in airways - increase in mucus production (to remove smoke particles) - stasis of mucus - can lead to secondary infections

59
Q

Reid’s index in case of Chronic bronchitis

A

> 0.5

60
Q

Clinical features of Chronic bronchitis

A

Productive cough
Obese
Decreased O2 - Pulmonary HTN - Cor pulmonale
Blue Bloaters
No amyloidosis

61
Q

“Blue Bloaters” referred to patients with which disease

A

Chronic bronchitis

62
Q

COPD is combination of

A

Emphysema + Chronic bronchitis + Small airway disease

63
Q

Treatment of COPD

A

Quit smoking or take Nicotine replacement
Supplemental O2 - increases longevity
Mucolytics
Ipratropium (Anticholinergic drug)

64
Q

Which is reversible airway obstructive disorder

A

Bronchial Asthma

65
Q

Airways in bronchial asthma

A

Hyper-responsive

66
Q

Types of Bronchial asthma

A

Extrinsic
Intrinsic

67
Q

Extrinsic bronchial asthma

A

Type 1 hypersensitivity reaction
External antigens - house dust, pollen
Increased IgE
Childhood onset
History of Atopy(Eczema)

68
Q

Intrinsic Bronchial Asthma

A

No type 1 HR
Normal IgE levels
Adult onset
History of viral infection or drugs exposure
Aspirin

69
Q

Samter’s Triad

A

Aspirin intolerance
Adult nasal polyps
Asthma

70
Q

Clinical features of Bronchial Asthma

A

Wheezing
Dyspnea
Nocturnal cough

71
Q

Diagnosis in case of Bronchial asthma

A

Clinical history
Spirometry
Sputum examination
Microscopic

72
Q

Findings on sputum examination in case of Bronchial asthma

A

Curschman Spirals - zigzag structure
Charcot leyden Crystals
Creola body - degenerated airway epithelial cells

73
Q

Charcot leyden Crystals are made up of

A

Galectin-10

74
Q

Microscopic findings in case of Bronchial asthma

A

Airway remodeling
Increase in thickness of basement membrane (increased collagen deposition)
Hypertrophy of smooth muscle
Increased no. Of mucus glands
Eosinophilic infiltration

75
Q

Gene responsible for hypertrophy of smooth muscles in Bronchial asthma

A

ADAM-33 gene

76
Q

Marker of severity of Bronchial asthma

A

YKL-40

77
Q

Treatment of Bronchial asthma

A

Avoid antigen exposure
Bronchodilators - Salbutamol,terbutaline, Formoterol
Anti-inflammatory drugs - Corticosteroids

78
Q

Bronchiectasis is

A

Chronic necrotizing infection of airways - leads to abnormal permanent airway dilatation

78
Q

Risk factors of bronchiectasis

A

Congenital
Obstruction
Infections
Miscellaneous conditions

79
Q

Congenital causes leading to Bronchiectasis

A

Kartagener Syndrome
Cystic fibrosis

80
Q

Obstructive risk factors of bronchiectasis

A

Foreign bodies or cancer

81
Q

Infectious causes leading to Bronchiectasis

A

TB
Staph aureus
Allergic Bronchopulmonary Aspergillosis

82
Q

Miscellaneous conditions leading to Bronchiectasis

A

Rheumatoid arthritis
Grafts vs host disease

83
Q

Clinical features of Bronchiectasis

A

Involvement of lower lobe of lungs (Basal involvement)
Dyspnea
Bronchorrhea (cups full of sputum)
Predominantly left lung involvement
Fever
Dilated airways - can seen upto pleural surfaces

84
Q

Investigation of choice in Bronchiectasis

A

HRCT Scan

85
Q

Appearance seen in HRCT Scan in case of Bronchiectasis

A

Tram-Track appearance
Honey comb lungs

Pathology (14 decks)

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