Obstructive lung dz Flashcards
Tobacco assoc vascular dz
Atherosclerosis
CAD
stroke
PVD
Tobacco assoc lung dz
COPD (chronic bronchitis, emphyzema)
lung cancer
worsens pneumoconioses and pneumonia b/c dec ciliary function
Tobacco assoc cancers (besides lung)
Synergistic with alcohol to inc risk for squamous cell carcinomas of the: mouth, throat, esophagus
bladder, pancreatic, and kidney cancer
Effect of tobacco in pregnancy
MR in babies
2 diseases of COPD
Chronic bronchitis and emphysema- they often coexist
Chronic bronchitis- definition
Defined clinically
cough with sputum production >3 mo/ yr for 3+ yrs
Chronic Bronchitis- RF
smoking, air pollution
Chronic bronchitis- mechanism
obstruction due to mucus
Chronic bronchitis- presentation
“Blue Bloater”
overweight, cyanotic, cardiomegaly, may have core pulmonale
NORMAL DIAPHRAGM
Chronic Bronchitis- symptoms
Productive cough
Pt’s often get pneumonia
Chronic Bronchitis- microscopy
inflammation
edema
Inc Reid index= mucous gland hyperplasia
Emphysema- definition
Defined anatomically as permanent enlargement of the airspaces from Alveolar destruction
Emphysema- risk factors
smoking
alpha 1 anti-trypsin deficiency
Emphysema- mechanism
obstruction due to collapsed airway so that the destroyed lung cant recoil (b/c of damage to elastic tissue)
Emphysema- presentation
Pink puffer thin/ anxious and non cyanotic uses accessory muscles to breath low and flat diaphragm b/c of expanded lungs inc AP diameter= barrel chest
Emphysema- symptoms
dyspnea and breathlessness
Emphysema- microscopy
damaged lung tissue
How does smoking cause emphysema
smoking –> nicotine –> PMN infiltration –> elastase release.
BUT
Nicotine deactivates alphat 1 antitrypsin –> elastase is not inhibited –> lung tissue is destroyed.
What type of emphysema does smoking cause?
What part of the lungs
Centrilobular
Upper lobes b/c that is where most air goes
How does alpha-1-antitrypsin deficiency cause emphysema
deficiency leads to an inability to break down elastase (–> inc elastin breakdown)
What type of emphysema does alpha 1 antitrypsin deficiency cause?
where in the lung?
panacinar emphysema
diffuse injury throughout the lungs, but worse in the lower lobes b/c there is more blood (therefore) more PMNs there.
Distal Acinar Emphysema- what is this? who get this? what is this a risk factor for?
dilated airspaces at the bottom of the lungs
Normally seen in TALL inviduals (I’d like Distal from the mouth and the people w/ alveoli most distal from the mouth are tall people)
Inc risk of spontaneous pneumothorax b/c of popped bleb.
Asthma- definition
Episodic/ reversible bronchoconstriction caused by Inflammation.
Asthma- Extrinsic asthma vs intrinsic asthma
Extrinsic: Type I HSR to an allergen
Intrinsic: cold, exercise (cause is less clear)
Asthma Symptoms
cough
dyspnea
wheezing
Asthma pathology
Bronchial inflammation with- LYMPHOCYTES, EOSINOPHILS, AND MAST CELLS
Hyperplasia on bronchial mucous glands and goblet cells
Hypertrophy of smooth muscle
Asthma- sings on microscopy
Cushmann spirals- whorl like accumulations of epithelial cells = mucus plug
Charcot- Leyden crystals- crystalloids of eosinophil derived proteins
Bronchiestasis- definition
permanent dilation of the bronchi
Bronchiectasis- caused by
repeated infections –> scarring –> cartilage and elastic tissue destruction
Bronchiectasis- risk factors
MCC= cystic fibrosis
asthma
Kartageners
Bronchiectasis- symptoms
cough
foul smelling sputum
hemoptysis
Bronchiectasis vs emphysema- how do you tell them apart
On x ray emphysema will still see cartilage, in brocheactasis you will not
