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Obstructive lung dz Flashcards

1
Q

Tobacco assoc vascular dz

A

Atherosclerosis
CAD
stroke
PVD

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2
Q

Tobacco assoc lung dz

A

COPD (chronic bronchitis, emphyzema)
lung cancer
worsens pneumoconioses and pneumonia b/c dec ciliary function

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3
Q

Tobacco assoc cancers (besides lung)

A

Synergistic with alcohol to inc risk for squamous cell carcinomas of the: mouth, throat, esophagus
bladder, pancreatic, and kidney cancer

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4
Q

Effect of tobacco in pregnancy

A

MR in babies

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5
Q

2 diseases of COPD

A

Chronic bronchitis and emphysema- they often coexist

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6
Q

Chronic bronchitis- definition

A

Defined clinically

cough with sputum production >3 mo/ yr for 3+ yrs

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7
Q

Chronic Bronchitis- RF

A

smoking, air pollution

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8
Q

Chronic bronchitis- mechanism

A

obstruction due to mucus

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9
Q

Chronic bronchitis- presentation

A

“Blue Bloater”
overweight, cyanotic, cardiomegaly, may have core pulmonale
NORMAL DIAPHRAGM

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10
Q

Chronic Bronchitis- symptoms

A

Productive cough

Pt’s often get pneumonia

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11
Q

Chronic Bronchitis- microscopy

A

inflammation
edema
Inc Reid index= mucous gland hyperplasia

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12
Q

Emphysema- definition

A

Defined anatomically as permanent enlargement of the airspaces from Alveolar destruction

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13
Q

Emphysema- risk factors

A

smoking

alpha 1 anti-trypsin deficiency

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14
Q

Emphysema- mechanism

A

obstruction due to collapsed airway so that the destroyed lung cant recoil (b/c of damage to elastic tissue)

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15
Q

Emphysema- presentation

A 
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
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16
Q

Emphysema- symptoms

A

dyspnea and breathlessness

17
Q

Emphysema- microscopy

A

damaged lung tissue

18
Q

How does smoking cause emphysema

A

smoking –> nicotine –> PMN infiltration –> elastase release.
BUT
Nicotine deactivates alphat 1 antitrypsin –> elastase is not inhibited –> lung tissue is destroyed.

19
Q

What type of emphysema does smoking cause?

What part of the lungs

A

Centrilobular

Upper lobes b/c that is where most air goes

20
Q

How does alpha-1-antitrypsin deficiency cause emphysema

A

deficiency leads to an inability to break down elastase (–> inc elastin breakdown)

21
Q

What type of emphysema does alpha 1 antitrypsin deficiency cause?
where in the lung?

A

panacinar emphysema

diffuse injury throughout the lungs, but worse in the lower lobes b/c there is more blood (therefore) more PMNs there.

22
Q

Distal Acinar Emphysema- what is this? who get this? what is this a risk factor for?

A

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.

23
Q

Asthma- definition

A

Episodic/ reversible bronchoconstriction caused by Inflammation.

24
Q

Asthma- Extrinsic asthma vs intrinsic asthma

A

Extrinsic: Type I HSR to an allergen
Intrinsic: cold, exercise (cause is less clear)

25
Q

Asthma Symptoms

A

cough
dyspnea
wheezing

26
Q

Asthma pathology

A

Bronchial inflammation with- LYMPHOCYTES, EOSINOPHILS, AND MAST CELLS
Hyperplasia on bronchial mucous glands and goblet cells
Hypertrophy of smooth muscle

27
Q

Asthma- sings on microscopy

A

Cushmann spirals- whorl like accumulations of epithelial cells = mucus plug
Charcot- Leyden crystals- crystalloids of eosinophil derived proteins

28
Q

Bronchiestasis- definition

A

permanent dilation of the bronchi

29
Q

Bronchiectasis- caused by

A

repeated infections –> scarring –> cartilage and elastic tissue destruction

30
Q

Bronchiectasis- risk factors

A

MCC= cystic fibrosis
asthma
Kartageners

31
Q

Bronchiectasis- symptoms

A

cough
foul smelling sputum
hemoptysis

32
Q

Bronchiectasis vs emphysema- how do you tell them apart

A

On x ray emphysema will still see cartilage, in brocheactasis you will not

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