Pathology

Question 1

What are the pathological signs of airway obstruction?

Answer 1

Muscle spasm, mucosal oedema, airway collapse due to loss of support.
(Could also be localised obstruction due to a tumour of foreign body)

Question 2

What is the epidemiological definition of chronic bronchitis?

Answer 2

A cough productive of sputum on most days for 3 months of at least 2 successive years.

Question 3

What are the three different types of emphysema? Give a brief description of these?

Answer 3

1. Centriaciner: Damage is concentrated around the respiratory bronchioles (more distal alveolar ducat and alveoli are better preserved) This type usually causes the least disability.
2. Panaciner: Distension affects the whole acinus and this causes severe airflow limitation and a large V/Q mismatch.
3. Irregular: Patchy scarring and damages to the lungs.

Question 4

What defines emphysema?

Answer 4

Increase beyond the normal in the size of the airspaces distal to the terminal bronchiole.

Question 5

How does emphysema appear in the lung tissue?

Answer 5

Holes

Question 6

As the disease advances you get a decrease in Pa02. What does this lead to?

Answer 6

Dysponea & increased respiratory rate

Pulmonary vasoconstriction and pulmonary hypertension

Question 7

What is alpha 1 anti trypsin?

Answer 7

An anti elastase

Question 8

Why does the alpha 1 anti trypsin deficiency predispose you to emphysema?

Answer 8

The lung tissue is sensitive to damage by elastases.

Question 9

What are elastases?

Answer 9

Enzymes produces by neutrophils and macrophages

Question 10

What effect does tobacco smoke have on the lungs?

Answer 10

1. Increases numbers of neutrophils and macrophages
2. Slows the transit of these cells
3. Promotes neutrophil degranulation
4. Inhibits alpha 1 anti trypsin

Question 11

What is bronchial asthma?

Answer 11

A chronic inflammatory disorder characterizes by hyperactive airways leading to episodic reversible bronchoconstriction.

Question 12

What is the difference between extrinsic and intrinsic asthma?

Answer 12

Extrinsic is inflammation in response to an inhaled antigen.

Intrinsic is non immune mechanisms such as cold or exercise.

Question 13

What kind of hypersensitivity reaction is allergic asthma?

Answer 13

Type 1 - The allergen binds to IgE on the surface of mast cells.

Question 14

What are the pathological features of asthma?

Answer 14

Narrow oedematous airways
Mucus plugs
Inflammatory cells (lymphocytes, plasma cells, eosinophils)Epithelial cell damage.