Pathology - Obstructive Lung Diseases Flashcards
What’s up wit it?
Is this an example of a fixed, or a functional obstruction?
Carcinoid tumor - fixed obstruction
What is this and what disease is it associated with?
Curschmann spiral - seen in the sputum of an asthma patient
What type of inflammatory cell is the predominant inflammatory cell seen in histologic sections of conducting airways in an asthma patient?
Eosinophils
What is the major histologic finding seen in a cross-section of a bronchiole of a patient with asthma?
Smooth muscle hypertrophy and hyperplasia
What is your Dx?
Asthma
What’s your Dx?
Asthma
What is your Dx?
Chronic bronchitis
What is the role of neutrophils in the pathogenesis of emphysema and how does smoking contribute to the development of the disease?
They make elastase, which destroys elastic fibers in the lungs. This protease is normally inhibited by alpha-1-antitrypsin, but smoking inactivates antitrypsin.
What is your Dx?
Emphysema
Aside from inactivating alpha-1–antitrypsin, smoking can damage tissues in the lungs through what other mechanism?
Reactive oxygen species
What are the two types of emphysema? What causes each?
Centrilobular - caused by smoking
Panacinar - caused by a genetic mutation (or genetic mutation + smoking)
In which region of the lungs would one find alveolar destruction in a patient with centrilobular emphysema, and in a patient with panacinar emphysema, respectively?
Centrilobular emphysema typically affects the upper lobes
Panacinar either affects the bases or the entire lung uniformly
Which section of the airways (bronchi, terminal bronchiole, respiratory bronchiole, etc.) is affected by centrilobular and panacinar emphysema, respectively?
Centrilobular destroys and dilates the respiratory bronchioles
Panacinar destroys and dilates the alveolar ducts and alveoli
What is your Dx?
Centrilobular emphysema
Name the structure at the tip of the arrow. What disease is this?
Terminal bronchiole (it’s spared) - centrilobular emphysema
What is your Dx?
Centrilobular emphysema
What is the etiology of this disease?
Panlobular emphysema - genetic etiology (alpha-1-antitrypsin deficiency)
What genotype causes most forms of alpha-1-antitrypsin deficiency? Which genotype makes a smoker susceptible to panacinar emphysema?
PiZZ causes most forms (very little A1-AT)
PiMZ smokers can get panacinar emphysema
The loss of ________ ________ is the primary reason why the conducting airways collapse upon exhalation in patients with emphysema.
loss of radial traction
What is bronchiectasis and what causes it?
Permanent dilation of the bronchi from chronic infection or inflammation leading to necrosis of the bronchial wall.
Name five conditions that can make a person susceptible to bronchiectasis.
- Bronchial obstruction (like a tumor, foreign body)
- Chronic sinusitis
- Post nasal drip
- Infection
- Genetic diseases: CF, Kartagener’s
What is your Dx? A picture of a normal lung is on the left.
Bronchiectasis
What is your Dx?
Bronchiectasis
Bronchiectasis usually occurs in which portion of the lung (upper, middle, lower) in patients with CF?
Upper
