Pathology of Lung Disease

Question 1

Asthma

Answer 1

Increased irritability of bronchial tree
Paroxysmal airway narrowing
Reversible - spontaneous or after treatment

Question 2

Most common asthma

Answer 2

Atopic
triggered by environmental agents
family history
type 1 hypersensitivity reaction

Question 3

Inflammatory reaction caused by

Answer 3

Mast cells in the bronchi 
Have IgE on surface
Allergen binds to specific IgE antibodies on surface of mast cell and cross links them 
Cross-linking triggers degranulation 
Inflammatory mediator release

Question 4

Treatment of asthma 1) PREVENTATIVE

Answer 4

Brown puff - steroid treatment

reduces number of mast cells in lung

Question 5

Treatment of asthmas 2) inhibiting degranulation

Answer 5

disodium chromoglycate stabilises mast cell membranes and doesn’t allow it to degranulate

Question 6

Treatment of asthma 3) after attack

Answer 6

Salbutamol which binds to beta adrenergic receptors and reverses effects of chemical mediators i.e promotes bronchodilation

Question 7

Chronic obstructive airway disease

2 types

Answer 7

Emphysema

Chronic bronchitis

Question 8

Chronic bronchitis 
Characteristics 
Definiton 
Aetiology 
Clinical features

Answer 8

Airways are permanently damaged 
Cough and sputum for 3 months in 2 consecutive years
Air pollution 
Cigarette smoking
Middle aged men 
Heavy smokers

Question 9

Chronic bronchitis pathology

microbiology

Answer 9

Defence of ciliated epithelial cells no longer exist 
More susceptible to infection 
Mucus hyper secretion
Bronchial glands stimulated to produce more secretions
Chronic inflammation 
Squamous metaplasia 
Dysplasia  
Bacteria
Viruses

Question 10

Emphysema

anatomical definition

Answer 10

Enlargement of airspaces distal to terminal bronchioles due to destruction of elastin in the walls
Affects efficiency of gas exchange

Question 11

Lung cancer

Answer 11

Incidence in GB has declined slightly

Greater incidence in increased social deprivation

Question 12

Lung cancer causes

Answer 12

Smoking
Asbestos exposure
Radon exposure

Question 13

Lung cancer pathology

Answer 13

Damage of ciliated epithelial cells by damaging agents
Metaplasia from ciliated columnar to squamous
Cells become dysplastic and eventually invasive carcinoma

Question 14

Lung cancer classification

Answer 14

Small cell and non-small cells
Small cell is highly aggressive
Small cell treated by systemic chemotherapy
Non-small cell is either adenocarcinoma or squamous carcinoma

Question 15

Economic aspect?

Answer 15

Cigarette tax
Lung cancer treatment is cheap
Ischaemic heart disease
COAD

Question 16

Prognosis of lung cancer

Answer 16

4-9% overall 5 year survival rate
due to low % of resectable tumours
poor response to systemic chemo

Question 17

industrial lung disease e.g

pathology

Answer 17

coal worker’s pneumoconiosis

reduction in volume of functional lung tissue

Question 18

silicosis
cause
pathology

Answer 18

inhalation of small particles of silicates
toxic to macrophages
inflammatory mediators are released into surrounding tissue –> fibrosis

Question 19

Asbestos

Answer 19

Exposure to asbestos fibre

Question 20

Asbestos related diseases (4)

Answer 20

Pleural plaque
Pleural fibrosis
mesothelioma
asbestosis
lung carcinoma

Question 21

Mesothelioma

Answer 21

Malignant tumour of pleural surface exposed to asbestos

can appear 40 years after exposures

Question 22

Lung carcinoma and asbestos

Answer 22

Greater in subjects with asbestos exposure
Increased in cigarette smoking
Cause of lung carcinoma