Pathology of obstructive disease

Question 1

What is the FEV1?

Answer 1

Forced Expiratory Volume of air exiting the lung in the first second of breathing out

Question 2

What is the FVC?

Answer 2

Final Total amount or air expired

Question 3

What percentage is the FEV1 of the FVC

Answer 3

70-80%

The ratio is FEV1:FVC = 0.7or0.8

Question 4

What is the normal FEV1 volume in litres?

Answer 4

3.5-4

Question 5

What is the volume of the FVC in litres?

Answer 5

5

Question 6

What happens to FEV1 and FVC in obstructive lung disease?

Answer 6

Reduced to less than 70% of the FVC

FVC can be also reduced

PEFR also reduced

Question 7

What type of hypersensitivity is bronchial asthma?

Answer 7

Type 1

Question 8

Is bronchial asthma reversible and if yes, how?

Answer 8

Reversible either natrually or by medical intervention

The bronchial smooth muscle contraction and inflammation can be modified by drugs

Question 9

What is the aetiology of chronic bronchitis and emphysema?

Answer 9

Smoking, atmospheroc pollution and occupation: dust

Effect of age and susceptibility

Question 10

Whats the clinical definition of chronic bronchitis?

Answer 10

Cough productive of sputum most days
in at least 3 consecutive months
for 2 or more consecutive years

Question 11

What is complicated chronic bronchitis?

Answer 11

Its when the mucopurulent (acute infective exacerbation) or when FEV1 falls

Question 12

What are the morphological changes in large airways for chronic bronchitis?

Answer 12

Mucous gland hyperplasia
Goblet cell hyperplasia
Inflammation and fibrosis is a minor component

Question 13

What are the morphological changes in small airways for chronic bronchitis

Answer 13

Goblet cells appear

Inflammation and fibrosis in long standing disease

Question 14

What is the pathological definition of emphysema?

Answer 14

Increase beyond the normal in the size of airspaces distal to the terminal bronchiole arising either from dilatation or from destruction of their walls and without obvious fibrosis.

Question 15

What occurs during centriacinar emphysema?

Answer 15

Begins with bronchiolar dilatation

Then alveolar tissue is lost

Question 16

What is the most important form of emphysema?

Answer 16

Centriacinar

Caused by smoking

Question 17

What does panacinar involve?

Answer 17

Involving wiping out of all the lung tissue

Question 18

What is a bulla?

Answer 18

is an
emphysematous
space
greater than 1cm

Question 19

Why do people with hyperinflation with emphysema find it easier to breathe?

Answer 19

Small airways are kept open

Question 20

What does alpha 1 antitrypsin deficiency

Answer 20

Anti-elastase decreases so the elastase and proteases quantity increases and so tissue destruction increases and leads to emphysema

Question 21

Why does smoking cause emphysema?

Answer 21

Inflammatory cells increase
Anti-elastase enzymes decrease
Repair mechanisms and elastin synthesis decreases

Question 22

Which mechanism of airway obstruction in COPD can respond to pharmacological intervation?

Answer 22

Smooth muscle tone and inflammation

Question 23

What is the most important aspect in emphysema?

Answer 23

LOSS OF ALVEOLAR ATTACHMENTS is most important