Pathology Of Obstructive Lung Disease

Question 1

What are the three primary obstructive diseases?

Answer 1

Chronic bronchitis
Emphysema
Asthma

Question 2

What is COPD?

Answer 2

Chronic bronchitis and emphysema

Question 3

What is FEV1?

Answer 3

Forced expiratory volume of air exiting the lungs in one second

Question 4

What is FVC?

Answer 4

After taking a deep breath and exhaling as much as possible, FVC is the final total amount of air expired

Question 5

How much is FEV1 compared to FVC normally?

Answer 5

FEV1 is usually 70-80% of FVC

Question 6

What us the normal volume of FVC?

Answer 6

5L

Question 7

What is the normal ratio of FEV1:FVC

Answer 7

0.7 - 0.8

Question 8

What does the ratio of FEV1:FVC indicate?

Answer 8

The limitations of air getting out of the lungs

Question 9

What tests can be used to show obstructive lung disease?

Answer 9

Peak Expiratory Flow Rate (PEFR)

Spirometry

Question 10

What are the characteristics of obstructive lung disease?

Answer 10

Airflow limitations
PEFR is reduced 
FEV1 is reduced 
FVC may be reduced 
FEV1 is less than 70% of FVC

Question 11

What is bronchial asthma?

Answer 11

Bronchial smooth muscle contraction and inflammation. It is an obstructive airway disease that is generally reversible either spontaneously or as a result of medical intervention

Question 12

What is the very rare inherited form of emphysema?

Answer 12

Inherited alpha-1-antiprotease deficiency

Question 13

What is the prevalence of COPD in the world?

Answer 13

More common in men than women and increasing in developing countries

Question 14

What are some causes of chronic bronchitis and emphysema?

Answer 14

Smoking 
Atmospheric pollution 
Occupation
Effect of age and Susceptibility 
Alpha-1-antiprotease deficiency

Question 15

What is the clinical definition of chronic bronchitis?

Answer 15

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

Question 16

What is complicated chronic bronchitis?

Answer 16

When the sputum produced is yellow or green so is infected

Question 17

What are the morphological changes in large airways due to chronic bronchitis?

Answer 17

Mucous glands hyperplasia
Goblet cell hyperplasia
Inflammation and fibrosis

Question 18

What are the morphological changes in small airways due to chronic bronchitis?

Answer 18

The appearance of goblet cells

Inflammation and fibrosis

Question 19

What are the different forms of emphysema?

Answer 19

Centriacinar
Panacinar
Periacinar

Question 20

What is centriacinar emphysema?

Answer 20

Emphysema mainly localised to the proximal respiratory bronchioles

Question 21

What is panacinar emphysema?

Answer 21

emphysema that destroys the entire alveoli uniformly predominantly in the lower half of the lungs

Question 22

What is periacinar emphysema?

Answer 22

Loss of tissue right at the edge of the acinar forming bulla

Question 23

What is a bulla?

Answer 23

An emphysematous space greater than 1cm

Question 24

What can happen if a bulla bursts?

Answer 24

It can cause a pneumothorax

Question 25

What is it like breathing with emphysema?

Answer 25

Breathing with half a lung full of air

Question 26

What is the PaO2 and PaCO2 in respiratory failure?

Answer 26

PaO2 < 8 kPa

PaCO2 > 6.5 kPa

Question 27

What are the abnormal states associated with hypoxaemia?

Answer 27

Ventilation / Perfusion imbalance
Diffusion impairment
Alveolar hypoventilation
Shunt

Question 28

When does a shunt happen in COPD?

Answer 28

During acute infective exacerbation

Question 29

What is chronic cor pulmonale?

Answer 29

Pulmonary arterial hypertension resulting from diseases affecting the structure and/or function of the lungs.