Pathology of Obstructive Lung Disease Flashcards
Which three main conditions are obstructive airway diseases?
- emphysema
- chronic bronchitis
- asthma
FEV1 is the…
Forced Expiratory Volume (FEV) of air exiting the lung in the first second of FVC.
FVC is the…
total amount of air expired after taking a maximum inspiration (FVC).
What factors is predicted FVC based on?
age, sex and height
FEV1 is usually about _____ of _____ in healthy persons.
70-80%
FVC
Normal FVC is around ____.
Normal FEV1 is _______.
Therefore, normal FEV1/FVC = ______.
5L
- 5-4L
- 7-0.8
What is a marked fall in PEFR?
<50% of best
What is a moderate fall in PEFR?
50-80% of best
What is a normal PEF in PEFR?
400 – 600 L/min
In obstructive lung disease:
- PEFR is ________.
- FEV1 is _________.
- FVC ________.
- FEV1 _______ of FVC.
- reduced
- reduced
- normal or low
- is less than 70% of
FEV1/FVC < 0.7
Outline the pathogenesis of bronchial asthma.
- mast cell degranulation
- smooth muscle contraction (immediate)
- acute inflammatory response
- chronic inflammation in chronic asthmatics.
When can bronchial asthma become irreversible?
Why?
when it becomes chronic
In lifelong asthmatics – ultimately there may be structural changes in airways (fibrosis, scarring) which are not reversible by pharmacological intervention.
What is the aetiology of COPD?
- SMOKING (tobacco)
- atmospheric pollution
- occupation e.g. dust
What impacts your susceptibility to COPD?
How your metabolism handles the chemicals in cigarettes or pollution.
___________ deficiency is an extremely rare cause of emphysema.
Alpha-1-antitrypsin
Does congenital alpha 1 antitrypsin deficiency cause chronic bronchitis?
no, only emphysema
What is the clinical definition of chronic bronchitis?
Cough productive of sputum most days
in at least:
- 3 consecutive months
- for 2 or more consecutive years
When can chronic bronchitis become complicated? (2)
- mucopurulent sputum (acute infective exacerbation)
- when FEV1 falls
What are the morphological changes in chronic bronchitis in the large airways (bronchi)? (3)
- Mucous gland hyperplasia
- Goblet cell hyperplasia
- Inflammation and fibrosis is a minor component
What are the morphological changes in chronic bronchitis in the small airways (bronchioles)? (2)
- Goblet cells appear (where they should not be)
- Inflammation and fibrosis in long standing disease