Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > Pathology of pulmonary airways disease > Flashcards

Pathology of pulmonary airways disease Flashcards

1
Q

What are the host defences?

A
  • Cough reflex
  • Cilia
  • Mucus
  • Antibody deficiency (IgA)
  • Immunosuppression- disease, drugs
  • Macrophage dysfunction
  • Pulmonary oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the organisation of the respiratory tree

A

-Trachea
-Bronchus (cartilage)
-Terminal bronchiole
=Respiratory bronchiole
=Alveolar duct
=Alveolar sac
=Alveolus
All = is acinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe Acute Bronchitis

A
  • Inflammation of bronchi
  • Often viral
  • May be bacterial (H. influenzae)
  • May also involve larynx and trachea= laryngotracheobronchitis
  • Acute exacerbations of ‘chronic bronchitis’ are common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe Bronchiolitis

A
  • Inflammation of bronchioles
  • A feature of chronic bronchitis
  • Primary bronchiolitis= usually in children/ respiratory syncytial virus (RSV)/ tachypnoea and dyspnoea
  • Rare types= follicular bronchiolitis, bronchiolitis obliterans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe Localised Airway Obstruction

A
  • Airway obstruction= lesion outside the wall (large lymph node), lesion in the wall (tumour), lesion in the lumen (foreign body)
  • Causes distal collapse or over-inflation
  • May be distal lipid or infective pneumonia
  • Normal pulmonary function tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe Diffuse Obstructive Airways Disease

A

-Reversible and intermittent OR Irreversible and persistent
-Centred on bronchi and bronchioles
-Diffuse disease as many airways involved
Pulmonary function tests ‘obstructive’= reduced vital capacity (VC), Reduced FEV1/FVC ratio, Reduced peak expiratory flow rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What clinico-pathological entities does Diffuse Obstructive Airways Disease encompass?

A
  • Chronic bronchitis
  • Emphysema
  • Asthma
  • Bronchiectasis
  • COPD (spectrum of co-existence of chronic bronchitis and emphysema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the clinical definition of Chronic Bronchitis?

A
  • Cough and sputum for 3 months in 2 consecutive years
  • Aetiology- pollution, smoking
  • Middle-aged heavy smokers, recurrent low-grade bronchial infections (exacerbations), H. influenzae, S. pneumoniae, viruses, airway obstruction may be partially reversible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the progression of chronic bronchitis

A
  • Hypercapnia
  • Hypoxia
  • Pulmonary hypertension
  • ‘Cor pulmonale’- right ventricular failure
  • Blue bloater
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the pathology of chronic bronchitis

A
  • Respiratory bronchiolitis (<2mm diameter)
  • Can lead to centrilobular emphysema
  • Mucus hypersecretion (mucous gland hypertrophy)
  • Chronic bronchial inflammation (squamous metaplasia, increased risk of malignancy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the anatomical definition of emphysema?

A
  • Irreversible dilation of alveolar spaces with destruction of walls
  • Associated with loss of surface area for gas exchange
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the classifications of emphysema?

A
  • Centrilobular
  • Panlobular
  • Paraseptal
  • Irregular
  • Others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe Centrilobular emphysema

A
  • Strongly associated with smoking
  • Seen in some with pneumoconiosis, particularly coal-workers
  • Most commonly in upper lobes
  • Respiratory bronchiolitis often present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe Panlobular emphysema

A
  • Usually lower lobes
  • Lungs overdistended
  • Associated with alpha-1-antitrypsin deficiency
  • Markedly accelerated in smokers with this disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe Paraseptal emphysema

A
  • Distension adjacent to pleural surfaces

- May be associated with scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe Irregular emphysema

A

Associated with scarring

-Overlap with Paraseptal emphysema

17
Q

Describe other emphysema classifications

A
  • Bullous: distended greater than 10mm

- Interstitial

18
Q

What are the clinical features of emphysema?

A
  • Hyperventilation
  • Normal pO2, pCO2
  • ‘Pink puffer’
  • Weight loss
  • Right ventricular failure
  • Often co-existing chronic bronchitis, in which case clinical features are mixed
19
Q

What is asthma?

A
  • Reversible wheezy dyspnoea’

- Increased irritability of the bronchial tree with paroxysmal airway narrowing

20
Q

What are the 5 aetiological categories?

A
  • Atopic
  • Non-atopic
  • Aspirin-induced
  • Occupational
  • Allergic bronchopulmonary aspergillosis (ABPA)
21
Q

How can asthma lead to sudden death?

A

Mucus plugging

22
Q

Describe Atopic asthma

A
  • Associated with allergy
  • Triggered by a variety of factors (dust, pollen, house dust mites)
  • Often associated with eczema and hay fever
  • Bronchoconstriction mediated by a type 1 hypersensitivity reaction
23
Q

What does the hypersensitivity reaction lead to in atopic asthma?

A
  • Bronchial obstruction with distal over inflation or collapse
  • Mucus plugging of bronchi
  • Bronchial inflammation
  • Mucous gland hypertrophy
  • Bronchial wall smooth muscle hypertrophy
  • Thickening of bronchial basement membranes
24
Q

Describe Non-atopic asthma

A
  • Associated with recurrent infections
  • Not immunologically mediated
  • Skin testing negative
25
Q

Describe aspirin-induced asthma

A
  • Associated with recurrent rhinitis, nasal polyps and urticaria
  • Mechanism of asthma unclear (prostaglandins/ leukotrienes)
26
Q

Describe occupational asthma

A
  • Hypersensitivity to an inhaled antigen
  • May be non-specific in those with hyper-reactive airways
  • May be a specific allergic response
27
Q

Describe Allergic Bronchopulmonary Aspergillosis

A
  • Specific allergic response to the stories of Aspergillus fumigatus
  • Mixed type 1 and type 3 hypersensitivity reaction
  • Mucous plugs common
  • Associated with bronchiectasis
  • Not to be confused with an aspergilloma, which a=is a fungal ball, usually colonising a pre-existing cavity in the lung (often tuberculous)
28
Q

What is Bronchiectasis?

A
  • Permanent dilation of bronchi and bronchioles
  • Due to a combination of obstruction and inflammation (usually infection)
  • May be localised or diffuse, depending on cause
  • Historically seen in patients with pulmonary tuberculosis involving hilar lymph nodes
  • Classically associated with childhood infections, particularly measles and whooping cough
  • Diffuse bronchiectasis seen in patients with cystic fibrosis
29
Q

What does Bronchiectasis cause?

A

Bronchial dilation
Acute and chronic inflammation
Fibrosis

30
Q

What are the clinical features of bronchiectasis?

A
  • Chronic cough productive of copious sputum

- Finger clubbing

31
Q

What are the complications of bronchiectasis?

A
  • Spread of infection (pneumonia, empyema, septicaemia, meningitis, metastatic abscesses e.g. brain)
  • Amyloidosis
  • Respiratory failure

Respiratory (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions