Pathology: Pulmonary Diseases

Question 1

Physical defence mechanisms of the lungs

Answer 1

1. Filtering within the upper airways
2. Reflexes increase coughing
3. Muco-cillary escalator

Question 2

Cellular defence mechanisms of the lungs

Answer 2

1. Alveolar phagocytic inflammatory cells

2. Alveolar immunologic mechanisms including IgA

Question 3

Above 10 um

Answer 3

Filtered and cleared by upper airway defences

Question 4

5-10 um

Answer 4

Trapped and cleared by mucocillary escalator

Question 5

less than 2 um

Answer 5

Phagocytosed by macrophages in alveoli

Question 6

Gases

Answer 6

Water-soluble dissipate in upper air ways whereas insoluble gases perfuse the lungs and cause extensive damage

Question 7

Example of acute inflammation with healing: pneumonia

Answer 7

• Lungs are most common site of infection
• Pneumonia is the most common lung infection
• Bacterial infection causes inflammation
• Alveoli fill with inflammatory exudate
• Lung becomes solid (CONSOLIDATED)
• Inflammation can RESOLVE during healing or ORGANISE by scaring

Question 8

4 stages of disease and healing in pneumonia

Answer 8

Congestion
Red hepatisation where vessels are dilated
Gray hepatisation where contents of alveolae heal
Resolution

Question 9

Antibiotics role in pneumonia

Answer 9

Can slow or inhibit disease progression and promote resolution

Question 10

Obstructive diseases

Answer 10

A resistance to air flow either through reversible factors (e.g. bronchospasm) Total lung capacity is normal or increased

Question 11

Restrictive disorders

Answer 11

Reduced lung compliance leading to the loss of lung volume

Question 12

Major obstructive pulmonary disorders/diseases

Answer 12

Emphysema 
Chronic bronchitis 
Bronchiectasis 
Asthmatic bronchitis 
Cystic fibrosis

Question 13

Causes of COPD

Answer 13

Smoking, urban living, occupation, hospitalisation

Question 14

Signs of COPD

Answer 14

Barrel chest
Pursed-lip breathing
Productive cough
Cyanosis

Question 15

Chronic bronchitis

Answer 15

Persistent cough with sputum production for at least three months in two consecutive years

Question 16

Pathology of chronic bronchitis

Answer 16

In large airways; increased thickness of the mucous gland layer; increase in secretion from goblet cells; reduced number of ciliated cells

Question 17

Bronchiolitis

Answer 17

Inflammation of the bronchioles

Question 18

Emphysema

Answer 18

Abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of their walls

Question 19

Characteristics of emphysema

Answer 19

Breathlessness
Weight loss 
Heart failure 
Respiratory failure 
Coma 
Lung collapse