Pulmonary Pathology 2

Question 1

wWhat occurs in chronic bronchitis?

Answer 1

mucus hypersecretion, inflammation, and infection

Question 2

how is chronic bronchitis defined from a clinical standpoint?

Answer 2

persistent cough with sputum production for 3 months out of 2 consecutive years

Question 3

what is the pathophysiology of chronic bronchitis?

Answer 3

mucous gland hyperplasia–> damage to airway epithelium

Question 4

what are 5 consequences of chronic bronchitis?

Answer 4

1) bronchiectasis 2) hypoxia 3) squamous metaplasia–> dysplasia–> carcinoma 4) pulmonary hypertension and cor pulmonale 5) death from respiratory infection

Question 5

what is emphysema?

Answer 5

an irreversible airspace enlargement occurring distal to the terminal bronchiole

Question 6

which type of emphysema is caused by smoking?

Answer 6

centrilobular

Question 7

where does smoking-related emphysema dilation start?

Answer 7

respiratory bronchiole

Question 8

what are some clinical presentations of emphysema?

Answer 8

enlarged lungs on CXR- barrel chest; diminished breath sounds with prolonged expiratory wheezes

Question 9

why is there elevated hemoglobin in chronic bronchitis?

Answer 9

when you smoke, you are exposed to CO, this created carboxy hemoglobin, which does not carry O2. so the oxygen dissociation curve shifts to the left. And we create more hemoglobin to compensate

Question 10

what type of emphysema does alpha-1 antitrypsin deficiency cause?

Answer 10

panacinar

Question 11

what two patterns should you be aware of in cases of alpha-1 antitrypsin deficiency?

Answer 11

1) alveoli with panacinar destruction 2) lung with predominantly basilar panacinar emphysema

Question 12

what is the primary means for diagnosing alpha-1 antitrypsin deficiency?

Answer 12

serum testing for alpha-1AT

Question 13

what are the complications associated with emphysema? (4)

Answer 13

pneumothorax, respiratory failure, CAD, pulmonary HTN and cor pulmonale

Question 14

what are the 3 components of asthma?

Answer 14

1) recurrent airway obstruction with a reversible component 2) airway hyper-responsiveness 3) airway inflammation

Question 15

what cells are you likely to associate with atopic asthma?

Answer 15

eosinophils, mast cells, and lymphocytes

Question 16

what cells are you likely to associate with non-atopic asthma?

Answer 16

t lymphocytes and neutrophils

Question 17

why is long-term asthma control important?

Answer 17

asthma has some very deleterious long term effects such as airway remodeling

Question 18

what occurs in airway remodeling due to long term asthma?

Answer 18

fibrosis, smooth muscle hyperplasia, increased goblet cells and submucosal glands

Question 19

what is the crisis condition associated with severe asthma?

Answer 19

status asthmaticus

Question 20

what is occurring in status asthmaticus?

Answer 20

unremitting, potentially fatal asthma attack–> bronchial occlusion by thick mucous

Question 21

what are the histologic features associated with status asthmaticus?

Answer 21

coiled mucus plugs aka “Curschmann spirals” and charcot leyden crystals

Question 22

how does aspirin-sensitive asthma occur?

Answer 22

when you block cyclooxygenase it will shunt arachidonic acid down the lipoxygenase pathway

Question 23

what triad is associated with aspirin -sensitive asthma?

Answer 23

samter’s triad

Question 24

what makes up samter’s triad?

Answer 24

nasal polyps, recurrent rhinitis, aspirin sensitive asthma

Question 25

what is bronchiectasis?

Answer 25

dilated bronchus with a tiny air passageway bc of all the mucus; dilated bronchi extended to pleural surface

Question 26

what are examples of diseases that are associated with bronchiectasis?

Answer 26

cystic fibrosis, primary ciliary dyskinesia, allergic bronchopulmonary aspergillosis

Question 27

what is occurring in primary ciliary dyskinesia?

Answer 27

dysfunction of the dynein arm of microtubules

Question 28

what syndrome is associated with primary ciliary dyskinesia?

Answer 28

kartagener’s syndrome

Question 29

what triad makes up kartagener’s syndrome?

Answer 29

sinusitis, bronchoiectasis, and situs inversus

Question 30

what is allergic bronchopulmonary aspergillosis?

Answer 30

exaggerated hypersensitivity response to aspergillus infection overlying chronic lung disease