Pulmonary Pathology 2 Flashcards
wWhat occurs in chronic bronchitis?
mucus hypersecretion, inflammation, and infection
how is chronic bronchitis defined from a clinical standpoint?
persistent cough with sputum production for 3 months out of 2 consecutive years
what is the pathophysiology of chronic bronchitis?
mucous gland hyperplasia–> damage to airway epithelium
what are 5 consequences of chronic bronchitis?
1) bronchiectasis 2) hypoxia 3) squamous metaplasia–> dysplasia–> carcinoma 4) pulmonary hypertension and cor pulmonale 5) death from respiratory infection
what is emphysema?
an irreversible airspace enlargement occurring distal to the terminal bronchiole
which type of emphysema is caused by smoking?
centrilobular
where does smoking-related emphysema dilation start?
respiratory bronchiole
what are some clinical presentations of emphysema?
enlarged lungs on CXR- barrel chest; diminished breath sounds with prolonged expiratory wheezes
why is there elevated hemoglobin in chronic bronchitis?
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
what type of emphysema does alpha-1 antitrypsin deficiency cause?
panacinar
what two patterns should you be aware of in cases of alpha-1 antitrypsin deficiency?
1) alveoli with panacinar destruction 2) lung with predominantly basilar panacinar emphysema
what is the primary means for diagnosing alpha-1 antitrypsin deficiency?
serum testing for alpha-1AT
what are the complications associated with emphysema? (4)
pneumothorax, respiratory failure, CAD, pulmonary HTN and cor pulmonale
what are the 3 components of asthma?
1) recurrent airway obstruction with a reversible component 2) airway hyper-responsiveness 3) airway inflammation
what cells are you likely to associate with atopic asthma?
eosinophils, mast cells, and lymphocytes
what cells are you likely to associate with non-atopic asthma?
t lymphocytes and neutrophils
why is long-term asthma control important?
asthma has some very deleterious long term effects such as airway remodeling
what occurs in airway remodeling due to long term asthma?
fibrosis, smooth muscle hyperplasia, increased goblet cells and submucosal glands
what is the crisis condition associated with severe asthma?
status asthmaticus
what is occurring in status asthmaticus?
unremitting, potentially fatal asthma attack–> bronchial occlusion by thick mucous
what are the histologic features associated with status asthmaticus?
coiled mucus plugs aka “Curschmann spirals” and charcot leyden crystals
how does aspirin-sensitive asthma occur?
when you block cyclooxygenase it will shunt arachidonic acid down the lipoxygenase pathway
what triad is associated with aspirin -sensitive asthma?
samter’s triad
what makes up samter’s triad?
nasal polyps, recurrent rhinitis, aspirin sensitive asthma
what is bronchiectasis?
dilated bronchus with a tiny air passageway bc of all the mucus; dilated bronchi extended to pleural surface
what are examples of diseases that are associated with bronchiectasis?
cystic fibrosis, primary ciliary dyskinesia, allergic bronchopulmonary aspergillosis
what is occurring in primary ciliary dyskinesia?
dysfunction of the dynein arm of microtubules
what syndrome is associated with primary ciliary dyskinesia?
kartagener’s syndrome
what triad makes up kartagener’s syndrome?
sinusitis, bronchoiectasis, and situs inversus
what is allergic bronchopulmonary aspergillosis?
exaggerated hypersensitivity response to aspergillus infection overlying chronic lung disease
