Respiratory 3

Question 1

What is FEV1 and when is it reduced

Answer 1

Volume of air expired in the 1st second during maximal expiratory effort

FEV1 is reduced in both obstructive and restrictive lung disease because of increased airway resistance and low vital capacity

Question 2

What is obstructive lung disease and examples

Answer 2

Patho condition that impaired the ability of air to leave alveoli during the expiration trapping it within

-Emphysema, Asthma, bronchietacis

Question 3

What happens to FEV1/FVC, Residual volume, functional residual capacity, total lung capacity in obstructive lung disease

Answer 3

FEV1/FVC decreased
residual volume- increased
functional residual capacity- increased
total lung capacity- may remain normal

Question 4

What is emphysema

Answer 4

characterized by a loss of lung parenchyma by destruction of alveoli so that there is permanent dilation of airspaces

Question 5

What are the types of emphysema (3)

Answer 5

1. Centriacinar emphysema- proximal airways
2. Panacinar- destruction involving the entire respiratory unit alveoli and alveolar ducts + lower lobes
3. Paraseptal- Upper lobe loc

Question 6

pathogenesis of emphysema

Answer 6

• loss of pulmonary parenchyma causes a loss of elastic recoil
• breathing out causes airway collapse and air is traped

Question 7

What is the criteria for chronic bronchitis + pathogenesis

Answer 7

Productive cough for 3 m in 2 connective years

cig smoking- airway irritation, increased mucus production hyperplasia or mucus producing glands

Question 8

What is allergic asthma

Answer 8

Type 1 hypersensitivity-> IgE mediated mast cell degranulation

Question 9

what is a non allergic asthma

Answer 9

adult asthma
non type 1 hypersensitivity
IgE normal

Question 10

What is bronchiectasis and pathogenesis

Answer 10

-prolonged bronchitis will cause abnormal permanent dilation of airways

Patho- inf and obstruction (results in destruction of the smooth mm and elastic fibres)

Question 11

What are the extra pulmonary restrictive lung diseases

Answer 11

Obesity

kyphoscoliosis

Question 12

What are the intrapulmonary restrictive lung diseases

Answer 12

Acute- ARDS

Question 13

how can a intraabdominal/ventral hernia cause restrictive lung disease

Answer 13

hernia needs to be pushed back in abdomen but this can cause a dangerous increase in intra diaphramic pressure and reduces the ability of diaphragm to expand chest and ability to breathe

Question 14

3 stages of ARDS

Answer 14

1. Exudative stage- pro and necrotic cells layer out on alveoli septa forming hyaline membranes
2. Proliferative stage- Response to a parenchyma damage
3. Fibrosis- Late stage

Question 15

chronic restrictive lung disease FEV1/FVC

Answer 15

normal

both FEV1 and FVC decrease equally

Question 16

pathogenesis of chronic restrictive lung disease

Answer 16

• begins with exposure to inciting agent (causes accumulation of that agent in airways)
• Chronic disease occurs after constant exposure to inciting agent

Question 17

What are diseases that cause chronic restrictive lung disease

Answer 17

Pneumocoonios (asbestosis, Silicosis, anthracosis)

Question 18

What is anthracosis

Answer 18

Inhalation of coal dust causes activation of carbon latent macrophages (fibrotic changes)

Question 19

What characterizes sarcoidosis

Answer 19

-multsystem disorder of unknown etiology characterized by accumulation of T lymphocytes, mononuclear phagocytes and noncaseating granulomas

Question 20

What is Mikulicz syndrome due to and what is it

Answer 20

Due to sarcoidosis

–lacrimal and parotid glans enlargement due to T1 lymphocytes infiltration

Question 21

When suspecting sarcoidosis what must you rule out

Answer 21

TB, Fungi

Question 22

What is hypersensitivity pneumonitis

Answer 22

Hypersensitivity to certain allergens (Type 3. 4)

occupational and recreational activities associated w exposure to allergens

Question 23

Morphological types of hypersensity pneumoinitis

Answer 23

simple- Infiltration of lung walls and alveoli septa w eosinophils (usually transient+ benign)

Tropical eosinophilia- inf w microflora

Chronic eosinophilic pneumonia- focal areas of consolidation, essiophilic infiltrates in insterstitium and parenchyma