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Disease Processes > Respiratory Pathology > Flashcards

Respiratory Pathology Flashcards

1
Q

possible consequence of asthma

A

Dyspnea, coughing, wheezing, increased chance of developing other forms of COPD

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2
Q

Atopic asthma

A 
Most common
Early onset
Other allergies & genetic link
Often seasonal
Elevated serum eosinophils and IgE
Known as allergic or extrinsic asthma
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3
Q

Define Chronic Bronchitis

A

long-term inflammation of the bronchi. Persistent productive cough that lasts for at least 3 months in at least 2 years. Common in smokers

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4
Q

Define asthma

A

Hyper-reactive airways —> bronchospasm due to smooth muscle contraction

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5
Q

Causes of chronic bronchitis

A

Tobacco smoke

pollution

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6
Q

Consequences of chronic bronchitis

A
  • Loss of cilia
  • Goblet cell hyperplasia leads to increased mucus
  • Proliferation of smooth muscle
  • Thickening of bronchial walls
  • Chronically Inflamed airways
  • Airways become obstructed
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7
Q

Define emphysema

A

Irreversible

Progressive destruction of alveolar walls without obvious fibrosis (loss of alveoli - scarring pulls apart alveoli)

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8
Q

Define Bronchiectasis

A

Irreversible and progressive dilatation of bronchi & bronchioles

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9
Q

Causes of Bronchiectasis

A
  • People with Cystic Fibrosis
  • Smoking
  • obstruction
  • infection
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10
Q

Bronchiectasis consequences

A
  • Destruction of elastic and muscle
  • Chronic necrotising infection of the bronchi and bronchioles
  • Congenital/hereditary disease
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11
Q

Emphysema symptoms

A 
Occasional infections
Pink puffer- cannot get rid of CO2 
Weight loss
Late cough, little sputum 
Severe early dyspnea
Small heart
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12
Q

Emphysema consequences

A
  • Airspaces become abnormally enlarged – over-inflation
  • Inflammation and loss of elasticity
  • Most often effects the upper lobes
  • Lungs can expand, but deflate poorly
  • Right sided heart failure, Pneumothorax—> atelectasis
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13
Q

What is pneumoconiosis?

A

one of a group of interstitial lung disease caused by breathing in certain kinds of dust particles that damage your lungs.

Causes chronic inflammation.
Hence heals through organisation, function lost. Increased risk of mesothelioma

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14
Q

Process of asthma attack

A
  1. Allergen enters (usually a common/normal substance)
  2. Response started by processing antigen
  3. Sets up reaction to create overexaggerated response when the antigen enters in the future
  4. Causes constriction of the airways
  5. Goblet cells release mucus in the lumen, hence difficult to breathe
  6. long term structural changes - increase in goblet cells, thicker muscle layer
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15
Q

Factors dictating extent of pneumoconiosis

A

Amount inhaled

Shape/size of particles

Solubility of particles

Toxicity of particles

Additional irritants (smoking)

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16
Q

3 restrictive disorders

A
  1. Alveolitis pneumonitis
    1. Chest wall disorders
  2. Chronic Interstitial Lung disease –>Pneumoconiosis
17
Q

Which particles are commonly implicated in Australia for causing Pneumoconiosis

A

Coal  Anthracnosis, excessive amounts make it toxic.

Silica  Silicosis, abscess, filled with granulation tissue, exposed in mining and renovation

Asbestos  Asbestosis, toxic particle and soluble. Damages lung and pleura

18
Q

Bronchopneumonia.

A

Common
Often an extension of bronchitis
Opportunistic infections affecting the old, young, immuno-compromised
May become confluent and then hard to distinguish from lobar pneumonia

19
Q

What is pneumonia

A
  • “Any infection of the lung”
  • Also “non-infectious” lung diseases
  • Caused by bacterial, viral and fungal infections
  • Reduced host defenses
    Chronic diseases
    Immunologic deficiency
    Immunosuppressive therapy
20
Q

Pathogenesis of primary cancers in lung

A

Squamous cell carcinoma:
Original cell —> metaplasia (cilliated epithelium to stratified squamous) —> Dysplasia —> carcinoma in situ —> invasive carcinoma

Adenocarcinoma:
Original cell—> Hyperplasia of goblet cells —> Dysplasia —> carcinoma in situ—> invasive carcinoma

21
Q

Epithelium types in the respiratory system

A

Trachea: Pseudo-stratified ciliated columnar epithelium with goblet cells

Alveoli: simple squamous
Macrophages around the alveoli

Respiratory: Simple cuboidal ciliated, no mucous

22
Q

How are the lungs affected by left ventricular failure?

A

Backwards effect is pulmonary congestion.
Leads to pulmonary oedema and haemorrhaging
Causes symptoms in patient relating to the lungs

23
Q

Respiratory regions

A

-Respiratory bronchioles
- Alveolar ducts
- Alveolar sacs
- Alveoli
Very vulnerable to damage

24
Q

Compliance and 3 factors that affect it

A

Expandibility

  1. Loss of connective tissue (e.g. emphysema) —> Increases compliance
  2. Surfactant levels. Decreased surfactant —> alveolar collapse during expiration —> Decreases Compliance
  3. Musculoskeletal disorders affecting the joints/muscles of the thoracic cavity.
25
Q

What is COPD and 4 types of COPD

A

Impaired airflow due to complete or partial obstruction at any level of the bronchial tree :

Chronic Bronchitis
Emphysema
Bronchiectasis
Bronchial Asthma

26
Q

Atelectasis

A

a complete or partial collapse of the entire lung or area (lobe) of the lung. Caused by various respiratory pathology (COPD, fibrosis etc.)

27
Q

Causes of pneumonia

A

Impaired clearing mechanism
- Loss/suppression of cough reflex
Coma, neuromusc disorders, drugs

  • Injury to cilia
    Smoking, inhalation of hot/corrosive substances, viral
  • Interference with phagocytic/bactericidal action of alveolar macrophages
    Smoke, AIDs,
28
Q

Possible complications of pneumonia

A
  1. Necrosis  Abscess
    1. Fibrosis
    2. Suppurative fluid in the pleural cavity (empyema) or fibrinous exudate
  2. Haematological dissemination of bacteria (endocarditis, meningitis osteomyelitis or glomerulonephritis)
29
Q

Tuberculosis

A

Cell mediated immune disorders (type 4 hypersensitivity)
Immune system overreacts and kills nearby cells
Necrotic form of death
Two types: primary and secondary

30
Q

Most common lung cancers

A

Adenocarcinoma, squamous cell carcinoma

31
Q

Local effects of lung cancer

A 
Obstruction  pneumonia, atelctasis
Pleural effusions
Laryngeal nerve invasion  Hoarseness
Invasion of oesophagus  Dysphagia
Phrenic nerve invasion  Diaphragm paralysis
Chest wall invasion  pathologic fractures
Pericarditis
SVC syndrome & invasion of SNS ganglions
32
Q

Name and explain some Pleural disease

A
  1. Pleural effusions - increased HP, increased vascular permeability (loss of plasma proteins), reduced lymphatic drainage (cancer), increased intrapleural negative pressure (atelactasis)
  2. Pneumothorax - marked respiratory distress, collapse, traumatic (air/gas pleural cavities)
  3. Pleural Tumours - malignant mesothelioma—> increased by smoking, asbestos
33
Q

Pleurisy or pleuritis

A

Inflammation of the pleural lining or surface of the lung.

Pneumonia (pus/oedema in pleural lining/cavity).

34
Q

Complications of pleurisy

A

Acute inflammatory exudate, containing lots of fibrin can be replaced by an in-growth of granulation tissue in pleural lining and into alveolar spaces  Fibrosis:
Abscess formation
Haematological dissemination of bacteria

35
Q

Lobar pneumonia

A 
Rare
Pleural exudate common
Highly virulent infections that can infect even the most healthy of individuals.
> 90% strep pneumococcus
    Cough fever with purulent sputem
36
Q

Intrinsic asthma

A

Not associated with family history

Hyperirritability of bronchial tree

Non-immune, normal IgE levels

Common triggers: viruses, irritants, stress, exercise, cold air, aspirin

37
Q

How do lung disease contribute to right ventricular failure?

A

COPD (increased workload), restrictive disease - pneumoconiosis, acute pulmonary syndrome (scarring) and pulmonary hypertension leads to RSHF

Leads to venous congestion and oedema
Causing liver, kidney and spleen disease

Disease Processes (13 decks)

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