Respiratory Pathology - Non-Neoplastic.

Question 1

What does the upper airways consist of?

Answer 1

Nose, accessory air sinuses, nasopharynx, larynx.

Question 2

What does the lower airways consist of?

Answer 2

Trachea, bronchi, bronchioles, terminal bronchioles, alveoli.

Question 3

What is the job of the upper airway?

Answer 3

To warm, humidify, and filter air.

Question 4

What infections can occur in the respiratory tract?

Answer 4

Sinusitis, Flu, Pneumonia, Rhinitis, Laryngitis, Tonsilitis

Question 5

Define infections of the upper airway

Answer 5

Acute inflammatory process that affects mucous membranes of the respiratory tract.

Question 6

What are the symptoms of upper airway infections?

Answer 6

Malaise, headache, sore throat, discharge. Commonly viral.

Question 7

How do these infections occur?

Answer 7

Virus attaches itself firmly to respiratory mucosa, invades the tissue, causing necrosis, inflammation and swelling. Virus spreads along continuous mucosa invading ears, sinuses or bronchi and lungs.

Question 8

Define pneumonia.

Answer 8

Inflammation of the lung parenchyma.

Question 9

What are the causes of pneumonia?

Answer 9

Infectious agents, inhalation of chemicals, chest wall trauma.

Question 10

What are the symptoms of pneumonia?

Answer 10

Fever, rigours, SOB, Pleuritic chest pain, purulent sputum, cough.

Question 11

What is community acquired pneumonia?

Answer 11

Relatively common, especially in elderly. Caused by strep. pnuemoniae and haemophilus influenzae.

Question 12

What is hospital acquired pneumonia?

Answer 12

Any pneumonia contracted by patient at least 48-72 hours after admission. Usually bacterial - gram negative bacilli and staph aureus.

Question 13

What are the symptoms of hospital acquired pneumonia?

Answer 13

fever, increased WCC, cough with purulent sputum, chest x-ray changes.

Question 14

What is aspiration pneumonia?

Answer 14

Develops after inhalation of foreign material. Common in: Elderly, strokes, dementia and anaesthetic. Caused by oral flora +/- other bacteria.

Question 15

What are the 3 main obstructive disorders?

Answer 15

COPD - bronchitis/emphysema. Asthma. Bronchiectasis.

Question 16

Define obstructive disease.

Answer 16

Characterised by partial or complete obstruction at any level from the trachea to respiratory bronchioles.

Question 17

Define restrictive disease.

Answer 17

Characterised by reduced expansion with decreased total lung capacity.

Question 18

What is COPD - Emphysema?

Answer 18

Irreversible enlargement of the airspaces distal to the terminal bronchiole - destruction of their walls without obvious fibrosis.

Question 19

How is emphysema caused?

Answer 19

Mild chronic inflammation throughout the airways. Role of smoking and genetics. Imbalance of oxidants and antioxidants.

Question 20

What are the symptoms of emphysema?

Answer 20

dyspnoea, cough, wheezing, weight loss, expiratory airflow limitation, congestive heart failure, pneumothorax.

Question 21

What is COPD - chronic bronchitis?

Answer 21

Persistent cough with sputum production - for at least 3 months in at least 2 consecutive years.

Question 22

What are the causes of chronic bronchitis?

Answer 22

Long-standing irritation by inhaled substances (smoking, dust from grain, cotton, silica). Hypertrophy of submucosal glands in trachea and bronchi. Mucus hyper secretion and alterations in the small airways - chronic airway obstruction.

Question 23

How does chronic bronchitis impact the respiratory structures?

Answer 23

Mucous membrane swelling and oedema, excessive mucous excretions, narrowing of the bronchioles.

Question 24

What are the symptoms of chronic bronchitis?

Answer 24

Persistent cough with sputum, dyspnoea or exertion, hypoxemia, mild cyanosis, cardiac failure.

Question 25

What is asthma?

Answer 25

Chronic inflammatory disorder of the airways.

Question 26

What are the symptoms of asthma?

Answer 26

Recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and/or early in the morning.

Question 27

What are the 3 stages of asthma production?

Answer 27

1. genetic predisposition and exposure to environmental triggers.
2. early phase reaction: bronchoconstriction, increased mucus production, vasodilation.
3. late phase reaction: inflammation, epithelial damage, more bronchoconstriction.

Question 28

What is bronchiectasis?

Answer 28

Permanent destruction and dilatation of the airways associated with severe infections or obstructions e.g TB

Question 29

What are the symptoms of bronchiectasis?

Answer 29

persistent cough, purulent sputum ++, haemoptysis (coughing up blood)

Question 30

What are restrictive disorders?

Answer 30

inflammation and fibrosis of the pulmonary connective tissue.

Question 31

What are the symptoms of restrictive lung disease?

Answer 31

Dyspnoea, tachypnoea, eventual cyanosis, secondary pulmonary hypertension, right-sided heart failure

Question 32

What are the 2 types of vascular disorders?

Answer 32

Pulmonary oedema, pulmonary embolism.

Question 33

What is a pulmonary embolism?

Answer 33

Blockage of a main or branch pulmonary artery by an embolus. Usual source of emboli are DVT of the legs.

Question 34

What are the symptoms of a pulmonary embolism?

Answer 34

abrupt onset of pleuritic chest pain, SOB, hypoxia, increased pulmonary vascular resistance.

Question 35

What is pulmonary oedema?

Answer 35

Accumulation of fluid in the air spaces and parenchyma of the lungs.

Question 36

How is pulmonary oedema caused?

Answer 36

Increased venous pressure e.g liver failure. Alveolar injury from infections, shock or trauma.

Question 37

What are the symptoms of pulmonary oedema?

Answer 37

SOB, pink frothy sputum, CXR findings.

Question 38

What are expansion disorders?

Answer 38

Pneumothorax - air in the pleural cavity.

Atelectasis - incomplete expansion of the lungs.