Respiratory7

Question 1

Types of Obstructive Lung Disease.

Answer 1

Chronic Bronchitis
Emphysema
Asthma
Bronchiectasis

Question 2

Pathophysiology of Obstructive Lung Disease.

Answer 2

Obstruction of air flow -> Air trapped in lungs
Airways close prematurely at High lung vol.

INcreased Residual Volume (RV)
DEcreased Forced Vital Capacity (FVC)

Question 3

Pulmonary Function Tests (PFTs) in Obstructive Lung Disease.

Answer 3

DECREASED FEV1
DEcreased FVC -> DEcreased FEV1/FVC ratio
*Hallmark
V/Q mismatch

Question 4

Pathology of Chronic Bronchitis.

Answer 4

Hypertrophy of mucus-secreting glands in bronchi –> Reid Index > 50%

Question 5

What is the Reid Index?

Answer 5

(thickness of gland layer) / (total thinkness of bronchial wall)

Question 6

Is chronic bronchitis a disease of small or large airways?

Answer 6

Small

Question 7

Chronic Bronchitis Findings.

Answer 7

• Productive cough for >3 months per year (+/- consecutive) for > 2 years
• Wheezing, crackles, cyanosis, late-onset dyspnea

Blue-Bloater

Question 8

Pathology of Emphysema.

Answer 8

Destruction of Alveolar walls:
- Enlargement of air spaces
- DEcreased recoil
INcreased Compliance

Question 9

Two types of Emphysema.

Answer 9

Centriacinar - Smoking

Panacinar - a1-antitrypsin deficiency

Question 10

Why is there an Increase in lung Compliance in Emphysema?

Answer 10

Increased Elastase activity

- Increased Compliance d/t los of elastic fibers

Question 11

Pathology of Asthma.

Answer 11

Bronchial hyperresponsiveness causes Reversible bronchocontsriction

Question 12

Histological findings in Asthma. (3)

Answer 12

Smooth Muscle Hypertrophy
Curschmann's Spirals
   - shed epithelial forms mucus plugs
Charcot-Leydon crystals
   - from breakdown of eosinophils in sputum

Question 13

What test do you perform to diagnose Asthma?

Answer 13

Methacholine challenge

Question 14

Pathology of Bronchiectasis.

Answer 14

Chronic necrotizing infection of bronchi -->
  Permanently dilated airways
     - Purulent sputum
     - Recurrent Infections
     - Hemoptysis

Question 15

What all is bronchiectasis associated with? (5)

Answer 15

Bronchial obstruction
Poor Ciliary motility (smoking)
Kartagener's syndrome
Cystic Fibrosis
Allergic bronchopulmonary aspergillosis

Question 16

Pathophysiology of Restrictive Lung Disease.

Answer 16

Restricted lung expansion causes:

• DEcreased lung volumes
  
  • DEcreased FVC & TLC

Question 17

Pulmonary Function Test (PFT) findings in Restrictive Lung Disease.

Answer 17

FEV1/FVC ratio > 80%

Question 18

2 types of Restrictive lung disease.

Answer 18

• Poor Breathing Mechanics
  
  • Extrapulmonary
  • Peripheral hypoventilation
  • Normal A-a gradient
• Interstitial Lung Diseases
  
  • Pulmonary
  • Lowered diffusing capacity
  • INcreased A-a gradient

Question 19

What causes restrictive lung disease d/t poor muscular effort?

Answer 19

Polio

Myasthenia gravis

Question 20

What causes restrictive lung disease d/t poor structural apparatus?

Answer 20

Scoliosis

Morbid obesity