Respiritory: Pulmonary Airways Disease Flashcards
What is brochitis?
- Inflammation of the the bronchi
- Often viral can be bacterial
- H influenzae
What is bronchitis called if it involves the larynx and trachea?
Laryngotracheobronchitis
What is Bronchiolitis?
- Inflammation of the bronchioles
- Usually in children
- Tachypnoea and dyspnoea
Rare types of bronchiolitis?
Rare types
Follicular bronchiolitis
Bronchiolitis obliterans
3 types of localised airway obstruction?
Lesion outside the wall e.g. large lymph node
Lesion in the wall e.g. tumour
Lesion in the lumen e.g. foreign body
Which lung is more likely to get infected?
Right lung as the bronchus is more verticle so infections/irritants can get in easier
What is lipid pneumonia?
This is where lipid build up in the lungs, can be inhalation of lipids
When does obstructive airways diseases become diffusive?
When it affects many airways
Types of diffuse obstructive airways disease?
Chronic bronchitis
Emphysema
Asthma
(Bronchiectasis)
Chronic obstructive pulmonary disease (COPD):
Spectrum of co-existence of chronic bronchitis and emphysema
What is the clinical defination of chronic bronchitis?
Cough and sputum for 3 months in 2 consecutive years
What other conditions can chronic bronchitis lead to?
Respiratory bronchiolitis (< 2mm diameter)
Can lead to centrilobular emphysema
Mucus hypersecretion:
* Mucous gland hypertrophy
Chronic bronchial inflammation:
* Squamous metaplasia, increased risk of malignancy
Definition of emphysema?
Irreversible dilatation of acinar spaces with destruction of walls
Classifications of emphysema
- Centilobula
- Panlobula
- Paraceptal
- Irregular
RB: respiratory bronchioles
A: Acinar
Feautures of centrilobular
Strongly associated with smoking
Seen in some with pneumoconiosis, particularly coal-workers
Most commonly in upper lobes
Respiratory bronchiolitis often present
RB: respiratory bronchioles
A: Acinar
Features of panlobular
Usually lower lobes
Lungs overdistended
Associated with alpha-1-antitrypsin deficiency
Markedly accelerated in smokers with this disorder
RB: respiratory bronchioles
A: Acinar
Features of paraseptal
Paraseptal
Distension adjacent to pleural surfaces
May be associated with scarring aka fibrosis
RB: respiratory bronchioles
A: Acinar
Features of irregular
Associated with scarring
Overlap with paraseptal emphysema
RB: respiratory bronchioles
A: Acinar
Features of emphysema alone
Hyperventilation
Normal pO2, pCO2
‘Pink puffer’
Weight loss
Right ventricular failure
Definition of COPD
- A combination of the features of chronic bronchitis and emphysema
- Typically assessed using pulmonary function tests e.g. FEV1/FVC < 0.7
FEV1 – forced expiratory volume in 1 second
FVC – forced vital capacity
Why with emphysema do poeple appear pink and with chronic bronchitis blue?
Bronchitis - airway obstruction due to inflamation, leads to wheezing and cyanation due to lack of oxygen
Emphysema - airway collapse, leads to short fast breaths with pused lips in order to maintain pressure and keep airways open. Pressure leads to pink appearence
5 types of asthma
Atopic asthma
- Associated with allergy
- Triggered by a variety of factors
Dust, pollen, house dust mite etc - Often associated with eczema and hay fever
- Bronchoconstriction mediated by a type I hypersensitivity reaction
What leads ot obstruction with asthma?
- Bronchial obstruction with distal overinflation or collapse
- Mucus plugging of bronchi
- Bronchial inflammation
- Mucous gland hypertrophy
- Bronchial wall smooth muscle hypertrophy
- Thickening of bronchial basement membranes
Non-Atopic Asthma
- Associated with recurrent infections
- Not immunologically mediated
- Skin testing negative
Aspirin induced asthma
- Associated with recurrent rhinitis, nasal polyps and urticaria
- Mechanism of asthma unclear
Occupational Asthma
- Hypersensitivity to an inhaled antigen
- May be non-specific in those with hyper-reactive airways
- May be a specific allergic response
Allergic Bronchopulmonary Aspergillosis
- Specific allergic response to the spores of Aspergillus fumigatus
- Mixed type I and type III hypersensitivity reaction
- Mucus plugs common
- Associated with bronchiectasis
Four factors the contribute to airway obstruction in asthma and the asscociated therepies
What is Bronchiectasis?
- Permanent dilatation of bronchi and bronchioles
- Due to a combination of obstruction and inflammation (usually infection)
- May be localised or diffuse, depending on cause
- Historically seen in patients with pulmonary tuberculosis involving hilar lymph nodes
- Classically associated with childhood infections, particularly measles and whooping cough
- Diffuse bronchiectasis seen in patients with cystic fibrosis
Dialation means that cilia don’t work properly and mucous can’t move up and out of the airways
What does parenchymal lung disease mean?
Parenchyma is any part of the lung involved in gas transfer
What is ARDS?
Kind of like pulmonary odema.
But is caused from extreme damage to the alveola allowing the fluid to leak in.
What is a granuloma and how does it relate to TB?
It is a collection of macrophages unable to kill off what they have injested so they stay there in an attempt to contain it.
This happens in TB
Are fibrosing diseases of the lung (aka. silicosis) restrctive or obstructive?
Restrictive
