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Block 4 > SFP: obstructive lung disease > Flashcards

SFP: obstructive lung disease Flashcards

1
Q

Describe FVC, FEV1, and FEV1/FVC ratio in obstructive lung diseases

A

FVC is usually normal, FEV1 is decreased, and the ratio is decreased.

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2
Q

In obstructive lung diseases, people have issues with breathing air ___

A

Out

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3
Q

What is atelectasis?

A

Collapse or loss of lung volume due to inadequate airspace expansion aka collapsed lung.

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4
Q

What is resorption atelectasis?

A

Those in which obstruction prevents distal aeration (mucus plugs).

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5
Q

What is compression atelectasis?

A

Caused by air or pleural effusions, often in CHF.

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6
Q

What is contraction atelectasis?

A

They’re adjacent to local or generalized lung scarring; this one is not reversible.

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7
Q

What is asthma?

A

Acute episodes of bronchospasm; it is episodic.

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8
Q

What is the clinical presentation of asthma?

A

Episodic dyspnea, cough, wheezing, expiratory whistle.

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9
Q

Describe intrinsic asthma.

A

Typically develops later in life and is characterized by hyperresponsive airways that respond abnormally to non-immune things like exercise, air pollution, infection, and virus.

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10
Q

Describe extrinsic asthma.

A

Involves type 1 hypersensitivity to exogenous allergen. It is IgE mediated. Eosinophils and mast cells are the key players!!

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11
Q

What is gross morphology of asthma?

A

Hyperinflation, bronchial mucus plugs, bullae in severe cases.

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12
Q

What do we see in microscopic morphology of asthma?

A
  1. Inflammation: Edema, EOSINOPHILS, other white cells
  2. Hyperplasia of mucus glands and goblet cells
  3. Hypertrophy of smooth muscle in airways
  4. Thickened basement membrane
  5. Elevated IgE in extrinsic.
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13
Q

When are curshmann spirals and Charcot Leyden crystals seen?

A

Sometimes seen in asthma.

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14
Q

What is status asthmaticus?

A

Acute asthma attack that won’t quit; hypercapnia (high CO2 in the blood), acidosis, and hypoxia may occur. This can be fatal.

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15
Q

What is emphysema?

A

Enlargement of airspaces distal to terminal bronchiole with destruction of the walls.

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16
Q

What is a major cause of centriacinar emphysema?

A

Smoking.

17
Q

What is centriacinar emphysema?

A

Widened airspace in centrilobular region.

18
Q

What is panacinar emphysema?

A

Involves the entire acinus.

19
Q

What genetic deficiency leads to panacinar emphysema?

A

a1AT deficiency.

20
Q

What is the inheritance pattern of a1AT deficiency?

A

Autosomal codominant.

21
Q

What is the function of a1AT?

A

It is an enzyme made in the liver that protects tissues from enzymes of inflammatory cells, particularly neutrophil elastase.

22
Q

Which is more destructive: panacinar or centriacinar emphysema?

A

Panacinar.

23
Q

A patient has emphysema, obstructive breathing pattern, and liver dysfunction. What do they likely have?

A

a1AT deficiency.

24
Q

What are bullae?

A

Balloon-like structures bulging out of lungs. Often seen in emphysema or asthma.

25
Q

What is the presentation of chronic bronchitis?

A

Productive cough and airway inflammation.

26
Q

Chronic bronchitis often co-exists with…

A

Emphysema.

27
Q

What is required for diagnosis of chronic bronchitis?

A

Cough with phlegm for 2 years in a row with 3 months in a row each year.

28
Q

What happens to FEV1 in chronic bronchitis?

A

It is often reduced.

29
Q

What is the pathology of chronic bronchitis?

A

Hyperplasia of mucus secreting glands and increased mucin gene and neutrophil elastase.

30
Q

What is bronchiectasis?

A

Permanent distortion/dilation of airways.

31
Q

What causes bronchiectasis?

A

Chronic obstruction of bronchi and/or chronic persistent infection.

32
Q

What are some congenital causes of bronchiectasis?

A

CF, Ig deficiencies, ciliary immotility syndromes.

33
Q

What would be microscopic presentation of bronchiectasis?

A

Peribronchiolar fibrosis and destroyed walls, as well as mixed flora in sputum. Will probably include pseudomonas if it is a CF patient.

34
Q

What are clinical presentations of bronchiectasis?

A

Clubbing, hypoxemia, pulmonary HTN.

35
Q

What is bronchiolitis?

A

Airway disease occurring in the bronchioles.

36
Q

What is the microscopic morphology of bronchiolitis?

A

Edema, fibrosis around and inside the airway, mucus metaplasia (goblet cells appear).

37
Q

Bronchiolitis is usually caused by…

A

Viral infection.

Block 4 (28 decks)

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