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Pulmonology > SM 167c Lung Pathology and Obstructive Lung Disease > Flashcards

SM 167c Lung Pathology and Obstructive Lung Disease Flashcards

1
Q

How do obstructive lung diseases effect the lungs?

A

Decreased airflow in large and small airways leading to increased lung volumes

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2
Q

What two diseases are classified as COPD?

A

Emphysema and Chronic Bronchitis

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3
Q

What diseases are classified as obstructive lung disease?

A

COPD, Asthma, Bronchiectasis

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4
Q

What factor tends to precipitate COPD?

A

Long term damage from smoking

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5
Q

Why are Emphysema and Chronic Bronchitis lumped together under COPD?

A

The two diseases have different processes but tend to occur together

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6
Q

What pathophysiology underlies Emphysema?

A

An imbalance between proteases and anti-proteases, leading to elevated protease activity

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7
Q

Where in the lungs does Emphysema have the greatest effect?

A

Emphysema results from the destruction of elastic tissue in the alveolar spaces, and has minimal involvement of the bronchi and bronchioles

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8
Q

What sets Emphysema apart from the other Obstructive Lung Diseases?

A

Emphysema has only minimal involvement of the Bronchi and Bronchioles

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9
Q

How does Emphysema lead to airway space collapse if it primarily effects the Alveoli?

A

Emphysema involves widespread loss of elastic tissue, leading to the loss of connective tissue throughout the lung, including Alveoli and the airspaces, which predisposes airway collapse

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10
Q

How does Emphysema appear on gross pathology?

A

More holes than normal, and more towards the periphery

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11
Q

Would pure Emphysema involve inflammation?

A

No, only protease mediated destruction

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12
Q

What are “floating septae”?

A

Alveolar walls that are not tethered to anything on Pathology, which act as a tell tale sign for Emphysema due to the destruction of elastic tissue

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13
Q

How does Emphysema appear on pathology?

A

Floating septae and large alveoli

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14
Q

What are the variants of Emphysema?

A

Centriacinar (Smoking), Distal Acinar (Scarring), and Paracinar (A1AT) Emphysema

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15
Q

What could cause Centriacinar Emphysema?

A

Smoking

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16
Q

What could cause Paracinar Emphysema?

A

A1AT deficiency

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17
Q

What could cause Distal Acinar Emphysema?

A

Scarring

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18
Q

How is Chronic Bronchitis diagnosed?

A

Based on clinical picture, and not pathology

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19
Q

What factor could cause Chronic Bronchitis?

A

Like Emphysema, the other form of COPD, Smoking can cause Chronic Bronchitis

20
Q

What is required for a clinical diagnosis of Chronic Bronchitis?

A

Productive cough for most days in 3 consecutive months for 2 consecutive years

21
Q

Where does Chronic Bronchitis affect the airways?

A

Chronic Bronchitis affects the larger airways

22
Q

How does Chronic Bronchitis differ from Emphysema in terms of the affected areas of the respiratory system?

A

Chronic Bronchitis affects the larger airways while Emphysema affects the Alveolar space

23
Q

How does Chronic Bronchitis alter the lungs?

A

Chronic airway inflammation and mucus gland hypertrophy

24
Q

What does Chronic Bronchitis predispose?

A

Superinfection

25
Q

What is the Reid Index and what does it measure?

A

The Reid index is a measure of the mucus gland size to distance from epithelium to cartilage, and is elevated in Chronic Bronchitis

26
Q

Which has more inflammation, Chronic Bronchitis or Emphysema?

A

Chronic Bronchitis

27
Q

Which results in mucus hypersecretion, Chronic Bronchitis or Emphysema?

A

Chronic Bronchitis

28
Q

What is Bronchiectasis?

A

Irreversible dilation of the airways that occurs in a vicious cycle

29
Q

What is the vicious cycle of Bronchiectasis?

A

Obstruction, infection, and bronchial wall destruction

30
Q

What can cause Bronchiectasis?

A

Cystic Fibrosis, repeated infections

31
Q

How does Bronchiectasis present?

A

Chronic productive cough with foul smelling sputum

32
Q

How does Bronchiectasis appear on pathology?

A

Dilated bronchi that are plugged with mucus made of inflammatory cells

33
Q

How do airways compare to vessels in the setting of Bronchiectasis?

A

Airways&raquo_space;> Vessels in Bronchiectasis

34
Q

What happens to airways during Bronchiectasis?

A

Airways lose smooth muscle and glands during Bronchiectasis due to repeated infections and inflammation

35
Q

What 3 traits define Asthma?

A

Reversible episodic obstruction, airway hyperreactivity, and chronic inflammation

36
Q

What underlies airway obstruction in Asthma?

A

Smooth muscle contraction, mucosal edema, and mucus secretion

37
Q

What causes chronic inflammation in Asthma?

A

Leukotrienes, Th2 Lymphocytes, and Eosinophils

38
Q

What are the two types of Asthma?

A

Atopic and Non-atopic

39
Q

What is Atopic Asthma?

A

Asthma due to Type I Hypersensitivity to an antigen

40
Q

What is non-Atopic Asthma?

A

Asthma due to cold weather or something else that isn’t an antigen

41
Q

What makes up the early phase of Asthma?

A

Airway obstruction, vascular permeability, and edema formation mediated by Leukotrienes and Histamine

42
Q

What makes up the late phase of Asthma?

A

Recruitment of inflammatory cells by Eosinophils

43
Q

What can be seen on pathology during an Acute Asthma attack?

A

Charcot-Leyden Crystals, Mucus Plugging, and Churchman’s Spirals

44
Q

What can be seen on pathology in the setting of Chronic Asthma?

A

Basement membrane thickening and smooth muscle hypertrophy

45
Q

How does Asthma causes airway remodeling?

A

Longstanding asthma results in smooth muscle hyperplasia, mucus gland hyperplasia, and epithelial damage that predisposes obstructive lung disease physiology

46
Q

Why does the basement membrane thicken in Chronic Asthma?

A

Chronic Asthma = chronic inflammation

47
Q

What are Charcot-Leyden Crystals?

A

Crystals composed of Eosinophils that form during Acute Asthma attacks

Pulmonology (22 decks)

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