T6 - L1 Benign Respiratory Pathology

Question 1

why are lung tubes lined with mucus?

Answer 1

collect and sweep out debris

Question 2

what is the definition of asthma?

Answer 2

“Widespread, reversible narrowing of the bronchial tree that changes in severity over short
periods of time, either spontaneously or under treatment”

Question 3

what is extrinsic asthma?

Answer 3

there’s an obvious trigger

Question 4

which type of asthma is often familial?

Answer 4

extrinsic asthma

Question 5

which type of eczema is associated with eczema and perennial rhinitis (hay fever) in later life?

Answer 5

extrinsic

Question 6

what are the two types of asthma?

Answer 6

extrinsic

intrinsic (non-atopic)

Question 7

what is intrinsic/non-atopic asthma?

Answer 7

no obvious common allergic trigger factor

Question 8

which type of asthma is more common in children?

Answer 8

extrinsic

Question 9

which type of asthma is more common in adults?

Answer 9

intrinsic

Question 10

which type of asthma is the most common?

Answer 10

extrinsic

Question 11

asthma is what type of hypersensitivity response?

Answer 11

type 1

 Key players:
• IgE 
• Mast cells 
• Eosinophils 
• Histamine, cytokines

Question 12

what are clinical features of asthma?

Answer 12

wheeze
SOB
cough
hyperinflation

Question 13

what is COPD?

Answer 13

chronic obstructive pulmonary disease

Question 14

COPD is a grouping of what combination of diseases?

Answer 14

• chronic bronchitis

- emphysema

Question 15

what is chronic bronchitis?

Answer 15

“Cough with sputum for three months in 2 consecutive years”

Question 16

what is emphysema?

Answer 16

“Abnormal enlargement of alveolar airspaces”

Question 17

what is the epidemiology of COPD?

Answer 17

• smokers

- middle-old age

Question 18

what is the pathogenesis of emphysema?

Answer 18

Increase elastase, decrease antielastase

→ alveolar wall loss

→ decrease gas exchange

Question 19

what is the pathogenesis of bronchitis?

Answer 19

Cell damage [of the lining] → inflammation → scar, mucus, infection

• Tubes/walls thickened or material in lumen narrowed/ blocked /damaged

Question 20

what is the pathogenesis of chronic bronchitis?

Answer 20

Mucus gland hyperplasia and hypersecretion, secondary infection by low virulence bacteria, chronic inflammation

• wall weakness and destruction

Question 21

what is Centrilobular (centiacinar) emphysema?

Answer 21

site: acinar (upper lobes of the lung)

due to coal dust, smoking

Question 22

what is Panlobular (panacinar) emphysema?

Answer 22

> 80% α1 antitrypsin deficient (rare, autosomal dominant) ,

severest in lower lobe bases

Question 23

what is Paraseptal (distal acinar) emphysema?

Answer 23

Upper lobe subpleural bullae adjacent to fibrosis.

Pneumothorax if rupture

Question 24

what are key clinical features of COPD?

Answer 24

• dyspnoea
• SOBOE
• cough
• sputum
• infection
• right heart signs/symptoms

Question 25

COPD is associated with which type of heart disease?

Answer 25

right sided heart disease

Question 26

what is Bronchiectasis ?

Answer 26

Permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue - not inflammatory process - not reversible - rare due to antibiotics - results from chronic necrotising infection

Question 27

what is the epidemiology of Bronchiectasis?

Answer 27

people predisposed to infection r.g. cystic fibrosis

Question 28

what are some complications of Bronchiectasis?

Answer 28

``` pneumonia, septicaemia, metastatic infection, amyloid [deposition] ```

Question 29

what is Interstitial Lung Disease (ILD)?

Answer 29

umbrella term for a large group of disorders that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs - restrictive rather than obstructive lung disease

Question 30

what are features of acute Interstitial Lung Disease (ILD)?

Answer 30

- diffuse alveolar damage - death of type I pneumocytes form hyaline membranes lining alveoli Histologically acute interstitial pneumonia

Question 31

what are features of chronic Interstitial Lung Disease (ILD)?

Answer 31

- dyspnoea increasing for moths to years - clubbing - fine crackles - dry cough - Interstitial fibrosis and chronic inflammatio - "honey comb lung"

Question 32

Idiopathic Pulmonary Fibrosis is also known as what?

Answer 32

cryptogenic fibrosing alveolitis

Question 33

"honeycomb" lung appearance is associated with what?

Answer 33

Chronic Interstitial Lung Diseases

Question 34

"cobblestone" lung appearance is associated with what?

Answer 34

Idiopathic Pulmonary Fibrosis - due to contraction of interstitial fibrous tissue accentuates lobular architecture

Question 35

what part of the lung lobes does Idiopathic Pulmonary Fibrosis commonly affect?

Answer 35

lower lobes affected first and most severely

Question 36

what lung disease commonly affects the Lower lung lobes?

Answer 36

Idiopathic Pulmonary Fibrosis

Question 37

what lung disease commonly affects the upper lung lobes?

Answer 37

Emphysema

Question 38

what is Sarcoidosis?

Answer 38

Sarcoidosis is a disease involving abnormal collections of inflammatory cells that form lumps known as granulomas. The disease usually begins in the lungs, skin, or lymph nodes. - hypercalcaemia and elevated serum ACE

Question 39

what is Pneumoconioses?

Answer 39

the non-neoplastic lung diseases due to inhalation of mineral dusts