Week 2

Question 1

What are the main causes of bronchiectasis?

Answer 1

Non-Obstructive:

• CF
• Kartagener’s Syndrome (ciliary dysfunction)
• Immune Deficiencies (ex. panhypogammaglobulinemia)
• Necrotizing pneumonias (TB, Staph)
• Infections (pertussis, measles, adenovirus)

Obstructive

• foreign bodies
• neoplasm
• inspissated mucus
• congenital

Question 2

What is Loeffler’s Syndrome?

Answer 2

Pulmonary Eosinophilia

- usually spontaneously resolves within one month

Question 3

What is bronchoprovocation testing?

Answer 3

Introducing possible triggers (ex. exercise, food, antigens, medications) and monitoring airway responsiveness.

Question 4

How is exercise-induced asthma tested for?

Answer 4

Uses eucapnic voluntary hyperpnea (EVH):

• administration of dry gases
• simulates exercising in cold & dry air
• better than methacholine challenge or actual exercise

Question 5

What is panacinar emphysema?

Answer 5

Distension and destruction of the ascinus:

• incl respiratory bronchiole, alveolar duct, and alveoli
• cause more likely to be alpha-1 AT deficiency

Question 6

What is centrilobar emphysema?

Answer 6

Damages the parenchyma where the respiratory bronchiole leads to the alveolar duct.
- Peripheral alveolar ducts and alveoli remain intact.

Question 7

What parts of the lung has hyaline cartilage?

Answer 7

Trachea and bronchi. (Bronchiole does not!)

Question 8

Describe the histology of the epithelial layer of the respiratory tract.

Answer 8

Begins as psuedostratified ciliated columnar with goblet cells.
Respiratory bronchioles: columnar then cuboidal.
Alveoli: simple squamous.

Question 9

Where are Bowman’s glands found?

Answer 9

Olfactory epithelium

Question 10

What size are bronchioles?

Answer 10

1 mm or less

Question 11

Where is the highest concentration of sensory receptors for the cough reflex?

Answer 11

Trachea (posterior wall), pharynx/larynx, and carina.

None in the respiratory bronchioles and alveoli.

Question 12

For the cough reflex, what irritants to the sensory receptors respond to?

Answer 12

Chemical, physical, immunological irritants

Question 13

What are some complications of poorly managed emphysema?

Answer 13

Alveolar hypoxemia & low perfusion

• -> Loss in alveolar walls & associated capillaries
• -> Reflex pulmonary vascular constriction (to maintain V/Q near 1)
• -> Increases pulmonary HTN
• -> elevated Right Heart Pressure
• -> Cor Pulmonale