Obstructive Lung Diseases

Question 1

Definition: Persistent COUGH with SPUTUM production for at least 3 MONTHS in at least 2 CONSECUTIVE YEARS i the ABSENCE of any other cause

Answer 1

CHRONIC BRONCHITIS

Question 2

Risk factors include SMOKING and Particles from DUST, GRAIN, AND SILICA

Answer 2

CHRONIC BRONCHITIS

Question 3

Gross:
~ Hyperemia, swelling, and edema of the mucous membranes
~ EXCESSIVE mucinous or MUCOPURULENT Secretions

Answer 3

CHRONIC BRONCHITIS

Question 4

Histology:
~ Bronchiolar wall thickening (FIBROSIS)
~ GOBLET CELL HYPERPLASIA
~ ENLARGEMENT OF MUCUS-SECRETING GLANDS of the trachea and bronchi
~ (+) BRONCHIOLITIS OBLITERANS
~ SQUAMOUS METAPLASIA AND DYSPLASIA

Answer 4

CHRONIC BRONCHITIS

Question 5

Definition: Irreversible ENLARGEMENT of the AIRSPACES distal to the terminal bronchiole

Answer 5

EMPHYSEMA

Question 6

Risk factors include SMOKING and ALPHA-1 ANTITRYPSIN DEFICIENCY

Answer 6

EMPHYSEMA

Question 7

GROSS
~ VOLUMINOUS lungs
~ LARGE Alveoli on cut sections
~ Apical blebs and bullae

Answer 7

EMPHYSEMA

Question 8

Histology
~ Abnormally LARGE Alveoli separated by thin septa with FOCAL centriacinar fibrosis

Answer 8

EMPHYSEMA

Question 9

It is the RATIO of the THICKNESS of the mucus gland layer to the wall thickness

Answer 9

Reid index

Normal = 0.4

Question 10

Associated with INCREASED Reid index

Answer 10

CHRONIC BRONCHITIS

Question 11

Associated with BLUE BLOATERS

Answer 11

CHRONIC BRONCHITIS

Question 12

Associated with PINK PUFFER and BARREL-CHEST

Answer 12

EMPHYSEMA

Question 13

Conditioned characterized by CHRONIC airway inflammation and variable expiratory outflow obstruction

Answer 13

BRONCHIAL ASTHMA

Question 14

Type of asthma that is IgE-mediated (TYPE 1 HYPERSENSITIVITY)

Answer 14

ATOPIC asthma

Question 15

Not immunologically mediated;
Noxious stimuli (pollutants, infections) —> AIRWAY hyperresponsiveness

Answer 15

BRONCHIAL ASTHMA

Question 16

Characteristic finding in STATUS ASTHMATICUS (acute severe asthma)

Answer 16

OCCLUSION of airways by thick mucus plugs

Question 17

CURSCHMANN SPIRALS which are spiral-shaped mucus plugs are seen in what condition

Answer 17

BRONCHIAL ASTHMA

Question 18

Derived from EOSINOPHIL-derived GALECTIN-10

Seen in Bronchial asthma

Answer 18

CHARCOT-LEYDEN CRYSTALS

Question 19

Condition in which there is PERMANENT DILATION of BRONCHI and BRONCHIOLES due to destruction of smooth muscle and elastic tissue by inflammation associated with PERSISTENT SEVERE INFECTIONS

Answer 19

BRONCHIECTASIS

Question 20

What are the associated conditions in BRONCHIECTASIS

Answer 20

~ CONGENITAL/HEREDITARY conditions that predispose to CHRONIC infections (Cystic fibrosis, Primary ciliary dyskinesia, KARTAGENER syndrome)
~ Infections
~ Bronchial obstruction
~ AUTOIMMUNE d/o (SLE, RA, IBD)

Question 21

KARTAGENER syndrome is characterized by

Answer 21

~ Bronchiectasis
~ Infertility (Male) (secondary to sperm dysmotility)
~ Sinusitis
~ SITUS INVERSUS (d/t ciliary dysfunction)

Recurrent infections d/t impaired mucociliary clearance

***SIS B

Question 22

WHAT CONDITION

Gross: (+) Mucopurulent secretions
Microscopic:
*ACUTE:
— Inflammatory EXUDATION
— DESQUAMATION of the lining
— NECROSIS

*CHRONIC:
~ FIBROSIS —> OBLITERATION of lumen of airways

Microbio:
~ H. Influenzae
~ P. Aeruginosa

(+) FOUL-SMELLING SPUTUM (d/t necrosis and bacterial growth)
(+) HEMOPTYSIS (d/t destruction of vessels in bronchial walls)

Answer 22

BRONCHIECTASIS