Pathology of Obstructive Lung Disease

Question 1

what does FEV1 stand for

Answer 1

forced expiratory volume of air exiting the lung in the first second of this exercise

Question 2

what does FVC mean

Answer 2

final total amount expired

Question 3

obstructive lung disease can be demonstrated by spirometry, what else can demonstrate it

Answer 3

PEFR peak expiratory flow rate

Question 4

in obstructive lung disease there is airflow limitation, true or false

Answer 4

true

Question 5

in obstructive lung disease peak expiratory flow rate is reduced, true or false

Answer 5

true

Question 6

in obstructive lung disease FEV1 is less than what percent of FVC

Answer 6

less than 70%

Question 7

What is bronchial asthma type 1 hypersensitivity

Answer 7

patient is sensitive to something that they breath in, this may go on to cause mast cell degranulation

Question 8

what are symptoms of bronchial asthma type 1 hyp.

Answer 8

bronchial smooth muscle constricts therefore airway narrows

inflammation

Question 9

what is chronic bronchitis defined as clinically

Answer 9

cough productive of sputum most days in at least 3 consecutive months for 2 or more consecutive years

Question 10

what are changes you may see to large airways in chronic bronchitis

Answer 10

mucous gland hyperplasia
goblet cell hyperplasia
inflammation and fibrosis(minor component)

Question 11

what are changes you may see to small airways in chronic bronchitis

Answer 11

goblet cells appear

inflammation and fibrosis ( in long standing disease)

Question 12

what are the two most common forms of emphysema

Answer 12

centriacinar

panacinar

Question 13

centriacinar emphysema is characterised by what

Answer 13

begins in the respiratory bronchioles and spreads peripherally, associated with long standing cigarette smoking, predominantly involves the upper half of the lungs

Question 14

what is a bulla in relation to emphysema

Answer 14

an emphysematous space greater than 1cm

Question 15

with emphysema comes hyperinflation of the lungs, in an x ray what key feature shows this

Answer 15

you can see too many ribs as the lungs are hyperinflated

Question 16

traditionally airway obstruction in patients with COPD is considered reversible or irreversible

Answer 16

irreversible

Question 17

In COPD small airways can be obstructed by what mechanisms

Answer 17

smooth muscle tone
inflammation
fibrosis
partial collapse of airway wall on expiration

Question 18

what is the normal kPa of PaO2

Answer 18

10.5-13.5 kPa

Question 19

what is the normal kPa of Paco2

Answer 19

4.8-6.0 kPa

Question 20

what are the 4 abnormal states associated with hypoxaemia

Answer 20

V/Q imbalance
diffusion impairment
alveolar hypoventilation
shunt

Question 21

what is the commonest cause of hypoxaemia encountered clinically

Answer 21

low V/Q

Question 22

define hypercapnia

Answer 22

abnormally elevated levels of CO2 in the blood

Question 23

what is chronic Cor pulmonale

Answer 23

hypertrophy (and failure) of the right ventricle resulting from disease affecting the function and/or the structure of the lung,

Question 24

define bronchitis

Answer 24

inflammation of the mucous membrane in the bronchial tubes. It typically causes bronchospasm and coughing.