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Pulmonary Week 2 > Pathology of Obstructive Lung Disease > Flashcards

Pathology of Obstructive Lung Disease Flashcards

1
Q

What are some OBSTRUCTIVE lung diseases?

A
  • emphysema
  • chronic bronchitis
  • asthma
  • bronchiesctasis

air is trapped in the lungs and cant get out

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2
Q

What is atelectasis?

A

collapse of previously inflated lung resulting in relatively airless pulmonary parenchyma

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3
Q

What are the types of atelectasis?

A
  • resorption (obstruction)
  • compression
  • contraction
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4
Q

Describe resorption atelectasis

A

airway obstruction due to mucus or tumor that causes respiration of trapped O2 in dependent alveoli and shifts the mediastinum toward the affected lung

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5
Q

Describe compression atelectasis

A

filling of pleural cavity by tumor, blood, or air that causes compression of pulmonary tissue causing the mediastinum to move AWAY from the affected lung

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6
Q

Describe contraction atelectasis

A

fibrotic lung or pleura preventing full expansion of the lung

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7
Q

Which type of atelectasis is not reversible?

A

contraction

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8
Q

What is emphysema?

A

permanent enlargement of airspaces caused by destruction of their walls

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9
Q

T or F. Fibrosis is a significant feature of emphysema

A

F.

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10
Q

What are the types of emphysema?

A
  • centroacinar
  • panacinar
  • paraseptal
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11
Q

Where is centracinar emphysema predominant?

A

upper lobes due to smoking (smokes rises)

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12
Q

Where is panacinar emphysema predominant?

A

lower lobes due to AIAT deficiency

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13
Q

What type of emphysema probably underlies spontaneous pneumothorax in young adults?

A

paraseptal

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14
Q

Where is A1AT made and what does it do?

A

liver and goes to the lung and neutralizes protease release by inflammatory cells

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15
Q

What else may accompany A1AT deficiency?

A

liver cirrhosis (the misfiled protein accumulated in ER of hepatocytes). PAS positive hyaline nodules

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16
Q

What is the normal allele for A1AT?

A

PiMM

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17
Q

What are the most common mutations of A1AT?

A

PiZ and PiS

18
Q

Describe the severity of disease in PiMZ patients

A

low levels of A1AT so normally okay unless they smoke

19
Q

PiZZ patients are at risk for what?

A

panacinar emphysema and liver cirrhosis

20
Q

Centriacinar emphysema affects what part of the lung?

A

respiratory bronchioles (distal is not affected)

21
Q

Panacinar emphysema affects what part of the lung?

A

from respiratory bronchioles distal

22
Q

Paraseptal emphysema affects what part of the lung?

A

alveoli

23
Q

What is the cause of paraseptal emphysema?

A

unknown

24
Q

How is chronic bronchitis defined?

A

persistent cough with sputum at least 3 months in at least 2 consecutive years

25
Q

Histologic manifestations of Chronic bronchitis?

A
  • submucosal gland hypertrophy of large airways (Reid Index)
  • increased goblet cells in small airways
  • peribronchial fibrosis
  • chronic inflammation
26
Q

What kinds of cells surround the bronchial epithelium in chronic bronchitis?

A

lymphocytes (lymphocyte rich infiltrates)

27
Q

What are the types of asthma?

A

1) Extrinsic- type I hypersensitivity

2) Intrinsic- non-immunologic reaction precipitates by infection, stress, exercise, etc.

28
Q

Gross features of asthma?

A
  • overinflation of lungs

- mucous plugs

29
Q

Microscopic features of asthma?

A
  • thickened BM
  • gland and smooth muscle hypertrophy
  • eosinophil-rich infiltrates
30
Q

Asthamtic mucuous often contains ____

A

Charcot-Leyden crystals (formed from dead eosinophils) OR

Curschmann spirals

31
Q

What causes Curschmann spirals?

A

when mucous gets into fluid it curls

32
Q

What is Bronchiestasis?

A

permanent airway dilation associated with smooth muscle and elastic tissue destruction leading to fibrosis of airway walls

33
Q

What are some causes of Bronchiectasis?

A

1) congenital (Cystic fibrosis, Immotile cilia syndromes like Kartagener)
2) Necrotizing pneumonia (e.g. Mycobacteria, Staph)
3) Bronchial obstruction

34
Q

What is a T-E fistula?

A

failure of fetal RT to seperate from the GI tract. Most common (86%) is a connection between the trachea and GI with a blind pouch

35
Q

Branching tubes from the ___ give rise to the trachea, bronchi, and bronchioles

A

foregut

36
Q

Between 26-32 weeks, what happens to fetal lung?

A

surfactant production begins

37
Q

When do alveoli begin to differentiate?

A

7 months

38
Q

What are the stages of alveolar differentiation?

A
  • glandular
  • saccular (surfactant made here)
  • alveolar
39
Q

What happens during the alveolar stage?

A

reduction of interstitial tissues and increasing capillaries

40
Q

When are the lungs histologically mature?

A

8 yo

Pulmonary Week 2 (25 decks)

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