Pathophys of Chronic Airflow Obstruction

Question 1

4 chronic obstructive airway diseases

Answer 1

Asthma
COPD
Bronchiectasis
Bronchiolitis

Question 2

Difference between bronchus and bronchiole

Answer 2

Bronchus has cartilage

Bronchiole does not

Question 3

4 general symptoms of chronic obstructive airway diseases

Answer 3

Cough
Sputum
Dyspnea
Wheeze

Question 4

Cough reflex

Answer 4

Afferent: stimulation of irritant receptors in airway
Efferent: activation of inspiratory muscles (including diaphragm)
Activation of expiratory muscles and the larynx

Question 5

Sputum definition

Answer 5

A mixture of saliva, airway lining mucus, and pus that is expelled during coughing
Phlegm is airway mucus

Question 6

2 sources of mucus

Answer 6

Goblet cells
Bronchial mucus gland
Both increase in obstructive lung diseases

Question 7

3 general causes of dyspnea in obstructive lung diseases

Answer 7

Increases work of breathing due to increased airway resistance
Hypoxemia
Hyperinflation

Question 8

5 ways you can get increased airway resistance

Answer 8

Smooth muscle contraction
Wall thickening
Lumenal occlusion
Decreased lung elasticity
Obliteration

Question 9

Obliteration

Answer 9

Inflammation-induced proteolytic damage to the CT framework of the lung and death of alveolar epithelial cells
Can occur in COPD, bronchiectasis, and bronchiolitis

Question 10

Inflammatory triggers for

1. Asthma
2. COPD
3. Bronchiectasis
4. Bronchiolitis

Answer 10

1. Primarily allergen driven Th2 response (but also viruses and pollutants)
2. Cigarette and biomass smoke (oxidant damage)
3. Bacteria
4. Various (inhaled fumes, immune rejection, etc)

Question 11

5 histological features of asthma

Answer 11

Mucus plug containing inflammatory and desquamated epithelial cells
Smooth muscle hypertrophy/hyperplasia
Thickened basement membrane
Goblet cell metaplasia
Inflammatory cell infiltration

Question 12

Emphysema

Answer 12

Proteolytic destruction of alveolar walls
Decreased surface area for gas exchange
Loss of lung elasticity

Question 13

2 types of emphysema

Answer 13

Centriacinar

Panacinar

Question 14

Bronchiectasis definition

Answer 14

Irreversible dilation of the bronchial tree
Obliteration of peripheral small airways
Repetitive or persistent infection of proximal airways

Question 15

Causes of bronchiectasis

Answer 15

CF
Ciliary dysfunction syndromes
Foreign bodies
Tracheomalacia
Inhalation of noxious fumes/gases
Infection

Question 16

Increasing lung volume (hyperinflation) causes what 3 things

Answer 16

Increased compliance
Shortening of inspiratory muscles
Increased airway resistance

Question 17

2 ways obstructive lung diseases cause hypoxemia

Answer 17

Ventilation/perfusion mismatch

Decreased surface area for diffusion

Question 18

Spirometry findings for obstructive lung diseases

Answer 18

FEV1 is decreased

FVC is also decreased