Clinical Airways Diseases Flashcards
(20 cards)
Asthma
Emphysema
Hallmark and dx
Airway inflammation with variable sx…demonstrate reversbility of obstruction and exclude others
Chest hyperexpansion…anatomic/radiographic findings
Chronic bronchitis
Bronchiectasis
Bronchiolitis
CLinical hallmarks and dx
Chronic sputum…hx
Chronic sputum…radiographic demonstration of enlarged airways
Dyspnea and cough…often clinical dx or maybe lung biopsy
COPD in general
Emphysema and chronic bronchitis
Cough
Sputum production
Due to irritation of airway epithelium
Inflammation, increased mucous production, airway infection
Hemoptysis
Wheezing
Dyspnea
Airway and/or lung injury
Narrowed small airway
Due to altered MECHANICS
Smoking effects and pack years
packs a day* years smoked
Emphysema, chronic bronchitis and lung cancer
Airflow of obstruction
SHows disproportionate expiratory phase involvement
Emphysema diaphragmatic
Hover’s sign - inward retraction
Minimal excursion
Impaired diaphragmatic excursion
Diffusion and emphysema
Diffusion impairment ID’s with exercise because losing surface area of the membrane
Astham in general
Inflammatory
Reversible onstruction
Sx - cough, wheeze, dyspnea worse at night
COPD
Airflow obstruciton irreversible to some extent
Usually smoking related
Pink puffer (pure emphysema) vs. blue bloater (chronic bronchitis)
Asthma pathology
Inflammation with eosinophilic infiltrates
Atopy/allergic
Demonstrably reversible
Bronchial hyper-reactivity
Normally present in childhood, remit in teens, recur in adulthood
Emphysema
Dx by CT imaging
Tobacco smoke produces imbalance in lung protease-anti-protease system
Centriacinar - smoking
Panacinar - alpha 1 antitrypsin def
Paraseptal - around margins
Airflow obstruction NOT mandatory for dx
Centriacinar emphysema
With chest hyperextension
Smokers
Will see more ribs
Alpha 1 AT def
Sx at 32-41 years if a smokes
Predominant in the lower lobes vs. centriacinar that is apical predominant
Chronic bronchitis dx
SPutum production on most days
More than 3 mos a year
Over 2 years
Most common is smoking
Associated iwth ob struction but not mandatory
Bronchiectasis
Enlarged and distorted bronchi that drain poorly, chronically infected and produce airflow obstruction
Signet ring sign
Sx usually chronic and similar to chornic brochitis…recurrent pneumonia and mayeb qwheezing
Etiologies of bronchiectasis
CF
IMmotile cilia syndrome…bronchiectasis, sinusitis, situs inversus, and infertility…missing dynein arms on ultrastructure
CT bronchiectasis
Bronchi larger than companion artery (ring sign)
Seen in lung periphery
Don’t taper as they should
Bronchiolitis syndromes
Dz where bronchioles are the primary locus of pathoogy
More involved in children
Peds infections like RSV
