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PATHOLOGY > COPD > Flashcards

COPD Flashcards

1
Q

DEFINE COPD.

A

COPD IS CHARACTERISED BY PROGRESSIVELY, PARTIALLY REVERSIBLE AIRFLOW OBSTRUCTION AND LUNG HYPERINFLATION.

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2
Q

DEFINITION OF EMPHYSEMA.

A

EMPHYSEMA IS CHARACTERISED BY ABNORMAL ENLARGEMENT OF THE AIRSPACES DISTAL TO THE TERMINAL BRONCHIOLES WITH DESTRUCTION TO THEIR WALLS WITHOUT SIGNIFICANT FIBROSIS.

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3
Q

TYPES OF EMPHYSEMA

A
  1. CENTRI- ACINAR
  2. PAN- ACINAR
  3. DISTAL- ACINAR
  4. IRREGULAR EMPHYSEMA
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4
Q

CENTRI- ACINAR
- AFFECTED SEGMENT
- AFFECTED AREA
- CAUSE

A
  • CENTRAL PART IS AFFECTED AS FOR THE REMAINING PART OF THE ACINAR, IT IS SPARED
  • UPPER LOBE
  • MAINLY CIGARETTE SMOKE
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5
Q

PAN- ACINAR
- AFFECTED SEGMENT
- AFFECTED AREA
- CAUSE

A
  • ALVEOLAR DUCTS ARE DIFFUSELY ENLARGED
  • LOWER LOBE
  • SEVERE a- 1 ANTITRYPSIN DEFICIENCY
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6
Q

DISTAL- ACINAR
- AFFECTED SEGMENT
- AFFECTED AREA
- CAUSE

A
  • DISTAL PART IS AFFECTED
  • ADJACENT OF THE PLEURA
  • DONT KNOW
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7
Q

THE IRREGULAR EMPHYSEMA IS SYMPTOMATIC/ ASYMPTOMATIC AND IS IRREGULARLY AFFECTED.

A

THE IRREGULAR EMPHYSEMA IS ASYMPTOMATIC AND IS IRREGULARLY AFFECTED.

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8
Q

THE RISK FACTORS OF EMPHYSEMA

A
  1. SMOKER
  2. PASSIVE SMOKER (SECOND HAND SMOKER)
  3. AIR POLLUTANTS (EXHAUST FUMES, HEATING FUEL, CHEMICAL FUEL, DUST)
  4. GENETIC PREDISPOSITION (a 1- ANTITRYPSIN DEFICIENCY)
  5. OLD AGE (MORE THAN 60 YEARS OLD)
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9
Q

PATHOGENESIS OF EMPHYSEMA

A
  1. SMOKING CAUSE THE ALVEOLAR DAMAGE
  2. INFILTRATION OF THE INFLAMMATORY CELLS INCLUDING THE NEUTROPHILS AND MACROPHAGES AS WELL AS THE CD4+ AND CD8+ T CELLS
  3. THE INFLAMMATORY CELLS AS WELL AS THE EPITHELIAL CELLS WILL RELEASE PROTEASE
  4. THE PROTEASE WILL CAUSE THE CONNECTIVE TISSUE TO BE BROKEN DOWN.
  5. THE ROS FROM THE CIGARETTE SMOKING AND ALSO FROM THE ACTIVATED INFLAMMATORY CELL WILL BE RELEASED TO CAUSE FURTHER DAMAGE TO THE TISSUE AS WELL AS INFLAMMATION
  6. HENCE, THERE WILL BE LOSS OF ELASTIC TISSUE WHICH WILL LEAD TO DAMAGE OF THE ALVEOLI WALL
  7. AS A RESULT, THERE WILL BE PARENCHYMAL DESTRUCTION
  8. IT IS ALWAYS A/W THE INFLAMMATION OF THE BRONCHUS AND ALSO THE BRONCHIAL.
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10
Q

CLINICAL FEATURES OF EMPHYSEMA.

A
  1. DYSPNEA, USUALLY APPEAR FIRST, START SLOWLY BUT PROGRESSIVELY BECOME WORST.
  2. IN SOME PT, COUGH OR WHEEZING IS THE C/C. EASILY CONFUSED WITH ASTHMA
  3. SEVERE EMPHYSEMA: BARREL-CHESTED, DYSPNEIC WITH OBVIOUSLY PROLONGED EXPIRATION, SITS FORWARD IN A HUNCH POSITION, AND BREATHS THROUGH PURSED LIPS
  4. PINK PUFFER: MAY OVERVENTILATE AND REMAIN WELL OXYGENATED, AND THEREFORE ARE SOMEWHAT DESIGNATED PINK PUFFERS
  5. TACHYPNOEA
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11
Q

EMPHYSEMA:
- PULMONARY FUNCTION TEST REVEALS
- CHEST X RAY

A
  • PULMONARY FUNCTION TEST REVEALS:
    1. REDUCED FEV1
    2. NORMAL/ NEAR NORMAL FVC
    3. RATIO FEV1/FVC REDUCED
  • CHEST X RAY
    1. HYPERLUCENCY
    2. HYPERINFLATION
    3. BARREL CHEST
    4. FLAT DIAPHRAGM
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12
Q

GROSS MORPHOLOGY OF EMPHYSEMA.

A
  1. SPARSE EMPTY SPACES
  2. ENLARGED AIRSPACES
  3. ANTRACOSIS
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13
Q

HISTOLOGICAL MORPHOLOGY OF EMPHYSEMA.

A
  1. AIRSPACE ENLARGEMENT
  2. FRAGMENTED ALVEOLAR WALLS
  3. NUMBER OF ALVEOLAR CAPILLARIES IS DIMINISHED
  4. TERMINAL AND RESPIRATORY BRONCHIOLES MAY BE DEFORMED
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14
Q

COMPLICATIONS OF EMPHYSEMA.

A
  • BRONCHIECTASIS
  • PNEUMOTHORAX
  • PULMONARY HPT
  • RESP. ACIDOSIS
  • COR PULMONALE
  • CAD
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15
Q

DEFINITION OF CHRONIC BRONCHITIS

A

CHRONIC BRONCHITIS CHARACTERISED BY IRREVERSIBLE AIRFLOW OBSTRUCTION AND PERSISTENT INFLAMMATION TO NOXIOUS ENVIRONMENTAL STIMULI.

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16
Q

DIAGNOSIS OF CHRONIC BRONCHITIS.

A

CHRONIC BRONCHITIS CAN BE DIAGNOSED BY:
PRESENCE OF PERSISTENT PRODUCTIVE COUGH FOR AT LEAST 3 CONSECUTIVE MONTHS FOR AT LEAST 2 CONSECUTIVE YEARS.

17
Q

RISK FACTORS OF CHRONIC BRONCHITIS.

A
  1. SMOKER
  2. PASSIVE SMOKER
  3. EXPOSURE TO AIR POLLUTANTS (CHLORINE, BROMINE, HYDROGEN SULFATE, DUST)
  4. ACUTE BRONCHITIS
  5. PNEUMONIA
  6. GASTRIC REFLUX
18
Q

PATHOGENESIS OF CHRONIC BRONCHITIS.

A

CIGARETTE SMOKING OR EXPOSURE TO AIR POLLUTANTS -> HYPERSECRETION OF MUCOUS IN THE LARGE AIRWAYS -> HYPERTROPHY OF THE MUCOUS GOBLET CELLS IN THE TRACHEA AND BRONCHIOLES -> THE NO OF THE MUCIN- SECRETING GOBLET CELL INCREASES IN THE EPITHELIAL SURFACE OF THE SMALLER BRONCHI AND BRONCHIOLES -> INFILTRATION OF THE INFLAMMATORY CELLS INCLUDING THE NEUTROPHILS, MACROPHAGES AND LYMPHOCYTES -> SMALL AIRWAY DISEASES WHICH IS DUE TO THE
- MUCOUS PLUGGING OF THE BRONCHIOLAR LUMEN
- BRONCHIOLAR INFLAMMATION
- BRONCHIOLAR WALL FIBROSIS

19
Q

CLINICAL FEATURES OF CHRONIC BRONCHITIS.

A
  • PRODUCTIVE COUGH
  • HAEMOPTYSIS
  • MUCOPURULENT SPUTUM
  • MILD DYSPNEA INITIALLY
  • PERIPHERAL OEDEMA
  • CYANOSIS
  • CRACKLES, WHEEZES
  • PROLONGED ASPIRATION
  • OBESE
  • BLUE BLOATERS
20
Q

INVESTIGATIONS OF CHRONIC BRONCHITIS.

A
  1. LAB INVESTIGATIONS
    - ABG: HYPOXAEMIA, HYPERCAPNOEA
    - FBC: POLYCYTHAEMIA
  2. CHEST X RAY
    - INCREASE BRONCHIAL MARKINGS
  3. PULMONARY FUNCTION TEST
    - FEV1 REDUCED
    - FVC NORMAL OR REDUCED
    - RATIO REDUCED
21
Q

GROSS MORPHOLOGY OF CHRONIC BRONCHITIS.

A
  • THE TRACHEA IN THE MID- UPPER FIELD IS HYPEREMIC
  • THE BIFURCATION AND BRONCHI CONTAIN MUCOPURULENT EXUDATE SECRETION
22
Q

HISTOLOGICAL MORPHOLOGY OF CHRONIC BRONCHITIS.

A
  • MUCOUS GLAND HYPERPLASIA
  • SQUAMOUS METAPLASIA
23
Q

COMPLICATIONS OF CHRONIC BRONCHITIS.

A
  • PULMONARY HPT
  • POLYCYTHAEMIA
  • COR PULMONALE
  • RECURRENT PULMONARY INFECTION
  • BRONCHIECTASIS
  • RESP. FAILURE
24
Q
A

PATHOLOGY (13 decks)

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