Lung: Emphysema, Chronic bronchitis, interstitial lung disease Flashcards Preview

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Flashcards in Lung: Emphysema, Chronic bronchitis, interstitial lung disease Deck (30):
1

Define chronic bronchitis

Chronic bronchitis is defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years in the absence of any other identifiable cause

2

Complications of chronic bronchitis

1. Cor pulmonale
2. Cancerous transformation (cuz epithelial dysplasia and metaplasia)

3

Pathogenesis of chronic bronchitis

1. Tobacco smoke, air pollutants 3 ways
2. Damage epithelium
3. Hypersecretion of mucous (IL-13 and histamine)
A. Induce protective goblet cell hyperplasia and submucosal gland hyperTROPHY
B. Mucous induced Airway obstruction
4. Inflammation
A. Both acute and chronic
B. Accompanying fibrosis might lead to chronic airway obstruction

4

Morphology of chronic bronchitis

Gross:
1. hyperemia
2. edema of the mucous membranes
3. excessive mucinous or mucopurulent secretions with casts maybe

Histology:
1. Submucosal mucous gland hyperplasia (assessed by reid index >0.4 post mortem)
2. Epithelium may have metaplasia and dysplasia
3. Bronchiolitis obliterans maybe if fibrosis obliterates lumen

5

C/P chronic bronchitis

Blue bloaters

1. Persistent productive cough
2. With time, dyspnea on exertion
3. Cyanosis

6

Define bronchiectasis

-Chronic necrotising infections
-Causing injury of elastic tissue and smooth muscle
-Leading to permanent dilation of bronchi and bronchioles

7

Risk factors for bronchiectasis

1. Ciliary motility disorder
A. Kartagener
B. Primary ciliary dyskinesia
C. Cystic fibrosis
2. Obstruction
A. Foreign body
B. Tumor
C. Mucus
3. Infection
4. Misc
A. RA, SLE, IBS, COPD
5. 25-50% idiopathic

8

Morphology of bronchiectasis

Gross:
1. Dilated airways
2. So much so, they can be traced upto the pleura
3. On cut section, bronchi appear cystic and filled with mucopurulent secretions

Histology:
1. Acute
A. Desquamation of epi
B. Ulceration
C. Intense inflammation acute and chronic in walls of bronchi and bronchioles
D. Pseudostratification
E. Squamous metaplasia
F. Lung abscess maybe

2. Chronic
A. Fibrosis: bronchiolitis obliterans

9

C/P of bronchiectasis

1. Severe, persistent, productive cough esp morning
2. Foul smelling, bloody sputum
3. Dyspnea
4. Orthopnea
5. Massive hemoptysis at times

10

Complications of bronchiectasis

1. Cor pulmonale
2. Brain abscess
3. Amyloidosis

11

Define chronic bronchitis

Chronic bronchitis is defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years in the absence of any other identifiable cause

12

Complications of chronic bronchitis

1. Cor pulmonale
2. Cancerous transformation (cuz epithelial dysplasia and metaplasia)

13

Pathogenesis of chronic bronchitis

1. Tobacco smoke, air pollutants
2. Damage epithelium
3. Hypersecretion of mucous (IL-13 and histamine)
A. Induce protective goblet cell hyperplasia and submucosal gland hyperplasia
B. Mucous induced Airway obstruction
4. Inflammation
A. Both acute and chronic
B. Accompanying fibrosis might lead to chronic airway obstruction

14

Morphology of chronic bronchitis

Gross:
1. hyperemia
2. edema of the mucous membranes
3. excessive mucinous or mucopurulent secretions

Histology:
1. Submucosal mucous gland hyperplasia (assessed by reid index >0.4 post mortem)
2. Epithelium may have metaplasia and dysplasia
3. Bronchiolitis obliterans maybe if fibrosis obliterates lumen

15

C/P chronic bronchitis

Blue bloaters

1. Persistent productive cough
2. With time, dyspnea on exertion
3. Cyanosis

16

Define bronchiectasis

-Chronic necrotising infections
-Causing injury of elastic tissue and smooth muscle
-Leading to permanent dilation of bronchi and bronchioles

17

Risk factors for bronchiectasis

1. Ciliary motility disorder
A. Kartagener
B. Primary ciliary dyskinesia
C. Cystic fibrosis
2. Obstruction
A. Foreign body
B. Tumor
C. Mucus
3. Infection
4. Misc
A. RA, SLE, IBS, COPD
5. 25-50% idiopathic

18

Morphology of bronchiectasis

Gross:
1. Dilated airways
2. So much so, they can be traced upto the pleura
3. On cut section, bronchi appear cystic and filled with mucopurulent secretions

Histology:
1. Acute
A. Desquamation of epi
B. Ulceration
C. Intense inflammation acute and chronic in walls of bronchi and bronchioles
D. Pseudostratification
E. Squamous metaplasia
F. Lung abscess maybe

2. Chronic
A. Fibrosis: bronchiolitis obliterans

19

C/P of bronchiectasis

1. Severe, persistent, productive cough esp morning
2. Foul smelling, bloody sputum
3. Dyspnea
4. Orthopnea
5. Massive hemoptysis at times

20

Complications of bronchiectasis

1. Cor pulmonale
2. Brain abscess
3. Amyloidosis

21

Define chronic bronchitis

Chronic bronchitis is defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years in the absence of any other identifiable cause

22

Complications of chronic bronchitis

1. Cor pulmonale
2. Cancerous transformation (cuz epithelial dysplasia and metaplasia)

23

Pathogenesis of chronic bronchitis

1. Tobacco smoke, air pollutants
2. Damage epithelium
3. Hypersecretion of mucous (IL-13 and histamine)
A. Induce protective goblet cell hyperplasia and submucosal gland hyperplasia
B. Mucous induced Airway obstruction
4. Inflammation
A. Both acute and chronic
B. Accompanying fibrosis might lead to chronic airway obstruction

24

Morphology of chronic bronchitis

Gross:
1. hyperemia
2. edema of the mucous membranes
3. excessive mucinous or mucopurulent secretions

Histology:
1. Submucosal mucous gland hyperplasia (assessed by reid index >0.4 post mortem)
2. Epithelium may have metaplasia and dysplasia
3. Bronchiolitis obliterans maybe if fibrosis obliterates lumen

25

C/P chronic bronchitis

Blue bloaters

1. Persistent productive cough
2. With time, dyspnea on exertion
3. Cyanosis

26

Define bronchiectasis

-Chronic necrotising infections
-Causing injury of elastic tissue and smooth muscle
-Leading to permanent dilation of bronchi and bronchioles

27

Risk factors for bronchiectasis

1. Ciliary motility disorder
A. Kartagener
B. Primary ciliary dyskinesia
C. Cystic fibrosis
2. Obstruction
A. Foreign body
B. Tumor
C. Mucus
3. Infection
4. Misc
A. RA, SLE, IBS, COPD
5. 25-50% idiopathic

28

Morphology of bronchiectasis

Gross:
1. Dilated airways
2. So much so, they can be traced upto the pleura
3. On cut section, bronchi appear cystic and filled with mucopurulent secretions

Histology:
1. Acute
A. Desquamation of epi
B. Ulceration
C. Intense inflammation acute and chronic in walls of bronchi and bronchioles
D. Pseudostratification
E. Squamous metaplasia
F. Lung abscess maybe

2. Chronic
A. Fibrosis: bronchiolitis obliterans

29

C/P of bronchiectasis

1. Severe, persistent, productive cough esp morning
2. Foul smelling, bloody sputum
3. Dyspnea
4. Orthopnea
5. Massive hemoptysis at times

30

Complications of bronchiectasis

1. Cor pulmonale
2. Brain abscess
3. Amyloidosis