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Respiratory II > Obstructive lung diseases > Flashcards

Obstructive lung diseases Flashcards

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1
Q

Type of lung disease indicated by decreased FEV1 and FEV1/FVC, and increased TLC and RV.

A

Obstructive lung diseases

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2
Q

Curvilinear flow-volume loop is seen in what type of lung disease

A

Obstructive

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3
Q

Lung disease characterized by mucous gland hyperplasia and hypersecretion within the bronchi.

A

Chronic bronchitis

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4
Q

Lung disease characterized by smooth muscle hyperplasia, excess mucous, and inflammation within the bronchi.

A

Asthma

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5
Q

Lung disease characterized by airspace enlargement and wall destruction in the acini.

A

Emphysema

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6
Q

Airway dilation and scarring in response to persistent or severe infections

A

Bronchiectasis

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7
Q

Most common type of emphysema

A

Centriacinar/centrilobular

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8
Q

Emphysema type commonly in the lower lung zones, involving the acinus.

A

Panacinar/panlobular

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9
Q

Type of emphysema seen in alpha-1 antitrypsin deficiency

A

Pancacinar/panlobular

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10
Q

Emphysema type associated with spontaneous pneumothorax in young adults. Seen adjacent to the pleura, and adjacent to areas of fibrosis, scarring, or atelactasis

A

Distal acinar

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11
Q

Emphysema characterized by subpleural blebs >1 cm

A

Bullous

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12
Q

Clinically insignificant emphysema type associated with scarring

A

Irregular

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13
Q

Gene mutation in alpha-1 antitrypsin deficiency

A

PiZZ (proteinase inhibitor) on chromosome 14

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14
Q

Change in pressure-volume curve in emphysema

A

Up and to the left

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15
Q

Entrance of air into the CT stroma of the lung, mediastinum, or subcutaneous tisse

A

Interstitial emphysema

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16
Q

Lung expands because air is trapped within it by tumor or foreign object, but there is no airway destruction

A

Obstructive overinflation

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17
Q

Pathogenesis of complications in emphysema

A

Damage to capillary bed
Hypoxic vasoconstriction
Secondary pulmonary HTN
Development of cor pulmonale
CHF

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18
Q

RHF secondary to a lung disease

A

Cor pulmonale

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19
Q

Clinical definition of chronic bronchitis

A

Productive cough for a least 3 months during 2 consecutive years without other cause

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20
Q

Inflammatory mediators in chronic bronchitis

A

Histamine
IL-13

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21
Q

Obstructive lung disease with an increased Reid index

A

Chronic bronchitis

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22
Q

Ratio of thickness of the gland layer to the thickness of the submucosa

A

Reid index

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23
Q

Hyperemia, swelling and edema of the mucous membranes of the lungs on gross inspection of cross section. Excessive mucinous or mucopurulent secretions. Heavy cases of secretions and pus fill the bronchi and bronchioles

A

Chronic bronchitis

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24
Q

Microscopy of the lung shows thickening of bronchiolar wall due to smooth muscle hypertrophy, goblet cell hyperplasia, and striking enlargement mucus-secreting glands of trachea and bronchi

A

Chronic bronchitis

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25
Maximum thickness of the bronchial mucus glands internal to the cartilage divided by the bronchial wall thickness
Reid index
26
Normal Reid index value
0.4
27
DLCO in chronic bronchitis
Normal
28
DLCO in emphysema
Decreased
29
Pressure volume in chronic bronchitis in absence of emphysema
Nearly normal
30
Complications of chronic bronchitis
Pulmonary HTN Cor pulmonale Respiratory failure Hypercapnia Respiratory acidosis
31
GOLD stage of COPD with a decreased FEV1/FVC and normal FEV1.
Stage 1 - mild
32
GOLD stage of COPD with decreased FEV1/FVC and FEV1 between 50-80%.
Stage II - moderate
33
GOLD stage of COPD with decreased FEV1/FVC and FEV1 between 30-50%
Stage III - severe
34
GOLD stage of COPD with FEV1/FVC decreased and FEV1 <30%, or <50% with signs of respiratory failure or RHF.
Stage IV - very severe
35
Haldane effect
Administered O2 displaces CO2 bound to Hgb, increasing free CO2
36
Sign of irreversible bronchoconstriction in post-bronchodilator test
Change in FEV1 <=12%
37
General values of PO2 and PCO2 in respiratory failure
PO2 <60 mmHg PCO2 >50 mmHg
38
4 general causes of hypoxemia
Hypoventilation Diffusion impairment Shunt V/Q mismatch
39
Pulmonary causes of V/Q mismatch
Obstructive lung diseases - chronic bronchitis Restrictive lung disease Pulmonary vascular disease Acute respiratory distress syndrome (ARDS)
40
Chronic obstructive airway disease with variable expiratory outflow obstruction. Characteristic airway inflammation.
Bronchial asthma
41
Most common type of asthma
Atopic
42
Hypersensitivity reaction in atopic asthma
Type 1 hypersensitivity reaction
43
Inflammatory mediators seen in atopic asthma
Leukotrienes Prostaglandin D2 Histamine Serotonin IL-4 IL-5 IL-13
44
Affect of inflammatory mediators in atopic asthma
Bronchoconstriction Increased vascular permeability Increased mucous secretion
45
Triggers of nonatopic asthma
Viral respiratory infections - most common Inhalants Cold Exercise
46
Types of asthma
Atopic Nonatopic Drug induced Occupational
47
Samter's triad
Asthma Aspirin sensitivity Nasal polyposis
48
Agent often implicated in drug induced asthma
Aspirin
49
Microscopy of lung shows goblet cell hyperplasia, sub-basement membrane fibrosis, eosinophilic inflammation, and muscle hypertrophy
Asthma
50
Mucous plugs with whorls of shed epithelium
Curschman spirals
51
Collections of crystalloids made of eosinophil proteins (galectin-10)
Charcot-Leyden crystals
52
Curschman spirals and Charcot-Leyden crystals are seen in what obstructive lung disease
Asthma
53
DLCO in asthma
Often increased
54
Methacholine challenge test
>/=20% decrease in FEV1 in response to provoking factor
55
Destruction of smooth muscle and elastic tissue of lungs by persistent or severe infections causing permanent dilation of bronchi and bronchioles
Bronchiectasis
56
Congenital/hereditary conditions predisposing for bronchiectasis
Cystic fibrosis Immunodeficiency states Primary ciliary dyskinesia
57
Dilated bronchi on cut surface of lungs appears cystic and filled with mucopurulent secretions
Bronchiectasis
58
Microscopy of lung shows intense inflammatory cells, ulcerations of bronchial lining, squamous metaplasia, fibrosis, and destruction.
Bronchiectasis
59
Complications of bronchiectasis
Metastatic brain abscess Secondary amyloidosis Cor pulmonale
60
Pt presents with new onset of foul smelling, sometimes bloody sputum. Cough is worse in the morning. They had a cough and mild fever over the last week.
Bronchiectasis
61
Multi-system involvement of cystic fibrosis
Chronic lung disease Pancreas insufficiency Hepatic cirrhosis Intestinal obstruction Male infertility
62
Inheritance of cystic fibrosis
Autosomal recessive
63
Gene mutation of cystic fibrosis
CFTR on chromosome 7q31.2
64
Anion channels affected in cystic fibrosis
Chloride channels Potassium channels Epithelial sodium channels (ENaC) Gap junction channels
65
Cellular processes affected in cystic fibrosis
ATP transport Mucous secretion
66
Class I cystic fibrosis
Defective protein synthesis --> absent CFTR
67
Class II cystic fibrosis
Abnormal protein folding, processing, and/or trafficking --> absent CFTR Phenylalanine at AA position 508
68
Class III cystic fibrosis
Defective channel regulation
69
Class IV cystic fibrosis
Defective CFTR channel
70
Class V cystic fibrosis
Reduced functional CFTR
71
Class VI cystic fibrosis
Decreased CFTR membrane stability
72
Meconium ileus
Thick viscid mucus plugs in the small intestines of infants in CF
73
Cause of male infertility in cystic fibrosis
Congenital bilateral absence of vas deferens
74
Diagnosis of CF via sweat chloride analysis
>60 mmol/L
75
Diagnosis of CF via nasal transepithelial potential difference
More negative
76
Inheritance of primary ciliary dyskinasia
Autosomal recessive
77
Triad of Kartagener syndrome
Situs inversus Bronchiectasis Sinusitis
78
Cause of decreased fertility in both males and females in primary ciliary dyskinesia
Immotile sperm Dysfunctional fallopian tube cilia
79
Risk factors for allergic bronchopulmonary aspergillosis
Asthma Cystic fibrosis Bronchiectasis
80
Indications for lung transplant
End stage COPD Idiopathic pulmonary fibrosis Cystic fibrosis Idiopathic/familial pulmonary arterial HTN Sarcoidosis
81
Most common reason for lung transplant
Cystic fibrosis
82
Prophylaxis for CMV pneumonia in the first few weeks post lung transplant
Ganciclovir
83
Prophylaxis for P jiroveci pneumonia in the first few weeks post lung transplant
Bactrim
84
Acute lung transplant rejection
Graft vessel vasculitis
85
Types of chronic lung transplant rejections
Bronchiolitis obliterans Bronchiectasis Pulmonary fibrosis
86
Fibrosis, scarring, and progressive obliteration of the small airways
Bronchiolitis obliterans

Respiratory II (17 decks)

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