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Obstructive Lung Disorders Flashcards

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1
Q

Which side of lung have more tendency of foreign body to enter

A

Right lung

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2
Q

Most common location of lung abscess

A

Right lower lobe

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3
Q

Most common cause of Lung abscess

A

Aspiration of foreign body

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4
Q

Most common aspirated foreign body

A

Food particles

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5
Q

Most common causative organism of Lung abscess

A

Anaerobes

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6
Q

If lung abscess seen in elderly patients, what should we rule out first

A

Ruleout lung cancer

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7
Q

If presence of multiple of lung abscesses we should rule out

A

Staph. Aureus Septicimea

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8
Q

Respiratory Epithelial lining

A

Pseudostratified ciliated columnar epithelium except Vocal cords

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9
Q

Epithelial lining of vocal cords

A

Stratified Squamous epithelium

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10
Q

Epithelial lining of vocal cords

A

Stratified Squamous epithelium

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11
Q

Cilia + Mucus are

A

Protective in nature

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12
Q

Decreased activity of cilia and mucus clearance can leads to

A

Increased risk of infection

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13
Q

Congenital disease leading to cilia dysfunction

A

Kartagener Syndrome

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14
Q

In Kartagener Syndrome, there is defect of

A

Dynein

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15
Q

Classical triad seen in Kartagener Syndrome

A

Bronchiectasis
Sinusitis
Situs inversus (Dextrocardia)

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16
Q

Acquired cause which affects cilia activity

A

Smoking

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17
Q

In Cystic fibrosis there is problem of which gene

A

CFTR Gene

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18
Q

Problem of CFTR gene in Cystic fibrosis can leads to

A

Chloride channel defect - Cl, Na, H20 Can’t move properly - mucus dries - mucus can’t move - increased risk of infection

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19
Q

Important parameters of lung

A

Ventilation
Perfusion
Ventilation perfusion ratio

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20
Q

Ventilation is most in which part of lung

A

Base

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21
Q

Perfusion is most in which part of lungs

A

Base

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22
Q

Ventilation perfusion ratio is most in which part of lungs

A

Apex

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23
Q

Normal range of Ventilation perfusion ratio

A

0.8
Can’t exceed 1

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24
Q

Wall of respiratory tract consist of

A

Epithelial lining
Smooth muscle
Mucus secreting cells
Cartilage

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25
In Bronchioles there is absence of
Cartilage Submucous glands
26
Reid's index =
A/B where, A- thickness of mucus glands B- distance between epithelium and cartilage
27
Normal value of Reid's index
0.4
28
Functional unit of lungs
Acinus
29
Types of Pneumocytes
Type 1 and Type 2
30
Function of Type 1 Pneumocytes
Lines the alveolar cells and increases surface area
31
Function of Type 2 Pneumocytes
More in number Secrets surfactants - decreases surface tension - important at time of expiration - prevents collapse of alveoli Reparative function - play important role in replacement of type 1 Pneumocytes
32
Spirometry findings in case of Obstructive lung disorders
FEV1 <80% FVC - Normal FEV1/FVC - <0.7% TLC - Normal or slightly increased
33
Spirometry findings in Restrictive lung disorders
FEV1 - Normal or Slightly decreased FVC decreases FEV1/FVC - >0.7 TLC - Decreases
34
Examples of Obstructive lung disorders
Emphysema Chronic bronchitis Bronchiectasis Bronchial asthma Small airway disease
35
Emphysema usually involves which part of lung
Disorder of acinus
36
Emphysema means
Abnormal permanent enlargement of air spaces distal to terminal bronchioles
37
Fibrosis in Emphysema
Minimal fibrosis Alveolar wall destruction
38
Damaging factor of lungs in case of Emphysema
Elastase - damages elastin fibers in lungs
39
Protective factors of lungs in case of Emphysema
Anti-elastases - Alpha-antitrypsin, Alpha 1 macroglobulin - neutralizes Elastase
40
Risk factors of Emphysema
Smoking Air pollution Occupational hazards (Pneumoconiosis)
41
How Smoking can lead to emphysema
Smoking - inflammation in airways - neutrophils and macrophages increases - elastase secretion increases - damage elastin fibers of lungs - increased risk of Emphysema Also smoking leads to formation of free radicals - decreases activity of Anti-elastase
42
If there is protein misfoldings in alpha 1 antitrypsin
Liver doesn't release it in circulation - doesn't able to reach lungs (No protective mechanism) - high risk of Emphysema or chronic bronchitis
43
Accumulation of misfolded proteins in liver can leads to
Micronodular Cirrhosis
44
Anatomical classification of Emphysema
Centriacinar emphysema Panacinar emphysema Distal acinar emphysema Irregular Emphysema
45
Centriacinar emphysema involves which part of acinus
Involves central or proximal part of acinus
46
Most common cause of Centriacinar emphysema
Smoking
47
Clinically most common type of Emphysema
Centriacinar emphysema
48
Centriacinar emphysema predominantly damages which lobe of lungs
Upper lobe
49
Which part of acinus is affected in Panacinar emphysema
Complete acinus is affected
50
Panacinar emphysema is most commonly associated with
Alpha-1 anti trypsin deficiency
51
In Panacinar emphysema which part of lung is commonly affected
Base of lung
52
Which part of acinus usually affected in Distal acinar emphysema
Distal part of acinus
53
Distal acinar emphysema commonly affected which lobe of lungs
Upper lobe
54
Enlarged air spaces in emphysema can leads to
Air trapping - BLEB formation - Pneumothorax
55
Clinical features of Emphysema
Elderly patients (60-70 years) Earliest complaint - Dyspnea Use of accessory muscles Weight loss Pink puffers Advanced - decreased O2 in blood - can lead to pulmonary Hypertension - Right heart failure
56
"Pink puffers" are referred to patients with which disease
Emphysema
57
Most common risk factor of Chronic bronchitis
Smoking
58
How Smoking can leads to Chronic bronchitis
Smoking - inflammation in airways - increase in mucus production (to remove smoke particles) - stasis of mucus - can lead to secondary infections
59
Reid's index in case of Chronic bronchitis
>0.5
60
Clinical features of Chronic bronchitis
Productive cough Obese Decreased O2 - Pulmonary HTN - Cor pulmonale Blue Bloaters No amyloidosis
61
"Blue Bloaters" referred to patients with which disease
Chronic bronchitis
62
COPD is combination of
Emphysema + Chronic bronchitis + Small airway disease
63
Treatment of COPD
Quit smoking or take Nicotine replacement Supplemental O2 - increases longevity Mucolytics Ipratropium (Anticholinergic drug)
64
Which is reversible airway obstructive disorder
Bronchial Asthma
65
Airways in bronchial asthma
Hyper-responsive
66
Types of Bronchial asthma
Extrinsic Intrinsic
67
Extrinsic bronchial asthma
Type 1 hypersensitivity reaction External antigens - house dust, pollen Increased IgE Childhood onset History of Atopy(Eczema)
68
Intrinsic Bronchial Asthma
No type 1 HR Normal IgE levels Adult onset History of viral infection or drugs exposure Aspirin
69
Samter's Triad
Aspirin intolerance Adult nasal polyps Asthma
70
Clinical features of Bronchial Asthma
Wheezing Dyspnea Nocturnal cough
71
Diagnosis in case of Bronchial asthma
Clinical history Spirometry Sputum examination Microscopic
72
Findings on sputum examination in case of Bronchial asthma
Curschman Spirals - zigzag structure Charcot leyden Crystals Creola body - degenerated airway epithelial cells
73
Charcot leyden Crystals are made up of
Galectin-10
74
Microscopic findings in case of Bronchial asthma
Airway remodeling Increase in thickness of basement membrane (increased collagen deposition) Hypertrophy of smooth muscle Increased no. Of mucus glands Eosinophilic infiltration
75
Gene responsible for hypertrophy of smooth muscles in Bronchial asthma
ADAM-33 gene
76
Marker of severity of Bronchial asthma
YKL-40
77
Treatment of Bronchial asthma
Avoid antigen exposure Bronchodilators - Salbutamol,terbutaline, Formoterol Anti-inflammatory drugs - Corticosteroids
78
Bronchiectasis is
Chronic necrotizing infection of airways - leads to abnormal permanent airway dilatation
78
Risk factors of bronchiectasis
Congenital Obstruction Infections Miscellaneous conditions
79
Congenital causes leading to Bronchiectasis
Kartagener Syndrome Cystic fibrosis
80
Obstructive risk factors of bronchiectasis
Foreign bodies or cancer
81
Infectious causes leading to Bronchiectasis
TB Staph aureus Allergic Bronchopulmonary Aspergillosis
82
Miscellaneous conditions leading to Bronchiectasis
Rheumatoid arthritis Grafts vs host disease
83
Clinical features of Bronchiectasis
Involvement of lower lobe of lungs (Basal involvement) Dyspnea Bronchorrhea (cups full of sputum) Predominantly left lung involvement Fever Dilated airways - can seen upto pleural surfaces
84
Investigation of choice in Bronchiectasis
HRCT Scan
85
Appearance seen in HRCT Scan in case of Bronchiectasis
Tram-Track appearance Honey comb lungs

Pathology (14 decks)

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