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Flashcards in Respiratory Diseases Deck (42):
1

What 3 types of Airway diseases?

Obstructive
Restrictive
Mixed Defect

2

Summarise Obstructive diseases:

- Characterised by reduced airway diameter
- Have increased airway resistance
- Examples: Asthma, COPD, Bronchiectasis

3

Summarise Restrictive diseases:

- Reduced lung compliance
- Decreased lung volume

4

What is Chronic Obstructive Pulmonary Disease (COPD)?

Progressive airflow obstruction, It not only affects the airways but the lung parenchyma and pulmonary vasculature

5

What are the 2 sub-types of COPD:

Emphysema
Chronic Bronchitis

6

What is Emphysema?

- Abnormal and permanent enlargement of airspaces distal to the terminal bronchioles
- It is destruction of the airways without fibrosis

7

Emphysema affects:

- Respiratory bronchioles
- Alveolar Ducts
- Alveolar Sacs
- Alveoli

8

What are the 2 patterns of Emphysema:

Centriacinar
Panacinar

9

Describe Centriacinar Emphysema:

- Primarily Upper lobes affected
- Loss of respiratory bronchioles in the proximal acinus - spares the alveoli
- Typical in smokers

10

Describe Panacinar Emphysema:

- Affects all lobes
- Loss of all parts of acinus
- Typical for α-1 antitrypsin deficiency

11

Describe the pathogenesis of COPD:

1. Exposure to tobacco or noxious substance
2. Airway epithelial cells and macrophages release cytokines to attract inflammatory cells
3. CD8 T-cells, Mast cells and Neutrophils begin to attack airway tissue via proteolytic enzymes and activates fibroblasts that cause scarring
4. Antiprotease α-1 antitrypsin is supposed to inhibit proteolytic enzyme activity but smoking can decrease its effect
5. Mucus secretion increases and airways narrow (due to scarring)

12

COPD leads to chronic ________ due to the destruction of the __________ and loss of the ___________.

Hypoxia
Lung Parenchyma
Vascular Bed

13

COPD causes thickening of the ___________ which increases _________ and decreases ________. This leads to ___________________.

Blood vessels
Increases resistance and decreases blood flow
Pulmonary Hypertension

14

What is asthma?

Airway hyper-responsiveness to certain triggers which causes inflammation of the conducting regions

15

What are the 2 types of asthma?

Intrinsic
Extrinsic

16

Inflammation in asthma is ______ and mediated by _________ and ________

Chronic
Helper T-cells
Cytokines

17

What is Intrinsic Asthma?

Asthma is non-immune mediated
Usually to do with viral infection, Aspirin and stress

18

What is Extrinsic Asthma?

- Asthma caused by a Type 1 hypersensitivity immune response
- It is associated with atopy (e.g. hayfever is associated with eczema
- Triggered by allergens

19

Describe the pathogenesis of Asthma:

1. Th2 helper cell overexpression stimulates plasma cells to synthesise and secrete IgE antibodies to allergens
2. IgE binds to high affinity receptors on mast cells and basophils
3. These cells release cytokines and histamine which causes bronchoconstriction
4. Re-exposure to allergen leads to early and late phase reactions

20

What are the symptoms of Asthma?

Coughing
Wheezing
Chest tightness
Shortness of breath
Triggered by environmental allergens
Diurnal variation in symptoms
Relapsing and remitting course

21

What is Bronchiectasis?

A disease characterised by chronically dilated airways that are filled with mucous

22

What are the clinical features of Bronchiectasis?

- Chronic Cough
- Increased sputum volume
- Recurrent worsening respiratory symptoms
- Bronchial wall thickening and airway dilation seen on x-ray and CT

23

Explain the pathophysiology of Bronchiectasis:

1. Airway infection
2. Airway Inflammation occurs
3. Airway damage = Bronchiectasis
4. Impaired mucocillary clearance, airflow is obstructed and we get an impaired immune response
5. Rinse and Repeat

24

What is Cystic Fibrosis?

An autosomal recessive disorder caused by Cystic Fibrosis Transmembrane Regulator (CFTR) gene mutations that cause an increase in mucous production and secretion

25

For people with CF, ____________ is the most common causes of morbidity and mortality

Bronchiectasis

26

CFTR gene mutations cause a defect in _________, this causes an __________ in production of ______ mucous.

Cl- channels
Increase
Thick

27

What is a clinical test for Cystic Fibrosis?

A sweat test
Patients with CF will have a high NaCl content in their sweat

28

How do we manage CF?

- Relieve airway obstruction
- Mx airway inflammation
- Antibiotics
- Manage Nutrietion
- Correct Cl- channel defect

29

What is restrictive lung disease?

Lung disease characterised by reduced compliance of the lungs and smaller lung volumes

30

Interstitial lung disease (ILD) is a pathological process that affects the _________ but often extends to involve the _________ and _________ structure.

Interstitium
Alveolar
Airway

31

What are the primary diseases causing ILD?

Sarcoidosis - granulomatous inflammation
Vasculitis - Systemic lupus erythematosis
Alveolar Proteinosis
Exposure to dust, fumes, vapours and aerosols

32

What is pneumonia?

Infection of the pulmonary parenchyma

33

What are the 3 classes of pneumonia?

Community-acquired = got it from the community
Healthcare-acquired = got it whilst hospitalised
Healthcare-associated = been in contact with healthcare

34

Development of pneumonia depends on:

Microbial virulence
Inoculum size
The hosts immune system

35

What is pulmonary arterial hypertension (PHTN)?

Elevated pulmonary blood pressure, often leads to right heart failure.
Pressures greater than 25mmHg at rest

36

What is Cor Pulmonale?

Right ventricular failure due to increased blood pressure in the pulmonary circulation due to chronic lung disease

37

What causes pulmonary arterial hypertension (PHTN)?

Proliferative vasculopathy: intimal layer hyperplasia, medial layer hypertrophy and obliteration of the vascular lumen

38

What are the symptoms of PHTN?

Exertional chest pain and syncope
Peripheral oedema
Abdominal pain
Anoerexia due to liver congestion

39

What is Pneumothorax?

Air in the pleural space

40

What is Haemothorax?

Blood in the pleural space

41

What is Pleural effusion?

Fluid in the pleural space

42

What are pleural plaques?

Solids in the pleural space