week 1 - obrstuctive airway disorders -COPD and Bronchietasis

Question 1

What is the primary distinction between obstructive and restrictive lung diseases?

Answer 1

Obstructive lung diseases are airway disorders with increased resistance to airflow, while restrictive lung diseases are chest wall or parenchymal disorders with decreased lung expansion and reduced volumes.

Question 2

What is the pathophysiology associated with obstructive lung diseases?

Answer 2

Increased resistance to airflow, resulting in problems getting air out of the lungs.

Question 3

What spirometry result is typically seen in obstructive lung diseases?

Answer 3

Reduced FEV1:FVC ratio.

Question 4

What spirometry result is typically seen in restrictive lung diseases?

Answer 4

Normal to increased FEV1:FVC ratio.

Question 5

List examples of obstructive lung diseases.

Answer 5

• Emphysema
• Chronic bronchitis
• Asthma
• Bronchiectasis

Question 6

List examples of restrictive lung diseases.

Answer 6

• Acute restrictive disease - ARDS
• Chronic restrictive diseases
• Interstitial fibrosis
• Pneumoconiosis
• Chest wall deformities - Kyphoscoliosis
• Neuromuscular disorders affecting the chest wall muscles

Question 7

What is the definition of emphysema?

Answer 7

Irreversible enlargement of airspaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls.

Question 8

What are the patterns of emphysema based on anatomy?

Answer 8

• Centriacinar
• Panacinar
• Distal acinar (para-septal)
• Irregular

Question 9

What is the most common type of emphysema?

Answer 9

Centriacinar emphysema.

Question 10

What is the pathogenesis of emphysema?

Answer 10

Smoking leads to the release of inflammatory mediators that destroy elastic fibers, resulting in overdistention of alveoli.

Question 11

What is the genetic condition associated with emphysema?

Answer 11

Alpha-1 antitrypsin deficiency.

Question 12

What are the gross features of emphysema?

Answer 12

Hyperinflated lungs with or without bulla formation and a ‘moth-eaten’ appearance of the parenchyma.

Question 13

What are key clinical features of emphysema?

Answer 13

• Insidious onset of expiratory dyspnea
• Barrel-chest appearance
• Prolonged expiration through pursed lips
• Weight loss due to hyperventilation

Question 14

What are the typical spirometry findings in emphysema?

Answer 14

Obstructive pattern with reduced FEV1:FVC ratio.

Question 15

What is the definition of chronic bronchitis?

Answer 15

Persistent cough with mucoid sputum for at least 3 months in the past 2 consecutive years, in the absence of any other identifiable cause.

Question 16

What is a distinctive feature of chronic bronchitis pathology?

Answer 16

Submucosal gland hypertrophy and hypersecretion of mucus.

Question 17

What are the clinical features of chronic bronchitis?

Answer 17

• Persistent cough with mucoid sputum
• Dyspnea on exertion
• Cyanosis

Question 18

What distinguishes ‘pink puffers’ from ‘blue bloaters’ in COPD?

Answer 18

‘Pink puffers’ (emphysema) exhibit absence of cyanosis and use pursed lips during expiration, while ‘blue bloaters’ (chronic bronchitis) show cyanosis and peripheral edema.

Question 19

What is bronchiectasis?

Answer 19

Destruction of smooth muscle and elastic tissue by inflammation leading to permanent dilation of bronchi and bronchioles.

Question 20

What are the clinical features of bronchiectasis?

Answer 20

• Severe persistent cough
• Foul-smelling, sometimes bloody sputum
• Dyspnea and orthopnea
• Clubbing of the fingers

Question 21

What is Kartagener’s syndrome?

Answer 21

A subset of primary ciliary dyskinesia characterized by bronchiectasis, dextrocardia, and sinusitis.

Question 22

What is the inheritance pattern of bronchiectasis associated with Kartagener’s syndrome?

Answer 22

Autosomal recessive.

Question 23

Fill in the blank: The spirometry finding in chronic bronchitis typically shows a _______.

Answer 23

reduced FEV1:FVC ratio.

Question 24

True or False: Chronic bronchitis is characterized by eosinophilic inflammation.

Answer 24

False.

Question 25

What is the pathogenesis of primary ciliary dyskinesia?

Answer 25

Mutations in cilia gene → defective ciliary motor proteins (e.g., dynein) → defective ciliary function → impaired mucociliary clearance → accumulation of secretions → recurrent infections → bronchiectasis ## Footnote This sequence outlines how genetic mutations can lead to severe respiratory complications.

Question 26

What is Kartagener syndrome?

Answer 26

Subset of primary ciliary dyskinesia ## Footnote Kartagener syndrome is characterized by specific clinical features.

Question 27

What are the three main characteristics of Kartagener syndrome?

Answer 27

* Bronchiectasis (defective mucociliary clearance) * Dextrocardia (defective movement of the organs during embryogenesis) * Sinusitis (impaired mucociliary clearance → recurrent sinus infections) ## Footnote These characteristics are crucial for diagnosis.

Question 28

What reproductive issue is associated with males who have Kartagener syndrome?

Answer 28

Infertility (due to sperm dysmotility) ## Footnote This highlights the impact of ciliary dysfunction on male fertility.

Question 29

Fill in the blank: Kartagener syndrome is characterized by a triad of bronchiectasis, dextrocardia, and _______.

Answer 29

[sinusitis]