Pathology of Obstructive and Restrictive Lung Disease Flashcards

restrictive lung disease
Terms Definitions
T/F: The alveolar walls do not have cells in them normally.
True.
Name the 4 components of COPD.
chronic bronchitis, emphysema, bronchiectasis, and asthma (ABC & E)
T/F: One must have all four components to have COPD.
False.
Pleural lymphatics help to demarcate _____.
the pulmonary secondary lobule.
Secondary lobule consists of ____ pulmonary acini.
5-7
How many divisions of the trachea are there?
23 (like Micheal Jordan... or Lebron)
What is the definition of chronic bronchitis? Hint: Clinical....
Production of excess mucus secretion in the bronchial tree occuring on most days for at least 3 months in a year for at least 2 succesive years.
Name the two alterations to mucosa seen in CB.
1)hyperplasia of glands2)some degree of inflammation
Reid index?
Ratio of mucus glands to wall thickness (increased in CB)
COPD is usually associated w/ ____ emphysema.
centrilobular
3 D's of emphysema.
DilationDestructionDistal to the terminal bronchioles
"Blue bloaters"
centrilobular emphysema
"Pink puffers"
panlobular emphysema
Type of emphysema: very focal, near scar. Not associated w/ general symptoms.
Paraseptal
Type of emphysema: diffuse plate-like scars
Irregular
T/F: Alveolar damage can cause small airways to collapse.
True
Why do emphysema patients purse their lips to breathe?
create positive pressure to keep their small airways open
End stage of emphysema.
The dialated areas coalesce forming bullae. Bullae are dead space w/ no gas exchange.
What is the most reproducible feature of emphysema, regardless of the type?
reduced expiration of air (decreased FEV1)
Define bronchiectasis.
Permanent state of abnormal airway dilation resulting from chronic necrotizing infection.
Three causes of bronchiectasis.
1)Pneumonia2)Obstruction (tumor, etc.)3)Genetic (CF)Think about a POG stuck in your bronchiole, dilating it.
CF patients tend to present w/ ____ lobe bronchiectasis.
upper (mucus defies gravity)
Two factors that must occur to get bronchiectasis.
1)Obstruction2)Recurrent infection"If you have bronchiectasis, then you better go the OR"
Two anatomic types of bronchiectasis.
1)Cylindroid2)Saccular"Think about a penis and scrotum (cylinder and sac)"
T/F: Bronchiole stays the same thickness and diameter in a healthy individual.
False. Bronchiole tapers normally, but in bronchiectasis there is no tapering (Tram lines). Think about a train driving through your lungs... that would hurt.
Define asthma.
REVERSIBLE airway narrowing which over time may produce specific morphological changes.
Four morphological changes seen in asthma:
1)Sputum changes2)EOSINOPHILS (important)3)Curshmann spirals4)Charcot-Leyden crystals"The SEC is Cool"
A cast of airway caused by clamping down on mucus. Seen in asthma.
Curshmann spirals.
Ashtma is a ____ airway disease.
small
Four bronchial alterations seen in asthma.
1) Thickening of BM2) Edema3) Eosinophil infiltration4) Hypertrophy and hyperplasia of s.m. and glands
Name 5 types of asthma:
1)Reaginic (immune)2)Nonreaginic (non-immune)3)Asprin sensitive4)Industrial5)Aspergillosis
T/F: Bronchiolitis is an essential component of COPD.
False. Not part of COPD.
Bronchiolitis is seen more frequently in ___.
children
Bronchiolitis involves what cells?
neutrophils
Asthma involves what cells?
eosinophils
When lung is injured it responds w/?
granulation tissue
T/F: Granulation is seen in tracheobronchial tree, pleura, and alveolar processes.
False. Not seen in alveoli
What happens when the alveoli are injured?
Fibrosis replaces alveoli w/ hyperplasia of alveolar type II cells.
What is the problem with a person w/ pulmonary fibrosis who tries to excercise?
unable to sprout new vascular beds, therefore the PaO2 drops
Fibrosis is caused by an imbalance in ___.
cell mediated factors that favor repair and antibody mediated factors that favor fibrosis.
How is a diagnosis of pulmonary fibrosis made?
open lung biopsy (good history important)
Acute form of restrictive lung disease?
Adults Respiratory Distress Syndrome (ARDS)
All morphologic forms of restrictive lung disease have?
fibrosis or hyaline membranes
When dust is inhaled what will cause a reaction to increase fibrosis?
silica
What cells dictate the response when dust is inhaled?
macrophages
Inhalation of organic dusts leading to restrictive disease.
Pneumoconiosis
Antigens from birds leads to granulamatous reaction in lung leading to lung destruction.
Hypersensitivity Pneumonitis
Pulmonary edema is first ____ and then later ____.
interstitial, alveolar
T/F: Cardiac and noncardiac pulmonary edema have V/Q mismatch.
True.
Floating a balloon in lung and measure pressure. This is called ____ and is equivalent to ____.
capillary wedge pressure, LA
Distinguishing characteristic of cardiac vs. non cardiac pulmonary edema.
Increased capillary wedge pressure in cardiac.
Will 100% oxygen fix a shunt problem?
No. since some of the blood is never oxygenated.
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