Asthma and Chronic Bronchitis Quiz

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Questions and Answers

What type of hypersensitivity reaction is associated with atopic asthma?

  • Type II Cytotoxic hypersensitivity
  • Type III Immune complex-mediated hypersensitivity
  • Type I IgE-mediated hypersensitivity (correct)
  • Type IV Delayed-type hypersensitivity

Which of the following is commonly a precursor to asthmatic attacks in atopic asthma?

  • Nasal polyps
  • Chronic bronchitis
  • Lung fibrosis
  • Allergic rhinitis (correct)

What is typically documented to diagnose asthma?

  • Presence of structural lung abnormalities
  • Episodic symptoms with airflow limitation (correct)
  • Chronic exposure to environmental pollutants
  • High levels of eosinophils in the bloodstream

What may trigger asthmatic attacks in sensitized individuals?

<p>Infections and specific allergens (C)</p> Signup and view all the answers

Which test can identify the presence of IgE antibodies for specific allergens?

<p>Skin prick test (B)</p> Signup and view all the answers

What does the Reid index indicate in patients with chronic bronchitis?

<p>The ratio of submucosal gland thickness to bronchial wall thickness (D)</p> Signup and view all the answers

Which group of inflammatory cells is predominantly seen in the bronchial mucosa of patients with chronic bronchitis?

<p>Lymphocytes and macrophages (B)</p> Signup and view all the answers

What is a common characteristic observed in severe cases of chronic bronchitis?

<p>Complete obliteration of airway lumens (D)</p> Signup and view all the answers

How does chronic bronchitis typically differ from emphysema in terms of dyspnea symptoms?

<p>Dyspnea in chronic bronchitis is often less prominent than in emphysema (D)</p> Signup and view all the answers

Which of the following is a likely consequence of fibrosis in patients with chronic bronchitis?

<p>Luminal narrowing leading to airway obstruction (D)</p> Signup and view all the answers

What is the potential impact of obesity on patients with chronic bronchitis?

<p>Decreased ventilation, especially during sleep (D)</p> Signup and view all the answers

What is a common outcome for patients with severe chronic bronchitis when compared to those with emphysema?

<p>More frequent exacerbations and poorer outcomes (A)</p> Signup and view all the answers

What percentage of patients with chronic bronchitis are estimated to have obstructive sleep apnea?

<p>10% to 30% (A)</p> Signup and view all the answers

Which of the following cells is NOT typically seen in chronic bronchitis?

<p>Eosinophils (A)</p> Signup and view all the answers

What is the typical pulmonary function test result in chronic bronchitis?

<p>Reduced FEV1 with normal FVC (A)</p> Signup and view all the answers

Which symptom is often associated with severe weight loss in chronic bronchitis patients?

<p>Presence of an occult malignant tumor (C)</p> Signup and view all the answers

How does airflow obstruction primarily occur in chronic bronchitis?

<p>Mucous plugging of bronchioles (B)</p> Signup and view all the answers

Which physical presentation is characteristic of emphysema patients?

<p>Hunched-over position (B)</p> Signup and view all the answers

What is a common imaging finding in patients with emphysema?

<p>Hyperinflated lungs (D)</p> Signup and view all the answers

How can hypoxia-induced vascular spasm in emphysema lead to complications?

<p>It decreases blood flow to the lungs (D)</p> Signup and view all the answers

What role does microbial infection play in chronic bronchitis?

<p>It has a secondary role in exacerbating symptoms (A)</p> Signup and view all the answers

What role do inflammatory mediators play in the development of emphysema?

<p>They recruit inflammatory cells from the circulation. (D)</p> Signup and view all the answers

Which feature is uniquely characteristic of chronic bronchitis compared to emphysema?

<p>Persistent productive cough for at least 3 months. (A)</p> Signup and view all the answers

What does the protease-antiprotease imbalance lead to in emphysema patients?

<p>Destruction of connective tissues. (B)</p> Signup and view all the answers

Which type of inflammatory cells are prevalent in the lesions of chronic bronchitis?

<p>Neutrophils and macrophages. (C)</p> Signup and view all the answers

Which factor is not associated with the development of emphysema?

<p>Excessive hydration of airways. (D)</p> Signup and view all the answers

What condition might exacerbate bronchospasm in patients with chronic bronchitis?

<p>Exposure to cold air or allergens. (C)</p> Signup and view all the answers

Which of the following is true regarding oxidative stress related to chronic bronchitis?

<p>It can be exacerbated by reactive oxygen species from cigarette smoke. (C)</p> Signup and view all the answers

What is considered a major environmental contributor to chronic bronchitis?

<p>Living in smog-ridden cities. (D)</p> Signup and view all the answers

What distinguishes centriacinar emphysema from panacinar emphysema?

<p>It involves central parts of the acini but spares the distal air spaces. (B)</p> Signup and view all the answers

In which lung areas is centriacinar emphysema most commonly found?

<p>Upper lobes, particularly the apical segments. (C)</p> Signup and view all the answers

Which type of emphysema is roughly 20 times more common than the other types associated with COPD?

<p>Centriacinar emphysema. (B)</p> Signup and view all the answers

What is the relationship between chronic bronchitis and centriacinar emphysema?

<p>Centriacinar emphysema is often accompanied by chronic bronchitis. (A)</p> Signup and view all the answers

Which emphysema type is often linked to a1-antitrypsin deficiency?

<p>Panacinar emphysema. (C)</p> Signup and view all the answers

What characterizes the lesions in advanced centriacinar emphysema?

<p>They show both emphysematous and normal air spaces. (C)</p> Signup and view all the answers

Which of the following emphysema types involves the respiratory bronchioles first?

<p>Centriacinar emphysema. (C)</p> Signup and view all the answers

How does the structure of the acinus differ in panacinar emphysema compared to centriacinar emphysema?

<p>All parts of the acini in panacinar emphysema are uniformly enlarged. (A)</p> Signup and view all the answers

Which of the following is NOT a direct consequence of neutrophil release of reactive oxygen species (ROS) in acute lung injury?

<p>Increased capillary permeability (C)</p> Signup and view all the answers

Which of the following is LEAST likely to be found in the alveolus of a patient with acute lung injury?

<p>Lymphocytes (A)</p> Signup and view all the answers

Based on the figure, which of the following statements regarding type II alveolar cells is TRUE?

<p>They are the main cells responsible for surfactant production. (D)</p> Signup and view all the answers

The presence of sloughed bronchial epithelium in a patient with acute lung injury suggests which of the following?

<p>A widespread inflammatory response affecting the airway epithelium (A)</p> Signup and view all the answers

Which cell type is primarily involved in the sequestration and migration of neutrophils into the alveolus during acute lung injury?

<p>Alveolar macrophages (B)</p> Signup and view all the answers

Hyaline membranes, a characteristic feature of acute lung injury, are primarily composed of which of the following?

<p>Fibrin and cellular debris (C)</p> Signup and view all the answers

Which of the following is NOT a direct contributor to the development of edema in acute lung injury?

<p>Inactivation of surfactant (A)</p> Signup and view all the answers

Which of the following is the BEST indicator of active inflammation in the alveoli of a patient with acute lung injury?

<p>Presence of neutrophils (C)</p> Signup and view all the answers

The presence of procollagen in the interstitium during acute lung injury suggests which of the following?

<p>A shift from acute to chronic inflammation (D)</p> Signup and view all the answers

Which of the following is the MOST critical factor determining the outcome of acute lung injury?

<p>The extent of initial damage to the alveolar epithelium (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic feature of chronic bronchitis, as described in the content?

<p>Presence of elevated eosinophil counts in bronchial mucosa. (D)</p> Signup and view all the answers

In the context of the provided content, what is the primary role of microbial infection in chronic bronchitis?

<p>Maintaining inflammation and exacerbating existing symptoms. (C)</p> Signup and view all the answers

Which of the following best describes the mechanism of airflow obstruction in chronic bronchitis, as outlined in the content?

<p>Inflammation and fibrosis of the bronchiolar walls, combined with mucous plugging. (A)</p> Signup and view all the answers

Given the content, which of the following best represents the role of IL-13 in the development of chronic bronchitis?

<p>IL-13 stimulates the production of inflammatory mediators, contributing to ongoing inflammation. (D)</p> Signup and view all the answers

Based on the content, what is the most likely consequence of chronic bronchitis, if left untreated, that could lead to right-sided congestive heart failure?

<p>Chronic inflammation and hypoxia-induced vascular spasm leading to pulmonary hypertension. (C)</p> Signup and view all the answers

From the text, the prominent symptom of which respiratory condition is "barrel chest" and prolonged expiration?

<p>Emphysema. (A)</p> Signup and view all the answers

What role does neutrophil elastase play in the development of chronic bronchitis, as presented in the content?

<p>Neutrophil elastase plays a significant role in maintaining inflammation and exacerbating symptoms. (A)</p> Signup and view all the answers

What distinguishes emphysema patients from those with chronic bronchitis, as described by the provided content?

<p>Emphysema involves destruction of alveolar walls, leading to air trapping, while bronchitis predominantly affects smaller airways. (C)</p> Signup and view all the answers

What is the defining microscopic characteristic of acute respiratory distress syndrome (ARDS) that is present in the lungs?

<p>Hyaline membranes lining the alveolar ducts (C)</p> Signup and view all the answers

What is considered a significant risk factor for a poor prognosis in patients with ARDS?

<p>Development of multiorgan failure (B)</p> Signup and view all the answers

What is the most common cause of death in patients with ARDS?

<p>Underlying condition or superimposed infection (A)</p> Signup and view all the answers

Which of the following is a microscopic finding in ARDS that is particularly associated with sepsis?

<p>Collections of neutrophils in capillaries (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic finding in the acute phase of ARDS?

<p>Increased lung compliance (A)</p> Signup and view all the answers

What is the typical duration of the acute phase of ARDS?

<p>2-3 days (A)</p> Signup and view all the answers

Which of the following is least likely to contribute to the development of ARDS?

<p>Asthma (D)</p> Signup and view all the answers

What is the most likely reason for the decreased physical endurance experienced by survivors of ARDS?

<p>Long-term damage to the lungs (B)</p> Signup and view all the answers

What condition may persist for days or weeks and is associated with hypercapnia and acidosis?

<p>Asthma status (A)</p> Signup and view all the answers

Which pathogens are commonly implicated in the culture results of advanced bronchiectasis?

<p>Staphylococcus aureus and Klebsiella spp. (B)</p> Signup and view all the answers

What primary processes contribute to the development of bronchiectasis?

<p>Obstruction and infection (B)</p> Signup and view all the answers

What occurs when the lining epithelium of the bronchi heals after injury?

<p>Healing usually leads to abnormal dilation and scarring (A)</p> Signup and view all the answers

In which scenario does bronchiectasis significantly contribute to morbidity?

<p>Post-pneumonia from SARS-CoV-2 (B)</p> Signup and view all the answers

What can obstruction from a foreign body lead to in the context of bronchiectasis?

<p>Impairment of secretions clearance (D)</p> Signup and view all the answers

Which of the following organisms is more commonly associated with bronchiectasis in children?

<p>Haemophilus influenzae (C)</p> Signup and view all the answers

What anatomical changes occur in chronic cases of bronchiectasis due to necrosis?

<p>Formation of abscess cavities (D)</p> Signup and view all the answers

What primarily indicates the presence of chronic bronchitis in terms of bronchial structure?

<p>Enlargement of the mucus-secreting glands (D)</p> Signup and view all the answers

What is the normal Reid index value indicative of a healthy bronchial structure?

<p>0.4 (B)</p> Signup and view all the answers

Which of the following inflammatory cells is consistently observed in the bronchial mucosa of chronic bronchitis patients?

<p>Lymphocytes (C)</p> Signup and view all the answers

What is a significant consequence of submucosal fibrosis in chronic bronchitis patients?

<p>Bronchial lumen obliteration (B)</p> Signup and view all the answers

How does chronic bronchitis typically differ from emphysema concerning the development of dyspnea?

<p>Chronic bronchitis shows less pronounced dyspnea than emphysema (A)</p> Signup and view all the answers

What is one of the challenges faced by patients with severe chronic bronchitis during sleep?

<p>Decreased ventilation due to obesity (A)</p> Signup and view all the answers

What is a common long-term outcome for patients with chronic bronchitis?

<p>Rapid disease progression and frequent exacerbations (D)</p> Signup and view all the answers

What percentage of chronic bronchitis patients is estimated to develop obstructive sleep apnea?

<p>20% to 30% (B)</p> Signup and view all the answers

What is the primary cause of pneumoconioses, particularly related to mineral dust exposure?

<p>Inhalation of coal dust and silica (A)</p> Signup and view all the answers

What is the prognosis for patients with pneumoconioses?

<p>Survival ranges from 3 to 5 years (B)</p> Signup and view all the answers

Which therapy has been found to be effective against pneumoconiosis-related complications?

<p>Antifibrotic therapies (B)</p> Signup and view all the answers

Which particle size is most concerning for lodging in the lungs and causing harm?

<p>Particles between 1 to 5 mm (B)</p> Signup and view all the answers

What is a significant risk associated with asbestos exposure beyond its direct impact on workers?

<p>Increased risk of familial cancers (D)</p> Signup and view all the answers

What characteristic distinguishes nonspecific interstitial pneumonia (NSIP) from other lung diseases?

<p>Distinct radiologic and histologic features (B)</p> Signup and view all the answers

What type of response do silica and asbestos elicit compared to coal dust?

<p>More severe fibrotic reactions (D)</p> Signup and view all the answers

Which treatment is considered definitive for advanced pneumoconiosis?

<p>Lung transplantation (C)</p> Signup and view all the answers

Which of the following is NOT a common characteristic of pneumoconiosis?

<p>Exclusively affects the lower lobe of the lungs (C)</p> Signup and view all the answers

What is the primary characteristic of cryptogenic organizing pneumonia?

<p>Formation of intraalveolar plugs of organizing connective tissue (D)</p> Signup and view all the answers

Which of the following is a potential complication of autoimmune disorders like systemic sclerosis or rheumatoid arthritis?

<p>Diffuse pulmonary fibrosis (D)</p> Signup and view all the answers

Which of the following is NOT a characteristic of Usual Interstitial Pneumonia (UIP)?

<p>Predominantly affects the upper lobes of the lungs (C)</p> Signup and view all the answers

What is the proposed mechanism implicated in the pathogenesis of idiopathic pulmonary fibrosis?

<p>Overproduction of Mucin 5B (MUC5B) in the lungs (C)</p> Signup and view all the answers

Which of the following conditions is most likely to require steroid therapy?

<p>Cryptogenic organizing pneumonia (B)</p> Signup and view all the answers

What is the primary purpose of the term "pneumoconiosis"?

<p>To encompass lung diseases caused by inhalation of various dusts and particulates (D)</p> Signup and view all the answers

Which of the following statements is TRUE regarding fibrosing pulmonary disorders?

<p>The differential diagnosis for fibrosing lung disorders includes autoimmune diseases, pneumoconiosis, and other conditions. (D)</p> Signup and view all the answers

Flashcards

Atopic Asthma

The most common type of asthma linked to type I IgE-mediated hypersensitivity.

Triggers of Atopic Asthma

Common triggers include allergens like dust, pollen, and animal dander.

Family History of Atopy

A common background factor in patients with atopic asthma, indicating genetic predisposition.

Diagnosis of Asthma

Diagnosis includes episodic symptoms and airflow limitation improved with bronchodilators.

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IgE Antibodies

Immunoassays detect IgE antibodies that react to specific allergens, aiding in diagnosis.

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Chronic Bronchitis

A condition characterized by a persistent productive cough lasting for at least 3 months over 2 consecutive years.

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Inflammatory Cells

Cells such as neutrophils and macrophages involved in the immune response during chronic bronchitis.

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Protease-antiprotease imbalance

An imbalance where proteases break down connective tissue faster than antiproteases can protect it, contributing to emphysema.

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Oxidative Stress

The presence of reactive oxygen species that can damage tissues, often from cigarette smoke.

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Mucoid Sputum

A thick, sticky mucus produced in the early stages of chronic bronchitis.

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Hyperresponsive Airways

Airways that react excessively to stimuli, seen in some patients with chronic bronchitis.

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Chemotactic Factors

Substances that attract inflammatory cells to the site of inflammation.

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Proinflammatory Cytokines

Cytokines that amplify the inflammatory response and promote more inflammation.

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Centriacinar Emphysema

A type of emphysema where the central parts of acini are affected, sparing distal alveoli.

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Panacinar Emphysema

A form of emphysema characterized by uniform enlargement of all acini from bronchioles to alveoli.

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Distal Acinar Emphysema

Emphysema affecting the distal acinus, often near the pleura.

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Irregular Emphysema

Emphysema with an irregular distribution, not fitting other types.

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COPD association

Chronic Obstructive Pulmonary Disease commonly includes centriacinar and panacinar emphysema.

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Acinus Structure

The basic unit of the lung located distal to terminal bronchioles, made of clusters of acini.

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Alpha-1 Antitrypsin Deficiency

A genetic disorder that can lead to panacinar emphysema due to lack of protease inhibitor.

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Key Symptoms

Initial symptoms include cough, wheezing, and weight loss.

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Pulmonary Function Tests

Tests showing reduced FEV1 and normal FVC; reduced FEV1/FVC ratio.

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Emphysema Presentation

Patients are barrel-chested, dyspneic, with prolonged expiration.

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Cytokines Role

Environmental irritants release cytokines like IL-13 from T cells, worsening inflammation.

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Hyperinflated Lungs

Imaging shows hyperinflated lungs that flatten the diaphragm.

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Secondary Pulmonary Hypertension

Gradual increase in blood pressure in pulmonary arteries due to alveolar destruction.

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Cor Pulmonale

Right-sided heart failure due to lung issues, seen in chronic bronchitis/emphysema.

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Neutrophils

White blood cells involved in inflammatory response and infection control.

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Reactive Oxygen Species (ROS)

Chemically reactive molecules containing oxygen, released by neutrophils.

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Acute Lung Injury (ALI)

A sudden damage to the lungs, leading to fluid accumulation and respiratory distress.

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Type I Cells

Cells that form the structure of the alveolar wall, facilitating gas exchange.

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Type II Cells

Cells in the alveoli that produce surfactant, reducing surface tension.

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Surfactant

A substance that reduces surface tension in the lungs, aiding in inflation.

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Cytokines

Proteins released during inflammation that mediate immunological responses.

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Edema

Swelling caused by fluid accumulation in tissues, often seen in ALI.

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Fibrin

A protein involved in blood clotting and inflammation, often seen in tissue repair.

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Capillary

Small blood vessels where gas exchange occurs between blood and tissues.

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Reid Index

A ratio that compares the thickness of the mucous gland layer to that of the bronchial wall, normally 0.4.

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Goblet Cell Metaplasia

Transformation of epithelial cells into mucus-secreting goblet cells commonly seen in chronic bronchitis.

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Cyanosis

Bluish discoloration of the skin due to low oxygen levels, often seen in chronic bronchitis.

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Bronchiolitis Obliterans

Severe condition where fibrosis leads to complete blockage of bronchioles in chronic bronchitis.

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Dyspnea

Difficulty breathing, often less prominent in chronic bronchitis compared to emphysema.

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Obstructive Sleep Apnea

A sleep disorder where breathing repeatedly stops and starts, occurring in 10%-30% of chronic bronchitis patients.

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Chronic Bronchitis Symptoms

Initial symptoms include cough, wheezing, and potential weight loss.

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Inflammatory Cell Types

Cells involved are macrophages, neutrophils, and lymphocytes, but not eosinophils.

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Pulmonary Function Test Results

Tests show reduced FEV1 with normal FVC; FEV1/FVC ratio is diminished.

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Bronchial Mucus Hypersecretion

Mucus build-up primarily affects large bronchi, causing obstruction.

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Cytokine Role in Inflammation

Cytokines like IL-13 are released by T cells, exacerbating inflammation.

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Pulmonary Imaging Results

Imaging shows hyperinflated lungs flattening the diaphragm.

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Acute Respiratory Distress Syndrome (ARDS)

A severe lung condition that develops quickly, typically within 72 hours of injury.

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Hyaline Membranes

Characteristic findings in ARDS, formed from fibrin-rich fluid and necrotic cells.

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Bilateral Ground Glass Opacities

CT scan appearance in ARDS showing diffuse, hazy regions in lungs.

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Risk Factors for Poor Prognosis

Factors such as advanced age and sepsis that indicate a challenging outcome in ARDS.

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Mortality Rate of ARDS

The overall death rate in ARDS is about 40%, often linked to the underlying condition.

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Physical Endurance in ARDS Survivors

Survivors of ARDS may experience decreased endurance due to lung function abnormalities.

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Microscopic Findings in ARDS

Exam reveals interstitial edema, hemorrhage, and alveolar cell damage.

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Neutrophil Collections

Accumulations of neutrophils in capillaries seen particularly in cases involving infection.

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Mucus-Secreting Glands

Glands that produce mucus, their enlargement is a feature of chronic bronchitis.

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Bronchial Inflammation

Chronic bronchitis can feature variable inflammatory cell presence, mainly lymphocytes and macrophages.

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Pulmonary Hypertension

A condition of increased arterial pressure in the lungs, potentially resulting from chronic bronchitis.

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Dyspnea in Chronic Bronchitis

Breathing difficulty typically less pronounced than in emphysema.

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Bronchiectasis

A condition characterized by permanent dilation of bronchi due to chronic infection or obstruction.

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Status Asthmaticus

A severe asthma attack that does not respond to therapy, leading to prolonged respiratory distress.

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Ciliary Abnormalities

Inherited defects in cilia function leading to impaired mucus clearance and infection.

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Necrotizing Pneumonia

Lung infection leading to tissue death, often caused by virulent organisms like Staphylococcus.

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Mixed Flora Cultures

Laboratory cultures showing diverse bacterial types in severe lung infections, including Staphylococcus and Streptococcus.

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Bronchial Scarring

Permanent changes in bronchial walls due to chronic inflammation and infection, often resulting in irreversible damage.

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Post-Tuberculosis Bronchiectasis

Bronchiectasis that develops after tuberculosis infection, leading to significant morbidity in endemic regions.

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Impaired Mucociliary Clearance

Reduced ability of the respiratory system to clear mucus and pathogens due to damaged cilia.

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Cryptogenic Organizing Pneumonia

A rare lung condition with cough and dyspnea, showing patchy airspace consolidation on imaging.

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Treatment for Cryptogenic Organizing Pneumonia

Most patients require treatment with oral steroids after initial recovery.

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Pneumoconiosis

Lung disorders caused by inhalation of mineral dusts and particulates.

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Fibrosing Pulmonary Disorders

Conditions that result in lung fibrosis, associated with autoimmune diseases.

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Systemic Sclerosis

An autoimmune disorder that can cause lung fibrosis among other complications.

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Environmental Irritants

Substances that exacerbate inflammation and lung damage.

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Oral Steroids

Medications used to reduce inflammation in lung conditions.

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Intraalveolar Plugs

Loose organizing connective tissue that can obstruct airspaces in lung conditions.

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Asbestos Exposure

Increased cancer risk due to inhaling asbestos fibers, affecting workers and their families.

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Nintedanib

A tyrosine kinase inhibitor approved for treating fibrotic lung diseases.

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Pirfenidone

An antifibrotic medication used for idiopathic pulmonary fibrosis (IPF).

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Lung Dust Particles

Particles ranging from 1 to 5 mm are most harmful as they lodge in airways.

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Non-Specific Interstitial Pneumonia (NSIP)

A chronic interstitial lung disease of unknown cause, distinct on radiology.

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Coal Dust Effects

Coal dust is relatively inert and requires high exposure for lung disease to develop.

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Fibrotic Response to Silica

Silica and asbestos cause stronger immune reactions than coal dust, promoting fibrosis.

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Related Documents

Robbins Pathology PDF - Chapter 11: Lung

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