Medicine Marrow Pg 261-270 (Pulmonology)
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Questions and Answers

Which of the following is NOT a type of Chronic Obstructive Pulmonary Disease (COPD)?

  • Emphysema
  • Mixed COPD
  • Asthma (correct)
  • Chronic bronchitis

    • Chronic Obstructive Pulmonary Disease is characterized by temporary respiratory symptoms.

    False

    What are the two main types of COPD based on clinical presentation?

    Chronic bronchitis and emphysema

    COPD results in progressive airflow limitation due to abnormalities of the airway and _____

    <p>alveoli</p> Signup and view all the answers

    Match the types of COPD to their corresponding characteristics:

    <p>Chronic bronchitis = Produces a lot of mucus and persistent cough Emphysema = Destruction of alveoli leading to less surface area Large airway involvement = Affects the bronchial tubes Small airway involvement = Involves bronchioles with smaller diameter</p> Signup and view all the answers

    At what age is chronic bronchitis typically diagnosed?

    <p>40-45 years</p> Signup and view all the answers

    Emphysema is characterized by cough with copious sputum.

    <p>False</p> Signup and view all the answers

    What is the primary pathological feature seen in chronic bronchitis?

    <p>Large airway disease and parenchymal destruction</p> Signup and view all the answers

    In emphysema, the dilation occurs in the airway distal to the __________.

    <p>terminal bronchiole</p> Signup and view all the answers

    Match the conditions with their respective clinical features:

    <p>Chronic Bronchitis = Cyanosis, RV failure Emphysema = Cachexia, pursed lips</p> Signup and view all the answers

    Which of the following is a common lung condition in smokers?

    <p>Both Chronic Bronchitis and Emphysema</p> Signup and view all the answers

    Pulmonary Function Tests in emphysema show decreased Total Lung Capacity (TLC).

    <p>False</p> Signup and view all the answers

    What type of emphysema is most commonly seen in smokers?

    <p>Centriacinar emphysema</p> Signup and view all the answers

    Which of the following is NOT a cause of transudative pleural effusion?

    <p>Malignancy</p> Signup and view all the answers

    Tracheal deviation towards the affected side is a common finding in pleural effusion.

    <p>False</p> Signup and view all the answers

    What imaging finding is characteristic of a pleural effusion on a chest X-ray?

    <p>White area or blunting of the costophrenic angle</p> Signup and view all the answers

    In a pleural effusion due to tuberculosis, approximately ____ to ____ percent of patients develop pulmonary TB after 5-10 years.

    <p>25-30</p> Signup and view all the answers

    Match the following diseases to their associated pleural effusion type:

    <p>Cirrhosis = Transudative Malignancy = Exudative Tuberculosis = Exudative Nephrotic syndrome = Transudative</p> Signup and view all the answers

    What is the significance of pleural fluid glucose levels in diagnosis?

    <p>It provides information on potential malignancy.</p> Signup and view all the answers

    Pleural effusion can result in elevated glucose levels in pleural fluid.

    <p>False</p> Signup and view all the answers

    What condition is indicated by low pleural fluid glucose levels?

    <p>Infection or malignancy</p> Signup and view all the answers

    Pleural effusion can be categorized into transudate and __________.

    <p>exudate</p> Signup and view all the answers

    Match the following conditions with their possible pleural fluid glucose levels:

    <p>Parapneumonic effusion = Low glucose Malignant effusion = Low glucose Transudative effusion = Normal glucose Tuberculosis pleuritis = Low glucose</p> Signup and view all the answers

    What is the primary treatment for Severe Obstructive Sleep Apnea (OSAS)?

    <p>Continuous Positive Airway Pressure (CPAP)</p> Signup and view all the answers

    A full face mask provides a less complete seal for ventilation compared to a nasal mask.

    <p>False</p> Signup and view all the answers

    Name one type of mask used in CPAP treatment.

    <p>Nasal mask or Full face mask</p> Signup and view all the answers

    Patients with Severe Obstructive Sleep Apnea (OSAS) often require _____ to help maintain open airways during sleep.

    <p>CPAP</p> Signup and view all the answers

    Match the type of CPAP mask with its description:

    <p>Nasal Mask = Fits over the nose and mouth for pressure ventilation Full Face Mask = Covers the entire face for a complete seal</p> Signup and view all the answers

    Which type of emphysema affects the entire acinus?

    <p>Panacinar</p> Signup and view all the answers

    Panacinar emphysema is associated with abnormalities in terminal bronchioles only.

    <p>False</p> Signup and view all the answers

    List the types of emphysema discussed.

    <p>Panacinar, Paraseptal, Irregular</p> Signup and view all the answers

    The primary pathological feature in emphysema is the destruction of __________.

    <p>alveoli</p> Signup and view all the answers

    Match the type of emphysema with the corresponding characteristics:

    <p>Panacinar = Affects the entire acinus Paraseptal = Affects peripheral alveolar ducts and alveoli Irregular = Irregular patterns of destruction</p> Signup and view all the answers

    Which of the following describes a symptom of obstructive sleep apnea syndrome?

    <p>Excessive daytime sleepiness</p> Signup and view all the answers

    Obstructive sleep apnea occurs only during the non-REM phase of sleep.

    <p>False</p> Signup and view all the answers

    What is the Apnea Hypopnea Index (AHI) value indicating severe obstructive sleep apnea syndrome?

    <p>30</p> Signup and view all the answers

    In obstructive sleep apnea syndrome, __________ cessation of breathing lasts for more than 10 seconds.

    <p>apnea</p> Signup and view all the answers

    Match the following risk factors with their descriptions:

    <p>Obesity = Increases fat that can obstruct airways Male sex = Higher prevalence in males compared to females Age 50-60 years = Associated with increased risk of sleep apnea Postmenopausal state = Hormonal changes that elevate risk</p> Signup and view all the answers

    Which of the following features distinguishes a complicated parapneumonic effusion from an uncomplicated one?

    <p>Glucose level &lt; 7.2 g/L</p> Signup and view all the answers

    Empyema is defined as uncomplicated parapneumonic effusion with the presence of pus.

    <p>False</p> Signup and view all the answers

    What is the characteristic appearance of chylothorax?

    <p>Milky white</p> Signup and view all the answers

    Pseudochylothorax is characterized by increased __________ and pleural thickening enriched with cholesterol crystals.

    <p>triglycerides</p> Signup and view all the answers

    Match the following conditions to their features:

    <p>Chylothorax = Milky white appearance due to trauma or lymphoma Pseudochylothorax = Pleural fluid with increased triglycerides and cholesterol Empyema = Complicated parapneumonic effusion with pus Complicated parapneumonic effusion = Bacterial invasion with high LDH and low glucose</p> Signup and view all the answers

    What is a common daytime symptom of Obstructive Sleep Apnea Syndrome?

    <p>Cognitive defects</p> Signup and view all the answers

    Snoring is considered a cardinal symptom of Obstructive Sleep Apnea Syndrome.

    <p>True</p> Signup and view all the answers

    What is the primary method used for diagnosing Obstructive Sleep Apnea Syndrome?

    <p>Polysomnography</p> Signup and view all the answers

    Obstructive Sleep Apnea Syndrome can lead to increased risk of __________ due to cardiac rhythm abnormalities.

    <p>sudden cardiac death</p> Signup and view all the answers

    Match the following symptoms with their associated descriptions:

    <p>Nocturia = Frequent urination at night Dry throat = A sensation of dryness in the throat upon waking Morning headache = Head pain experienced after waking from sleep Cognitive defects = Problems with concentration and mood changes</p> Signup and view all the answers

    Which feature is absent in chronic bronchitis but present in severe asthma?

    <p>Necrosis of epithelium</p> Signup and view all the answers

    In emphysema, the alveoli are easily inflatable due to disrupted alveolar attachments.

    <p>True</p> Signup and view all the answers

    What condition results in hyperinflated lungs with increased total lung capacity (TLC) and residual volume (RV)?

    <p>Emphysema</p> Signup and view all the answers

    In chronic bronchitis, __________ metaplasia is present, while in severe asthma it is absent.

    <p>squamous</p> Signup and view all the answers

    Match the features to their related conditions:

    <p>Increased bronchospasm = Chronic Bronchitis Peribronchial fibrosis = Emphysema Mucus secretion increased = Chronic Bronchitis Inflammatory exudate in lumen = Emphysema</p> Signup and view all the answers

    What happens during forceful exhalation in emphysema?

    <p>Driving Pressure (DP) becomes less than Airway Pressure (AP)</p> Signup and view all the answers

    Bronchospasm is not increased in mild chronic bronchitis.

    <p>False</p> Signup and view all the answers

    List one type of inflammatory cell found in the thickened walls of small airways affected by emphysema.

    <p>Macrophages</p> Signup and view all the answers

    Study Notes

    Chronic Obstructive Pulmonary Disease (COPD)

    • COPD is a chronic, progressive lung disease characterized by airflow limitation and abnormalities in the airways and alveoli.
    • Chronic bronchitis is defined by a cough with sputum production for at least 3 months per year for 2 consecutive years.
    • Emphysema is characterized by the abnormal dilatation of airspaces distal to the terminal bronchiole, leading to destruction of the alveolar walls.
    • Emphysema affects the small airways, while chronic bronchitis affects the large airways.
    • Centriacinar emphysema is the most common type of emphysema and is often seen in smokers.

    Obstructive Sleep Apnea Syndrome (OSAS)

    • OSAS is a sleep disorder characterized by repeated episodes of upper airway obstruction during sleep, leading to snoring, pauses in breathing (apnea), and reduced breathing (hypopnea).
    • The severity of OSAS is measured by the Apnea Hypopnea Index (AHI), which is the number of apneas and hypopneas per hour of sleep.
    • An AHI of 30 or more is considered severe OSAS and typically necessitates treatment with Continuous Positive Airway Pressure (CPAP).
    • Risk factors for OSAS include: obesity, central fat distribution, male sex, age 50-60 years, postmenopausal state, alcohol use, sedative use, and smoking.
    • Complications of OSAS include: sudden cardiac death, stroke, congestive heart failure, and metabolic syndrome.
    • Management of OSAS includes polysomnography (sleep study) and CPAP.

    Pleural Effusion

    • A pleural effusion is an abnormal accumulation of fluid in the pleural space, the space between the lungs and the chest wall.
    • Pleural effusions can be transudative or exudative.

    Transudative Pleural Effusion

    • Transudative pleural effusions are caused by increased hydrostatic pressure or decreased oncotic pressure in the capillaries.
    • Causes of transudative pleural effusions include: congestive heart failure, cirrhosis, nephrotic syndrome, hypoalbuminemia, and hypothyroidism.

    Exudative Pleural Effusion

    • Exudative pleural effusions are caused by inflammation or infection.
    • Causes of exudative pleural effusions include: pneumonia, tuberculosis, malignancy, and connective tissue disorders.

    Pleural Effusion with Tuberculosis

    • Pleural effusion due to tuberculosis typically occurs in individuals aged 20-30 years, with a female predominance.
    • It is often associated with recent exposure to tuberculosis.
    • Patients with pleural effusion due to primary tuberculosis may develop pulmonary tuberculosis in 25-30% of cases within 5-10 years.

    Empyema

    • Empyema is a complicated parapneumonic effusion characterized by the presence of macroscopic pus in the pleural space.
    • Empyema is a common complication of parapneumonic effusions.
    • Low pleural fluid pH can indicate complicated parapneumonic effusion, rheumatoid arthritis, or malignancy.

    Chylothorax

    • Chylothorax is a milky white pleural effusion caused by lymphatic rupture, most commonly triggered by trauma, tuberculosis, or lymphoma.

    Pseudochylothorax

    • Pseudochylothorax is a milky white pleural effusion that mimics chylothorax but is not actually due to lymphatic leakage.
    • The milky color is due to high levels of cholesterol crystals in the pleural fluid caused by inflammation.
    • Often associated with tuberculosis or rheumatoid arthritis.

    Chronic Bronchitis (Large Airways)

    • Bronchospasm is increased in chronic bronchitis, but less so than in asthma.
    • Mucus secretion is also increased in chronic bronchitis.
    • Epithelial necrosis is absent in mild chronic bronchitis, but squamos metaplasia is present.

    Emphysema (Small Airways)

    • Inflammation is evident in the small airways, with inflammatory exudate in the lumen.
    • Alveolar attachments are disrupted.
    • The alveoli are easily inflatable due to decreased elastic recoil pressure (ERP).
    • The airway wall thickens with inflammatory cells, including macrophages, CD8+ cells, and fibroblasts.
    • Emphysema is characterized by peribronchial fibrosis and lymphoid follicle formation.
    • Emphysema causes hyperinflation of the lungs (increased total lung capacity, increased residual volume).

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    Description

    Test your knowledge on Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea Syndrome (OSAS). This quiz covers key definitions, symptoms, and differences between these chronic conditions. Enhance your understanding of these critical respiratory disorders.

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