أسئلة المحاضرة الخامسة باثولوجي RESP (قبل التعديل)
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Questions and Answers

What is the primary characteristic of COPD?

  • Reversible airway obstruction
  • Increased lung elastic recoil
  • Resistance to air flow due to obstruction (correct)
  • Acute respiratory distress

Which of the following is a cause of chronic bronchitis?

  • Cigarette smoking (correct)
  • Viral infections
  • Exposure to cold weather
  • Genetic mutations

What is a common pathological finding in the bronchial mucosa of a COPD patient?

  • Decreased mucous production
  • Squamous cell metaplasia (correct)
  • Increased ciliated cells
  • Dilation of the airway

Which type of emphysema predominantly affects the respiratory bronchioles?

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

What defines chronic bronchitis clinically?

<p>Cough with sputum for 3 consecutive months (D)</p> Signup and view all the answers

What is a common complication of COPD?

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

In which demographic is emphysema most commonly observed?

<p>Middle-aged males aged 40-60 (B)</p> Signup and view all the answers

What is one effect of mucous gland hyperplasia seen in COPD?

<p>Excess mucous production (D)</p> Signup and view all the answers

What is the main consequence of the elastase-antielastase imbalance theory associated with smoking?

<p>Weakening of the walls of air spaces (D)</p> Signup and view all the answers

Which of the following best describes the Direct Damage Theory related to cigarette smoking?

<p>It states that the walls of air spaces are injured by toxic substances from smoke. (C)</p> Signup and view all the answers

In chronic bronchitis, what role do neutrophils play in the disease process?

<p>They secrete elastase, which contributes to tissue damage. (C)</p> Signup and view all the answers

What anatomical changes characterize centriacinar emphysema?

<p>Enlargement of upper zones of lung lobes (A)</p> Signup and view all the answers

Which description fits the appearance of the lungs in panacinar emphysema?

<p>Pale and dry with a feathery feeling (C)</p> Signup and view all the answers

What notable physical feature develops in patients with panacinar emphysema?

<p>Barrel-shaped chest (C)</p> Signup and view all the answers

What are bullae in the context of panacinar emphysema?

<p>Fluid-filled sacs larger than 1 cm in diameter (D)</p> Signup and view all the answers

How does smoking affect mucus secretion in chronic bronchitis?

<p>It stimulates excessive mucus secretion, causing obstruction. (C)</p> Signup and view all the answers

What characterizes centrilobular emphysema?

<p>Dilated respiratory bronchioles with normal alveoli (C)</p> Signup and view all the answers

Which condition is characterized by the escape of alveolar air into interstitial tissue?

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

What is the main cause of bronchiectasis?

<p>Frequent lung infections (A)</p> Signup and view all the answers

Which of the following is a feature of panacinar emphysema?

<p>Few in number and ruptured alveolar septa (D)</p> Signup and view all the answers

What type of emphysema results from increased lung volume caused by chronic obstruction?

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

Which of the following symptoms may indicate respiratory failure?

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

What distinguishes chronic bronchitis from other COPD conditions?

<p>Presence of chronic suppurative inflammation (C)</p> Signup and view all the answers

Which statement is true about respiratory bronchioles in emphysema?

<p>They undergo irreversible dilatation (B)</p> Signup and view all the answers

What pathological change occurs in the bronchial mucosa due to chronic irritation in COPD?

<p>Thickening and opacity of the mucosa (A)</p> Signup and view all the answers

Which of the following describes the primary physiological change in emphysema?

<p>Permanent dilation of air spaces with wall damage (B)</p> Signup and view all the answers

What is the most common demographic profile for patients diagnosed with emphysema?

<p>Middle-aged men aged 40-60 (B)</p> Signup and view all the answers

Which of the following best describes centriacinar emphysema?

<p>Primarily involves the respiratory bronchioles (D)</p> Signup and view all the answers

Which of the following best describes the effect of smoking on elastase and antielastase levels?

<p>Smoking increases elastase and decreases antielastase levels. (C)</p> Signup and view all the answers

What direct consequence of chronic bronchitis involves mucus secretion?

<p>Increased mucus production that leads to airway obstruction. (D)</p> Signup and view all the answers

Chronic inflammation in COPD is primarily triggered by which factors?

<p>Cigarette smoking and atmospheric pollution (C)</p> Signup and view all the answers

What complication associated with COPD can lead to sustained pulmonary hypertension?

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

Which statement accurately reflects the structural changes in the lungs of patients with panacinar emphysema?

<p>Large bullae form due to the destruction of elastic tissue. (B)</p> Signup and view all the answers

Which process best describes the impact of smoking on mucous glands in COPD?

<p>Hyperplasia of mucous glands leading to excess mucous (C)</p> Signup and view all the answers

What role do neutrophils play in the pathogenesis of smoking-related lung disease?

<p>They recruit macrophages and release elastase. (A)</p> Signup and view all the answers

What clinical symptom characterizes chronic bronchitis as defined in COPD?

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

In which anatomical regions does centriacinar emphysema primarily manifest?

<p>Upper zones of lung lobes. (B)</p> Signup and view all the answers

What defines the physical appearance of lungs affected by severe panacinar emphysema?

<p>They present indentations from adjacent ribs. (D)</p> Signup and view all the answers

Which statement describes an effect of the elastase-antielastase imbalance in patients with genetic susceptibility?

<p>A deficiency of antielastase leading to lung tissue degradation. (D)</p> Signup and view all the answers

How does the wall structure of air spaces change in response to cigarette smoke toxicity according to the Direct Damage Theory?

<p>The walls are destroyed and become porous. (C)</p> Signup and view all the answers

Which type of emphysema is characterized by the irreversible dilation of bronchi and bronchioles?

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

What type of emphysema results from compression of interalveolar capillaries?

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

What finding is characteristic of the lumen in bronchi affected by bronchiectasis?

<p>Shedded epithelial cells, inflammatory cells, and RBCs (B)</p> Signup and view all the answers

What effect does chronic pyogenic infection have on bronchial walls in bronchiectasis?

<p>They show chronic suppurative inflammation (D)</p> Signup and view all the answers

Which form of emphysema is characterized by the escape of alveolar air into interstitial tissue of the lung?

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

Which of the following best describes the pathology of chronic bronchitis in the respiratory system?

<p>Chronic suppurative inflammation in the walls (C)</p> Signup and view all the answers

What are the potential forces contributing to the dilatation in bronchiectasis?

<p>Internal pushing forces and external pulling forces (B)</p> Signup and view all the answers

What is a possible clinical appearance of bronchi affected by interstitial emphysema?

<p>Presence of interstitial air pockets in the lung tissue (D)</p> Signup and view all the answers

Flashcards

COPD Definition

A group of lung diseases causing airflow problems due to obstructions.

COPD Types

Chronic bronchitis, bronchial asthma, emphysema and bronchiectasis are types of COPD.

Chronic Bronchitis Definition

Persistent cough with phlegm (sputum) for at least 3 months in 2 consecutive years.

Emphysema Definition

Permanent damage to air sacs (alveoli) leading to difficulty breathing.

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Emphysema Causes

Smoking, pollution, and upper respiratory infections can cause emphysema.

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Emphysema Pathology

Thickened bronchial walls with excess mucus, reduced cilia, and inflammatory cells are common findings in emphysema.

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Emphysema Complications

Hypoxia, pulmonary hypertension, and heart failure can occur.

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Emphysema Types (Centrilobular/Panacinar)

Centrilobular affects the central part of the air sacs, while panacinar affects the whole air sac.

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Elastase-antielastase imbalance

Smoking increases elastase, weakening lung tissue, while decreasing antielastase, leading to lung damage.

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Direct damage theory (smoking)

Toxic substances in cigarette smoke directly injure the walls of air spaces in the lungs.

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Chronic bronchitis

Smoking causes increased mucus production and inflammation in the airways, partially blocking them.

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Centriacinar emphysema

Lung damage from smoking, affecting the upper parts of the lungs first, creating enlarged air spaces.

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Panacinar emphysema

Lung damage affecting the lower parts of the lungs first, resulting in large, air-filled spaces.

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Barrel chest

Abnormal chest shape with increased anteroposterior (front-to-back) diameter.

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Bullae (lung)

Large, air-filled spaces in the lungs, usually in the weakened areas.

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α1 antitrypsin Deficiency

Inherited deficiency of the protein that protects lung tissue from damage, leading to an imbalance with elastase.

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Centrilobular Emphysema

A type of emphysema where the respiratory bronchioles are dilated, but the alveoli remain normal.

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COPD Complications

COPD can lead to pulmonary hypertension (high blood pressure in the lungs), right-sided heart failure, and respiratory failure.

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Bronchiectasis Definition

Permanent, irreversible widening of medium-sized bronchi and bronchioles, often accompanied by chronic suppurative inflammation.

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Bronchiectasis Causes

Bronchiectasis can be caused by chronic pyogenic infection, weak bronchial walls, or forces from inside or outside the airways.

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Bronchiectasis Pathology

Bronchiectasis involves dilated bronchi filled with pus, thick lining, and inflammation, with fibrosis in the walls.

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Bronchiectasis Microscopic Features

Microscopic examination shows chronic suppurative inflammation with the presence of shedded epithelial cells, inflammatory cells, and RBCs.

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Direct Damage Theory

Toxic substances in cigarette smoke directly injure the walls of air spaces in the lungs, causing inflammation and damage.

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Chronic Bronchitis Theory

Smoking causes increased mucus production, inflammation, and narrowing of airways, leading to difficulty breathing. Mucus plugs partially block bronchi and bronchioles, trapping air during exhalation.

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Bullae

Large air-filled spaces that develop in the lungs, usually in areas where lung tissue has been weakened by emphysema.

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COPD Pathophysiology

COPD involves both chronic bronchitis and emphysema, leading to airflow limitations due to airway inflammation and damage to the lung's air sacs.

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Bronchiectasis

Permanent widening of medium-sized bronchi and bronchioles, often accompanied by chronic inflammation and pus formation.

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COPD Clinical Manifestations

COPD can lead to pulmonary hypertension, right-sided heart failure, and respiratory failure due to the reduced airflow and oxygen levels.

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COPD Risk Factors

Smoking, air pollution, and occupational exposures are major risk factors for COPD.

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Emphysema Types

Centrilobular (central part of acinus) and panacinar (entire acinus) are two types of emphysema based on the area affected.

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Study Notes

Chronic Obstructive Pulmonary Disease (COPD)

  • COPD is a group of lung diseases characterized by resistance to airflow due to partial or complete obstruction.
  • Types include chronic bronchitis, emphysema, and bronchiectasis.

Chronic Bronchitis

  • Definition: Persistent productive cough (coughing up sputum) for at least 3 consecutive months in at least 2 consecutive years.
  • Causes: Chronic irritation of bronchial mucosa, due to:
    • Cigarette smoking
    • Atmospheric pollution
    • Chronic inflammation of upper respiratory tract, tonsils, or mouth.
  • Pathology: Bronchial mucosa appears thick, opaque, and covered by excess mucus. Mucus gland hyperplasia and decreased number of ciliated cells are observed. Squamous metaplasia and chronic inflammatory cell infiltrations are also present.

Emphysema

  • Definition: Permanent dilatation of air spaces distal to the terminal bronchioles, with damage to their walls (respiratory bronchioles, alveolar ducts, and alveoli).
  • Incidence: The most common chronic lung disease, more frequent in males aged 40-60 years.
  • Types: Centrilobular (affects respiratory bronchioles first, commonly in smokers) and Panacinar (affects the entire acinus, often associated with genetic deficiency of alpha-1-antitrypsin) are two kinds of emphysema.

Bronchiectasis

  • Definition: Permanent (irreversible) dilatation of medium-sized bronchi and bronchioles.
  • Cause: Chronic suppurative inflammation within the walls and surrounding lung tissue.
  • Clinical Presentation: Frequent before age 20; males more than females. Weak bronchial wall, often linked to chronic pyogenic infection. Forces for dilatation due to bronchial obstruction (pushing forces) and external factors (pulling forces).

Complications

  • Respiratory System: Chronic bronchitis, interstitial emphysema, spontaneous pneumothorax, and respiratory failure.
  • Cardiovascular System: Pulmonary hypertension and right-sided heart failure.

Other Types of Emphysema

  • Obstructive hyperinflation
  • Compensatory hyperinflation
  • Senile (atrophic) hyperinflation
  • Interstitial Emphysema: alveolar air enters the interstitial tissue of the lung.

Pathological Findings

  • Centrilobular Emphysema: Dilated respiratory bronchioles, normal alveolar ducts and alveoli.
  • Panacinar Emphysema: Few, enlarged alveolar sacs; thinning and distortion of alveolar septa; disruption of alveolar septa; compression of interalveolar capillaries by dilated air spaces.
  • Bronchiectasis: Bilaterally affected (typically basal), dilated bronchi and bronchioles filled with pus, thickened lining and fibrotic walls; chronic suppurative inflammation in the lumen, mucosa showing extensive ulceration and infiltration of the wall by inflammatory cells. Areas of lung collapse and fibrosis, as well as compensatory emphysema are common.

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