Lung Diseases Overview
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Questions and Answers

What is the most common cause of resorption atelectasis?

Obstruction of a bronchus by a mucous or mucopurulent plug, frequently postoperatively

What are the three forms of atelectasis?

Resorption atelectasis, Compression atelectasis, Contraction atelectasis

What is the most common cause of compression atelectasis?

Pleural effusion, most commonly by (CHF)

What is contraction atelectasis also known as?

<p>Cicatrization atelectasis</p> Signup and view all the answers

What is a common characteristic of obstructive airway disease?

<p>Limitation of airflow, usually resulting from an increase in resistance caused by partial or complete obstruction at any level</p> Signup and view all the answers

What are the five conditions listed as obstructive lung (airway) diseases?

<p>Emphysema, Chronic bronchitis, Bronchiectasis, Asthma</p> Signup and view all the answers

What are the two main types of restrictive lung diseases?

<p>Obstructive airway disease, Restrictive disease</p> Signup and view all the answers

What is the definition of emphysema?

<p>Abnormal permanent enlargement of air spaces distal to terminal bronchioles + destruction of walls without significant fibrosis</p> Signup and view all the answers

The definition of emphysema is based on which criteria?

<p>morphologic and radiologic features (C)</p> Signup and view all the answers

Chronic bronchitis is defined on the basis of which criteria?

<p>Clinical features</p> Signup and view all the answers

The clinical features of emphysema present with what characteristic?

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

What is the common name for patients with emphysema who have prominent dyspnea and adequate oxygenation of the lungs?

<p>Pink puffers</p> Signup and view all the answers

What is the definition of chronic bronchitis?

<p>Persistent productive cough for at least 3 consecutive months in at least 2 consecutive years</p> Signup and view all the answers

Who is chronic bronchitis common among?

<p>Cigarette smokers and urban dwellers in smog-ridden cities</p> Signup and view all the answers

What is the common name for patients with chronic bronchitis due to the discoloration of their skin?

<p>Blue bloaters</p> Signup and view all the answers

What is the most important cause of chronic bronchitis?

<p>Cigarette Smoking</p> Signup and view all the answers

What is the ratio of submucosal gland layer to bronchial wall known as?

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

What types of cells are the main inflammatory cells seen in the bronchial mucosa of patients with chronic bronchitis?

<p>Mononuclear cells and neutrophils</p> Signup and view all the answers

What are the two major ways that airflow obstruction in chronic bronchitis occurs?

<p>Small airway disease (A), Coexistent emphysema (C)</p> Signup and view all the answers

Chronic bronchiolitis, which is a form of small airway disease, is characterized by goblet cell metaplasia, mucous plugging, inflammation, and fibrosis.

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

What is bronchiolitis obliterans characterized by?

<p>Submucosal fibrosis</p> Signup and view all the answers

What is the definition of asthma?

<p>Chronic inflammatory disorder of airways causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and/or early in the morning</p> Signup and view all the answers

Asthma can be triggered by many different things, what is one example of what might trigger asthma?

<p>Environmental antigens, such as dusts, pollen, animal dander, and foods</p> Signup and view all the answers

What is the 'hygiene hypothesis' in relation to asthma?

<p>According to eradication of infections may alter immune homeostasis and promote allergic and other harmful immune responses</p> Signup and view all the answers

People with a genetic predisposition to type I hypersensitivity (atopy) are more at risk for asthma.

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

Skin tests for asthma are a form of immediate wheal-and-flare reaction.

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

What are the key cytokines produced in an atopic asthma reaction?

<p>IL-4, IL-5, IL-13</p> Signup and view all the answers

What are the two waves of asthma reaction, after an allergen engages with IgE coated submucosal mast cells?

<p>Early reaction, Late-phase reaction</p> Signup and view all the answers

What are the main characteristics of the early reaction phase of asthma?

<p>Bronchoconstriction, Increased mucus production, Variable vasodilation</p> Signup and view all the answers

The late-phase reaction of asthma is marked by bronchospasm and increased mucus production.

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

What is 'airway remodeling' in association with asthma?

<p>Structural changes in bronchial wall, as: Hypertrophy of bronchial smooth muscle and mucus glands, Increased vascularity, Deposition of subepithelial collagen</p> Signup and view all the answers

What are the key hallmarks of asthma?

<p>Intermittent, reversible airway obstruction (A), Chronic bronchial inflammation with eosinophils (B), Bronchial smooth muscle cell hypertrophy and hyperreactivity (C), Increased mucus secretion (D)</p> Signup and view all the answers

Non-atopic asthma is characterized by evidence of allergen sensitization and positive skin test results.

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

What are the two main examples of respiratory viruses commonly linked to non-atopic asthma?

<p>Rhinovirus, Parainfluenza virus</p> Signup and view all the answers

What are the three main types of inhaled air pollutants that can trigger non-atopic asthma?

<p>Sulfur dioxide, Ozone, NO</p> Signup and view all the answers

Eosinophils are primarily found in atopic asthma and not nonatopic asthma.

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

What is a key symptom of aspirin sensitivity in relation to drug-induced asthma?

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

What does aspirin inhibit in relation to drug-induced asthma?

<p>Cyclooxygenase pathway of arachidonic acid metabolism</p> Signup and view all the answers

What are three examples of fumes that can stimulate occupational asthma?

<p>Epoxy resins, plastics, organic and chemical dusts</p> Signup and view all the answers

What are the two main morphological features seen in asthma?

<p>Curschmann spirals, Charcot-Leyden crystals</p> Signup and view all the answers

What is the definition of bronchiectasis?

<p>Permanent dilation of bronchi and bronchioles caused by destruction of muscle and supporting elastic tissue associated with chronic necrotizing infections</p> Signup and view all the answers

What are the main symptoms of bronchiectasis?

<p>Cough and expectoration of copious amounts of purulent sputum</p> Signup and view all the answers

What are the two key diagnostic criteria for bronchiectasis?

<p>Appropriate history, Radiographic demonstration of bronchial dilation</p> Signup and view all the answers

What are two conditions that can predispose a patient to bronchiectasis?

<p>Bronchial obstruction, Congenital or hereditary conditions</p> Signup and view all the answers

What are the two main pathogenetic factors contributing to bronchiectasis?

<p>Obstruction, Chronic infection</p> Signup and view all the answers

Bronchiectasis typically affects the upper lobes of the lungs.

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

What are two notable histologic findings of bronchiectasis in an active case?

<p>An intense acute and chronic inflammatory exudate within walls of bronchi and bronchioles, Desquamation of lining epithelium</p> Signup and view all the answers

What are two of the most common bacteria seen in active bronchiectasis?

<p>Staphylococcus aureus, Klebsiella spp</p> Signup and view all the answers

What is a notable histologic finding of bronchiectasis in a chronic case?

<p>Fibrosis of bronchial and bronchiolar walls and peribronchiolar fibrosis develop</p> Signup and view all the answers

Bronchiectasis is characterized by the destruction of bronchial walls, which leads to the formation of abscess cavities.

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

What are the three complications that can result from bronchiectasis?

<p>Cor pulmonale (A), Metastatic brain abscesses (B), Reactive amyloidosis (C)</p> Signup and view all the answers

What is the most prevalent chronic occupational disease in the world?

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

What are the two forms of silica?

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

Silicotic nodules are typically found in which zone of the lungs?

<p>Upper zones of lungs</p> Signup and view all the answers

What is the characteristic appearance of collagen fibers in silicosis?

<p>&quot;Whorled&quot;</p> Signup and view all the answers

Silicotic nodules are primarily found in the center of the lungs.

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

When does shortness of breath typically manifest in silicosis?

<p>Late in the course, after PMF present</p> Signup and view all the answers

What are the two major complications that can result from silicosis?

<p>Both A and B (C)</p> Signup and view all the answers

Silicosis is linked to a higher risk of developing pulmonary cancer.

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

What is asbestosis?

<p>Parenchymal interstitial fibrosis</p> Signup and view all the answers

What are asbestos bodies?

<p>Golden brown, fusiform or beaded rods with a translucent center</p> Signup and view all the answers

What is the most common manifestation of asbestos exposure?

<p>Pleural plaques</p> Signup and view all the answers

Asbestosis is typically more common in the upper lobes of the lungs.

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

How much is the risk of lung carcinoma increased for asbestos workers?

<p>About five-fold</p> Signup and view all the answers

How much higher is the relative risk of developing mesothelioma for asbestos workers compared to the general population?

<p>Over 1000 times greater</p> Signup and view all the answers

Cigarette smoking is known to increase the risk of both lung carcinoma and mesothelioma in asbestos workers.

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

A complication associated with irradiation of pulmonary and other thoracic tumors can result in what condition?

<p>Radiation pneumonitis</p> Signup and view all the answers

In what stage of radiation pneumonitis is a patient most likely to experience fever, dyspnea, pleural effusion, and pulmonary infiltrates?

<p>Acute radiation pneumonitis</p> Signup and view all the answers

Flashcards

Atelectasis

Loss of lung volume caused by inadequate expansion of air spaces.

Resorption Atelectasis

Occurs when obstruction prevents air from reaching distal airways, causing alveolar collapse.

Compression Atelectasis

Occurs when fluid, blood, or air in the pleural cavity mechanistically collapses the adjacent lung.

Contraction Atelectasis

Occurs due to fibrotic changes in the lung or pleura that hamper expansion.

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Obstructive Pulmonary Diseases

Characterized by airflow limitation due to increased resistance from obstruction.

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Restrictive Pulmonary Diseases

Characterized by reduced lung expansion, leading to decreased lung capacity.

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Emphysema

Abnormal enlargement of air spaces distal to bronchioles with wall destruction, without significant fibrosis.

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Chronic Bronchitis

Persistent productive cough for at least 3 months in 2 consecutive years, often due to smoking.

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Asthma

Chronic inflammation of airways causing recurrent wheezing, breathlessness, and cough.

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Atopic Asthma

The most common asthma type, often starts in childhood, IgE-mediated hypersensitivity.

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Non-Atopic Asthma

Asthma without evidence of allergen sensitization; often triggered by respiratory infections.

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Drug-Induced Asthma

Recurrent bronchospasm associated with aspirin sensitivity.

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Bronchiectasis

Permanent dilation of bronchi and bronchioles caused by chronic infections and destruction of tissue.

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Acute Respiratory Distress Syndrome (ARDS)

Respiratory failure within 1 week of a clinical insult with bilateral opacities seen on imaging.

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Idiopathic Pulmonary Fibrosis (IPF)

Progressive bilateral interstitial fibrosis with unknown cause, often leading to dyspnea and cough.

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Pneumoconiosis

Lung disease caused by inhalation of mineral dust, such as coal or silica.

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Silicosis

Chronic disease from inhalation of crystalline silica, causing lung nodules and fibrosis.

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Asbestosis

Pulmonary interstitial fibrosis caused by asbestos exposure, potentially leading to cancer.

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Curschmann Spirals

Tenacious mucous plugs containing whorled shed epithelium, indicative of asthma.

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Charcot-Leyden Crystals

Crystalloids made up of eosinophil proteins, often found in asthma.

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Hyaline Membranes

Characteristic finding in ARDS consisting of edema and necrotic epithelial cells.

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Declining Lung Compliance

Reduced ability of lungs to expand, often seen in restrictive diseases.

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Cor Pulmonale

Right heart failure resulting from respiratory system disorders, often related to lung disease.

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Bronchial Smooth Muscle Hypertrophy

Increased muscle size in bronchi, common in asthma, causing airway narrowing.

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Pulmonary Alveolar Macrophage

Key cells in lung that initiate and perpetuate damage and fibrosis due to inhaled substances.

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Dyspnea

Difficult or labored breathing, a common symptom in lung diseases.

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Fibrin-Rich Edema Fluid

Fluid in ARDS that contains fibrin and necrotic cells, leading to hyaline membrane formation.

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Honeycomb Fibrosis

Characteristic finding in advanced pulmonary fibrosis with cystic spaces in lung tissue.

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Study Notes

Lung Diseases

  • Atelectasis (Collapse): Loss of lung volume from inadequate expansion of air spaces. Three types: resorption, compression, and contraction.
  • Resorption Atelectasis: Airway obstruction prevents air from reaching distal airways, causing air absorption and alveolar collapse. Causes include mucous plugs (often post-operative), bronchial asthma, chronic bronchitis, tumors, and foreign body aspiration (especially in children).
  • Compression Atelectasis (Passive/Relaxation): Fluid, blood, or air in the pleural cavity mechanically collapses the adjacent lung. Causes include pleural effusions (often due to congestive heart failure) and pneumothorax.
  • Basal Atelectasis: Failure to breathe deeply, commonly affecting bedridden patients with ascites, occurs during and after surgery.
  • Contraction Atelectasis (Cicatrization): Local or generalized fibrotic changes in the lung or pleura impair lung expansion.
  • Obstructive vs Restrictive Lung Diseases: Differentiated based on airflow limitation.
  • Obstructive (Airway) Diseases: Characterized by airflow limitation, typically due to increased resistance caused by partial or complete airway obstruction at any level. Examples include emphysema, chronic bronchitis, bronchiectasis, and asthma.
  • Restrictive Diseases: Characterized by reduced expansion of the lung parenchyma accompanied by decreased total lung capacity. This can result from chest wall disorders or acute/chronic interstitial lung diseases. Examples include severe obesity, diseases of the pleura, neuromuscular disorders (like Guillain-Barré syndrome), acute respiratory distress syndrome (ARDS), pneumoconiosis, interstitial fibrosis, and infiltrative conditions (like sarcoidosis).
  • Emphysema: Abnormal permanent enlargement of air spaces distal to terminal bronchioles, along with the destruction of alveolar walls without significant fibrosis. Types include: centriacinar (centrilobular), panacinar (panlobular), and distal acinar (paraseptal). The most common types are centriacinar (often associated with smoking) and panacinar (often associated with a1-antitrypsin deficiency).
  • Chronic Bronchitis: Persistent productive cough for at least 3 consecutive months in at least 2 consecutive years, prevalent in smokers and urban dwellers in polluted cities. Typically accompanied by cyanosis (“blue bloaters”). The main cause is cigarette smoking and other air pollutants. Mucus hypersecretion and thickening of the submucosal gland layer are observed.
  • Asthma: Chronic inflammatory disorder of the airways causing recurrent episodes of wheezing, breathlessness, chest tightening, and cough, especially at night or early morning. Types include atopic and non-atopic. Atopic asthma is triggered by environmental antigens. Non-atopic asthma has no clear trigger.
  • Bronchiectasis: Permanent dilation of bronchi and bronchioles due to destruction of muscle and supporting elastic tissue, associated with chronic necrotizing infections and characterized by a cough producing copious amounts of purulent sputum. Conditions that predispose to bronchiectasis include bronchial obstruction, congenital/hereditary conditions (like cystic fibrosis), immunodeficiency states, primary ciliary dyskinesia (immobile cilia syndrome), and necrotizing/suppurative pneumonia (caused by bacteria).
  • Acute Respiratory Distress Syndrome (ARDS): Respiratory failure within a week of a known clinical insult, characterized by bilateral pulmonary opacities, severe arterial hypoxemia, and refractory to oxygen therapy. Caused by widespread alveolar damage, primary pulmonary diseases, sepsis, pneumonia, aspiration, trauma, pancreatitis, and transfusion reactions. The main cause of ARDS is diffuse alveolar damage.
  • Chronic Interstitial Lung Diseases: Bilateral, often patchy, pulmonary fibrosis mainly affecting the alveolar walls. Categorized into fibrosing diseases (e.g., idiopathic pulmonary fibrosis (IPF) which is characterized by a gradual onset of a non-productive cough), granulomatous disease (e.g., sarcoidosis), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia, and pneumoconioses (e.g., coal worker's pneumoconiosis (CWP), silicosis, and asbestosis).
  • Pneumoconiosis: Lung disorders caused by inhaling mineral dusts (organic and inorganic particulates). Silica, asbestos, and beryllium are more strongly associated with fibrosis than coal dust.

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Description

This quiz covers various lung diseases, focusing on atelectasis and its types, including resorption, compression, and contraction. Additionally, it explores the differences between obstructive and restrictive lung diseases. Perfect for students and healthcare professionals looking to solidify their understanding of respiratory conditions.

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