55 Questions
Which of the following is a chronic obstructive lung disease?
Emphysema
What is the major function of the lung?
Replenishing oxygen and removing carbon dioxide from blood
Which condition is characterized by inflammation and narrowing of the airways?
Asthma
What is a common cause of pleural effusion?
Congestive heart failure
What is the major pattern of emphysema?
Centriacinar
Which type of structures can form in the alveoli, leading to bullae and spontaneous pneumothorax in young adults?
Cystic structures
What is a common cause of emphysema?
Smoking or air pollutants
What is the characteristic feature of emphysema on macroscopic appearance?
Pale, voluminous lungs in panacinar emphysema
What can chronic injury such as smoking lead to in the lungs?
Alveolar wall destruction and overinflation
What is a characteristic feature of chronic bronchitis?
Productive cough and airway inflammation
Which condition is characterized by diffuse alveolar damage and affects approximately 190,000 patients per year in the US?
Acute Respiratory Distress Syndrome (ARDS)
What is the crucial role of neutrophils and their products in the pathogenesis of ARDS?
Inducing endothelial and epithelial injury
What is the effect of interleukin 8 (IL-8) synthesis on neutrophils in ARDS?
Leads to neutrophil sequestration and activation in pulmonary capillaries
What is observed in the acute phase upon histologic examination of lungs in ARDS?
Increased neutrophils in vascular spaces, interstitium, and alveoli
What role do activated neutrophils play in ARDS?
Release reactive oxygen species, proteases, and other damaging products
What occurs in the organizing stage of ARDS?
Fibroblasts proliferate, resulting in intraalveolar fibrosis and thickening of alveolar septa
What are predictors of poor prognosis in ARDS?
Advanced age, bacteremia (sepsis), and multiorgan failure
Which component of the normal alveolus is affected by proinflammatory cytokines in ARDS?
Surfactant layer
What shared similarity does ARDS have with respiratory distress syndrome of the newborn?
Presence of hyaline membranes
Which type of lung disease includes conditions causing reduced lung volumes with preserved expiratory flow rates?
Acute restrictive lung diseases
What is a characteristic feature of chronic restrictive lung diseases?
Interstitial fibrosis
What plays a crucial role in causing vascular leakiness and surfactant loss in ARDS?
Activated neutrophils' release of damaging products
Which structure is the ultimate site of gas exchange in the lung?
Alveoli
What is the most common trigger of acute respiratory distress syndrome (ARDS)?
Pneumonia
Which form of atelectasis occurs due to a failure to breathe deeply, commonly in bedridden patients or those with ascites?
Basal atelectasis
What is the characteristic feature of acute respiratory distress syndrome (ARDS)?
Inflammatory reaction initiated by pro-inflammatory mediators
What is the division of the lung for classification of diseases, including the airways, interstitium, and pulmonary vascular system?
Compartments
What is the loss of lung volume leading to inadequate oxygenation and hypoxia called?
Atelectasis
Which form of atelectasis occurs due to an obstruction that prevents air from reaching distal airways?
Resorption atelectasis
What is a severe form of respiratory failure characterized by extensive bilateral injury to alveoli, caused by diverse clinical insults?
ARDS
Which type of atelectasis is caused by accumulation of fluid, blood, or air within the pleural cavity?
Compression atelectasis
What is a potentially reversible condition characterized by an inflammatory reaction initiated by pro-inflammatory mediators?
ARDS
What are the smaller airways called that result from the division of the main bronchi?
Bronchioles
What is the term for a form of diffuse alveolar damage having three forms of atelectasis: resorption, compression, and basal?
Atelectasis
What is the primary cause of chronic airflow obstruction in severe emphysema?
Reduced radial traction on the small airways
Which symptom is usually the first to appear in patients with emphysema?
Dyspnea
What is the classic presentation of emphysema with no 'bronchitic' component?
Barrel-chested and dyspneic, sitting forward in a hunched-over position
What is the term used to describe the dilation of residual alveoli in response to loss of lung substance elsewhere?
Compensatory emphysema
What may occur if a sudden increase in intraalveolar pressure causes alveolar rupture, allowing air to dissect into the interstitium of the lung?
Mediastinal emphysema
What causes bullous emphysema to produce large subpleural blebs or bullae?
Localized accentuations of alveolar walls
What type of emphysema is characterized by expansion of the lung due to air trapping?
Obstructive overinflation
What condition involves dilation of residual alveoli in response to loss of lung substance elsewhere?
Compensatory emphysema
What type of emphysema is most commonly seen in α1-anti-trypsin deficiency?
Panacinar emphysema
In which form does bullous emphysema produce large subpleural blebs or bullae?
Panacinar form
What causes mediastinal (interstitial) emphysema?
Entry of air into the interstitium of the lung
What is the characteristic feature of emphysema?
Uniform enlargement of the acini from the respiratory bronchiole to the terminal blind alveoli
Which lung disease is characterized by an increase in resistance to airflow due to partial or complete airway obstruction?
Chronic bronchitis
What is the distinguishing feature of panacinar emphysema compared to centriacinar emphysema?
Uniform enlargement of the acini from the respiratory bronchiole to the terminal blind alveoli
Which lung disease involves resorption of hyaline membranes and thickening of alveolar septa by inflammatory cells, fibroblasts, and collagen during the healing stage?
Pulmonary fibrosis
What is a characteristic feature of distal acinar (paraseptal) emphysema?
Primarily affected distal part of the acinus with severe lower lung zone involvement
Which lung disease affects more than 10% of the US adult population and is the fourth leading cause of death in the country?
Chronic obstructive pulmonary disease (COPD)
What distinguishes obstructive lung diseases from restrictive lung diseases?
Increase in resistance to air flow due to partial or complete airway obstruction
What is a common cause of chronic obstructive pulmonary disease (COPD)?
Tobacco smoke and air pollutants
Which pulmonary disease is characterized by reversible airflow obstruction?
Asthma
What is a distinguishing feature of centriacinar emphysema?
Central or proximal parts of the acini being affected, while distal alveoli are spared
Study Notes
- Some alveoli in the lungs have collapsed air spaces, while others are expanded with hyaline membranes.
- The healing stage of lung diseases involves the resorption of hyaline membranes and thickening of alveolar septa by inflammatory cells, fibroblasts, and collagen.
- Diffuse pulmonary diseases can be classified into obstructive (airway) and restrictive diseases.
- Obstructive lung diseases, including emphysema, chronic bronchitis, asthma, and bronchiectasis, are characterized by an increase in resistance to air flow due to partial or complete airway obstruction.
- Emphysema is a chronic condition marked by permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by destruction of their walls without significant fibrosis.
- Centriacinar emphysema is characterized by the central or proximal parts of the acini being affected, while distal alveoli are spared. It is more common in cigarette smokers and often occurs in association with chronic bronchitis.
- Panacinar emphysema is characterized by uniform enlargement of the acini from the respiratory bronchiole to the terminal blind alveoli. It is more common in the lower lung zones and is associated with α1-anti-trypsin deficiency.
- Distal acinar (paraseptal) emphysema involves the distal part of the acinus being primarily affected. It is more severe in the upper half of the lungs and occurs adjacent to areas of fibrosis, scarring, or atelectasis.
- Chronic obstructive pulmonary disease (COPD) is a grouping of obstructive lung diseases that affects more than 10% of the US adult population and is the fourth leading cause of death in the country.
- COPD is characterized by largely irreversible airflow obstruction, while asthma, which is also a pulmonary disease, is characterized by reversible airflow obstruction.
- COPD can be caused by tobacco smoke and air pollutants, while asthma can be caused by immunologic or undefined causes.
- Emphysema can occur without chronic bronchitis, but the two diseases often coexist due to their common cause, cigarette smoking.
Learn about the classification of diffuse pulmonary diseases into obstructive and restrictive categories, and the different stages of healing in the lungs. Explore the distinctions between collapsed and distended alveoli, hyaline membranes, and the role of type II pneumocytes in regeneration and repair.
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