Respiratory pathology: obstructive and restrictive lung diseases

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Questions and Answers

What are the causes of bronchiectasis?

Lung fibrosis only

Bronchial obstruction only

Pulmonary inflammation only

All of them (correct)

The respiratory system is divided structurally and functionally into:

What is the relationship between the respiratory bronchiole and the terminal bronchioles?

The respiratory bronchiole is a branch from the alveolar ducts.

The respiratory bronchiole is a branch from the terminal bronchioles. (correct)

The respiratory bronchiole is a branch from the alveoli.

The respiratory bronchiole is a branch from the alveolar sacs.

How many alveolar ducts does each respiratory bronchiole branch into?

2 to 11 Signup and view all the answers

What type of epithelium is retained by the alveolar ducts?

Cuboidal epithelium Signup and view all the answers

What is the space at the entrance from the alveolar duct to an alveolar sac called?

Atrium Signup and view all the answers

Which of the following conditions can cause limitation of airflow due to obstruction?

All of the above Signup and view all the answers

What is the primary characteristic of obstructive diseases?

Increased airway resistance Signup and view all the answers

Which of the following conditions is associated with airway narrowing?

Asthma Signup and view all the answers

Which condition is characterized by the loss of elasticity in the airways?

Emphysema Signup and view all the answers

Which respiratory disease is characterized by increased secretions?

Bronchitis Signup and view all the answers

What is the primary characteristic of restrictive diseases?

All of the above Signup and view all the answers

Which of the following is a feature of restrictive diseases?

None of the above Signup and view all the answers

Which lung capacity is typically decreased in restrictive diseases?

Total lung capacity Signup and view all the answers

What is the term used to describe the coexistence of chronic bronchitis and emphysema?

Chronic obstructive pulmonary disease (COPD) Signup and view all the answers

What is the main cause of COPD?

Urban pollution and smoking Signup and view all the answers

Which part of the respiratory system does COPD primarily affect?

Distal respiratory tree Signup and view all the answers

COPD is a reversible disease

False Signup and view all the answers

Chronic bronchitis is defined clinically as:

Persistent cough for at least 3 consecutive months in at least 2 consecutive years Signup and view all the answers

What is the most common cause of chronic bronchitis?

Smoking Signup and view all the answers

Which part of the respiratory system is primarily affected by chronic bronchitis?

Trachea and bronchi Signup and view all the answers

What causes lung parenchymal destruction in emphysema?

Imbalance of proteases and anti-proteases Signup and view all the answers

Chronic bronchitis is characterised by:

Mucus hyper secretion Signup and view all the answers

The pathogenesis of chronic bronchitis involves all of the following except:

Eosinophil infiltration Signup and view all the answers

What is the main pathological feature of chronic bronchitis in the small airways?

Goblet cell metaplasia Signup and view all the answers

What can be found in the bronchiolar lumen in chronic bronchitis?

Mucus plugs Signup and view all the answers

Which of the following is a consequence of chronic bronchitis?

Bronchiolar wall fibrosis Signup and view all the answers

What is a characteristic symptom of chronic bronchitis?

Persistent cough Signup and view all the answers

Emphysema is a chronic lung condition that primarily affects which part of the respiratory system?

Alveoli Signup and view all the answers

Which of the following best describes the manifestation of emphysema?

Both a) and b) Signup and view all the answers

Which type of emphysema is the most common?

Centri-acinar (CA) Signup and view all the answers

Which lobes of the lungs are more commonly affected by centri-acinar emphysema?

Upper lobes Signup and view all the answers

Which type of emphysema is more commonly associated with smoking?

Centri-acinar (CA) Signup and view all the answers

Which type of emphysema is more commonly associated with hereditary factors?

Paraacinar (PA) Signup and view all the answers

Emphysema pathology is characterized by:

Enlarged air spaces Signup and view all the answers

What happens to the number of alveolar capillaries in emphysema?

It decreases Signup and view all the answers

Which of the following is a feature of emphysema pathology?

Loss of alveolar septa Signup and view all the answers

What is the main characteristic of alveolar walls in emphysema pathology?

Destruction without fibrosis Signup and view all the answers

What triggers an inflammatory response in emphysema?

Smoking Signup and view all the answers

Which type of protease is released by immune cells in emphysema?

Elastases Signup and view all the answers

What do proteases break down in emphysema?

Collagen and elastin Signup and view all the answers

What does smoking inhibit in emphysema?

Anti-proteases Signup and view all the answers

Which of the following is a characteristic of asthma?

Chronic bronchial inflammation with eosinophils Signup and view all the answers

Characteristics of asthma includes:

Intermittent and reversible airway obstruction Signup and view all the answers

What are the triggers of asthma?

Seasonal allergens and exercise Signup and view all the answers

Which of the following is a clinical manifestation of asthma?

Shortness of breath, wheeze, chest tightness, and cough Signup and view all the answers

What cells amplify and sustain the inflammatory response in asthma?

Eosinophils Signup and view all the answers

Which cytokine is responsible for stimulating mucus production in asthma?

IL-13 Signup and view all the answers

Which cytokine stimulates eosinophils, contributing to the inflammatory response in asthma?

IL-5 Signup and view all the answers

Which of the following is a characteristic of the early reaction in asthma?

Hypersecretion of mucus leading to airway plugging Signup and view all the answers

What is the main effect of bronchoconstriction in asthma?

Narrowing of the airway lumen Signup and view all the answers

Which of the following occurs during the late reaction in asthma?

All of the above Signup and view all the answers

What is the consequence of repeated inflammation in asthma?

Airway remodeling Signup and view all the answers

Which of the following is a morphological change associated with asthma?

Smooth muscle hypertrophy and fibrosis Signup and view all the answers

What is bronchiectasis?

Permanent dilation of main bronchi and bronchioles Signup and view all the answers

What causes bronchial wall oedema in asthma?

Accumulation of eosinophils and mast cells Signup and view all the answers

Which of the following is NOT a morphological change associated with asthma?

Reduction in airway diameter Signup and view all the answers

What happens to the airways in bronchiectasis?

They dilate Signup and view all the answers

What is one of the consequences of damage to the bronchial epithelium in bronchiectasis?

Clubbing of fingers Signup and view all the answers

What is a characteristic feature of bronchiectasis sputum?

Discolored and foul-smelling Signup and view all the answers

Which of the following symptoms is commonly associated with bronchiectasis?

Chronic cough with dyspnea Signup and view all the answers

What are some potential causes of bronchiectasis?

Bacterial infections and pneumonia Signup and view all the answers

What syndrome is associated with impaired mucociliary clearance and stagnant secretions?

Kartagener syndrome Signup and view all the answers

Which condition is characterized by the production of abnormally viscoid mucus leading to obstruction and increased susceptibility to infection?

Cystic fibrosis Signup and view all the answers

What type of immunodeficiency can predispose individuals to bronchiectasis?

Antibody deficiencies Signup and view all the answers

What factor contributes to the increased risk of carcinoma in asbestos workers who smoke?

Absorption of carcinogens onto fibers trapped deep in the lung Signup and view all the answers

What is the main cause of Acute Respiratory Distress Syndrome (ARDS)?

Direct lung injury Signup and view all the answers

Which of the following can cause direct lung injury leading to ARDS?

Both a) and b) Signup and view all the answers

What is the main reason for the acute onset of dyspnea and hypoxemia in ARDS?

Vascular leakiness and loss of surfactant Signup and view all the answers

What is the primary characteristic of idiopathic pulmonary fibrosis (IPF)?

Persistent inflammation of alveolar walls and spaces Signup and view all the answers

Which cell type is primarily affected by inflammation in idiopathic pulmonary fibrosis (IPF)?

Type I pneumocytes Signup and view all the answers

What is the role of fibroblasts in the pathogenesis of idiopathic pulmonary fibrosis (IPF)?

They transform into myofibroblasts and contribute to abnormal repair mechanisms Signup and view all the answers

Which of the following statements is true regarding the understanding of abnormal repair mechanisms in idiopathic pulmonary fibrosis (IPF)?

Injury-induced proliferation of fibroblasts is the main factor contributing to abnormal repair Signup and view all the answers

What is the main process involved in the development of Idiopathic Pulmonary Fibrosis (IPF)?

Stimulated fibroblasts depositing collagen and ECM excessively Signup and view all the answers

How does the interstitial fibrosis in Idiopathic Pulmonary Fibrosis (IPF) progress over time?

Patchy distribution that worsens with time Signup and view all the answers

What characterizes the fibroblastic foci in Idiopathic Pulmonary Fibrosis (IPF)?

Increased collagen deposition and reduced cellularity Signup and view all the answers

Which term is used to describe the lung appearance in advanced stages of Idiopathic Pulmonary Fibrosis (IPF)?

Honeycomb fibrosis/Honeycomb lung Signup and view all the answers

What structural changes occur in the lungs due to Idiopathic Pulmonary Fibrosis (IPF)?

Formation of cystic spaces and collapse of alveolar walls Signup and view all the answers

Which of the following is NOT a type of pneumoconiosis?

Emphysema Signup and view all the answers

What is the main cause of pneumoconiosis?

Exposure to toxic inhaled particulates Signup and view all the answers

Which particle size does NOT reach the distal airways in pneumoconiosis?

<blockquote> 10 μm </blockquote> Signup and view all the answers

What is the role of macrophages in pneumoconiosis?

They mediate the immune response Signup and view all the answers

What are the characteristic lesions in pneumoconiosis?

Pigmented nodules Signup and view all the answers

Which of the following statements is true about pneumoconiosis?

It can develop over a long period of time, even after exposure is stopped. Signup and view all the answers

Which types of pneumoconiosis are associated with an increased risk of cancer?

Asbestosis and silicosis Signup and view all the answers

Study Notes

Bronchiectasis and Its Causes

Bronchiectasis is a permanent dilatation of the bronchi due to chronic inflammation and infection.
Causes include infections (e.g., cystic fibrosis, tuberculosis), autoimmune conditions, and bronchial obstructions.
Impaired mucociliary clearance syndrome, such as primary ciliary dyskinesia, can lead to bronchiectasis.

Respiratory System Structure and Function

The respiratory system is divided into the upper and lower tracts, with upper including the nose, pharynx, and larynx, and lower comprising trachea, bronchi, and lungs.
Functional divisions classify it into conducting (anatomical dead space, no gas exchange) and respiratory (gas exchange areas, includes alveoli).

Respiratory Bronchioles and Alveolar Ducts

Respiratory bronchioles are short, branched extensions of terminal bronchioles that lead into alveolar ducts.
Each respiratory bronchiole branches into 2 to 11 alveolar ducts.
Alveolar ducts retain simple squamous epithelium, facilitating gas exchange.

Airflow Limitation Conditions

Conditions causing airflow limitation due to obstruction include asthma, chronic bronchitis, and emphysema.
Obstructive diseases are characterized by reduced airflow, often due to airway narrowing.
Chronic bronchitis is marked by excessive mucus production and airway inflammation.

COPD and Its Characteristics

Chronic obstructive pulmonary disease (COPD) primarily affects the lungs, leading to persistent respiratory symptoms and airflow limitation.
The main cause of COPD is long-term exposure to irritants such as cigarette smoke.
COPD is defined as a progressive disease and is not fully reversible.

Chronic Bronchitis

Chronic bronchitis is clinically defined by a productive cough for at least three months over two consecutive years.
The most common cause is smoking, leading to inflammation and obstruction in the bronchi.
Characterized by mucus hypersecretion and airway edema, with mucous plugs often found in bronchiolar lumen.

Emphysema

Emphysema primarily affects the alveoli and results in destruction of the alveolar walls.
Pathology includes loss of elastic recoil and an increase in lung compliance.
Centriacinar emphysema commonly affects the upper lobes and is strongly associated with smoking.

Asthma and Its Triggers

Asthma is a chronic inflammatory condition with episodes of airway constriction.
Common triggers include allergens, pollution, and respiratory infections.
Inflammatory responses are sustained by eosinophils and mast cells, affecting airway hyperresponsiveness.

Idiopathic Pulmonary Fibrosis (IPF)

IPF is characterized by progressive scarring of lung tissue, leading to severe respiratory impairment.
Fibroblasts play a crucial role in the pathogenesis by producing collagen and other extracellular matrix components.
Understanding abnormal repair mechanisms is crucial in the context of IPF, and the disease progresses to extensive fibrosis over time.

Pneumoconiosis

Pneumoconiosis results from inhalation of mineral dusts or organic particles, leading to lung damage.
Macrophages play a key role in responding to inhaled particles, forming characteristic lesions.
Different types of pneumoconiosis can predispose individuals to lung cancer, particularly asbestosis and silicosis.

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Test your knowledge about bronchiectasis and asthma with this quiz. Explore questions related to the causes, consequences, and features of bronchiectasis, as well as morphological changes associated with asthma.