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26 Cards in this Set
- Front
- Back
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Match the dz the the following descriptions:
- irreversible airway dilation - destruction of aveolar parenchyma - episodic, reversible airway narrowing - bronchiolar and aveolar airspace fibroblasts - productive cough >3mos, >2ys |
Bronchiectasis
Emphysema Asthma BOOP Chronic Bronchitis |
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Describe what is seen, and name the dz.
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Patchy (focal) airspace infiltrates
BOOP |
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Pt presents with:
- acute onset of cough, fever, dyspnea, and malaise - multiple patchy airspace infiltrates - Patchy fibromyxoid plugs in distal bronchioles and aveoli, +/- endogenous lipid pneunomia ...what txt is most appropriate? What is the name of the disease if we know the cause? if we don't? Are any of these Sx/signs specific? Even in combination? |
Corticosteroids (60-70% will respond)
Bronchiolitis Obliterans/Organizing Pneumonia (BOOP) Cryptogenic Organizing Pneumonia (COP) No. Nope. |
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Why are thin-walled aveoli necessary?
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If the walls are too thick gas-exchange won't work.
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What are the two types of bronchiectasis?
Which is seen in CF pts? Kartangener (primary ciliary dyskinesia syndrome)? What is seen on Xray? Pathology? |
obstructive
non-obstructive, post-inflammatory both are the non-obstructive variety airway dilation which extends to the periphery Dilation of bronchi, with a degree of inflammation and scarring. - organization = fibrosis |
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What dz is seen here?
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Bronchiectasis
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What is seen here? What is in the airway?
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Bronchiectasis;
muco-purulent debris in airway lumen (all of the purple mush on the left) |
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Could anything that obstructed outflow for long enough cause bronchiectasis?
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yes.
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Missing Dynein arms causes are implicated in which dz?
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primary ciliary dyskinesia
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What is the general pathogenesis of Bronchiectasis?
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impaired mucus flow --> microbial colonization --> microbial products --> 1) mucus hypersecretion 2) structural damage ---> back to even more impair mucus flow
...**vicious cycle** |
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Is Bronchiectasis reversible?
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No, irreversible.
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Edema, smooth muscle thickening, BM thickening, mucous cell hyperplasia, increased submucosal eosinophils, and thickened intralumenal mucus...
...this describes the pathogenesis of which diz? |
asthma
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Is Wheezing expiratory or inspiratory? Strider?
Does Radiograph help Dx asthma? Tiss biopsy? |
expiratory
inspiratory No, we do neither. |
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What do we call it when a pt dies of asthma?
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status asthmaticus
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What are seen here? What dz are they seen in?
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Charcot-Leyden crystals
- related to the granules in eosinophils Asthmatics (typically extrinsics) |
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Are the pathologic criterion for chronic bronchitis the relevant ones for making the Dx?
What are the units of "productive cough"? Are X-rays specific in Chronic bronchitis? |
No; it is a clinical Dx.
productive cough more than 3months at least two times a year. for more than 2 years. Cups of mucin per day. No. |
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In which dz might you find mucous cellular and glandular hyperplasia; along with possible submucosal chronic inflammation and/or respiratory bronchiolitis?
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chronic bronchitis.
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Most pts with Chronic bronchitis have what characteristic?
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They're smokers.
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What are the two main causes of Emphysema?
More in the upper lobe suggest which? Lower lobe? |
Smoking
a1-antitrypsin deficiency. centrilobular type: the one more common in smokers panlobular type: more common in late cigarette smokers or those with a1-antitrypsin def. |
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In which dz do you see:
- septal destruction w/ dilation of distal airspaces - increased elastase activity |
emphysema
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If you stabbed an emphysema pt in the lung, would their lung collapse like a normals? Why?
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no.
Default elasticity of the lung has be lost. |
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____ is due to too much elastase.
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Emphysema
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Does smoking elevate elastase? how about lower antielastase actv (like a1-antitrypsin)?
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It can do both.
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COP (Cryptogenic organizing pneumonia) is a term that should be reserved for which sort of BOOP?
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ideopathic (i.e. we don't know the cause)
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Dz?
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BOOP (Bronchiolitis obliterans)
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Dz?
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BOOP (Bronchiolitis obliterans)
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