Path, Lung, Obstructive Disorders

Front 1

what are the prototypical forms of obstructive pulmonary disease?

Back 1

asthma
bronchiectasis
chronic bronchitis
disease of the small airways, bronchiolitis
emphysema

based on distinct anatomical and clinical features

mnemonic: ABCDE

Front 2

what is the broad classification of diffuse noninfectious pulmonary disease based on?

Back 2

pulmonary function test

Front 3

what is the major pathologic change and the affected anatomic site in chronic bronchitis?

Back 3

bronchus with mucous gland hyperplasia with hypersecretion

Front 4

what is the major pathologic change and the affected anatomic site in bronchiectasis?

Back 4

bronchus with airway dilation and scarring

Front 5

what is the major pathologic change and the affected anatomic site in emphysema?

Back 5

acinus with airspace enlargement and wall destruction

Front 6

what is the major pathologic change and the affected anatomic site in small-airway disease?

Back 6

bronchiole with inflammatory scarring and obliteration

Front 7

what is the major etiology in bronchiectasis?

Back 7

persistent or severe infection

Front 8

what is the major etiology in chronic bronchitis?

Back 8

smoking and air pollutants

Front 9

which two prototypical obstructive disorders are grouped together to COPD?

Back 9

damage at both the acinary level (emphysema) and the bronchial level (chronic bronchitis)

Front 10

what are common and distinguishing features of asthma to chronic bronchitis or emphysema?

Back 10

all three with affection of the bronchus

asthma with reversible bronchospasm

Front 11

what is the definition of emphysema?

Back 11

irreversible enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of their walls without obvious fibrosis

Front 12

what is the definition of chronic bronchitis?

Back 12

clinically with chronic productive cough for at least 3 months in at least two consecutive years

Front 13

what are the 4 major types of emphyseme?

Back 13

centriacinar or centrilobular emphysema

panacinar or panlobular emphysema

distal acinar or paraseptal emphysema

airspace enlargement with fibrosis or irregular emphysema

Front 14

what are the anatomical characteristics of centriacinar emphysema?

Back 14

proximal parts of the acini, formed by the respiratory bronchioli are affected, whereas distal alveoli are spared

thus both emphysematous and normal airspaces within the same acinus

Front 15

what is an acinus composed of?

Back 15

part of the lung distal to the terminal bronchioli

composed of respiratory bronchioles with alveolar ducts and alveolar sacs

Front 16

what are the anatomical characteristics of panacinar emphysema?

Back 16

acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal blind alveoli

Front 17

where is the panacinar emphysema commonly located?

Back 17

lower zones and anterior margins of the lung

usually most severe at bases of the lung

Front 18

what is panacinar emphysema associated with?

Back 18

alpha1-antitrypsin deficiency

Front 19

what is distal acinar emphysema associated with?

Back 19

probably many of the cases of spontaneous pneumothorax in young adults

Front 20

what are the anatomic characteristics of distal acinary emphysema?

Back 20

proximal portion of the acinus is normal, while the distal part is predominantly involved

emphysema more striking adjacent to the pleura and along the lobular septa and the margins of the lobules

multiple, continuous enlarged airspaces

Front 21

where is distal acinary emphysema commonly located?

Back 21

more severe in the upper half of the lungs

Front 22

where is centriacinar emphysema commonly located?

Back 22

more severe in upper lobes particularly in the apical segments

Front 23

what are the associations of centriacinar emphysema?

Back 23

heavy smoker often in association with chronic bronchitis

Front 24

what is the pathogenetic hypothesis for emphysema?

Back 24

protease-antiprotease imbalance

with smoking oxidant-antioxidant impalance in addition

Front 25

what percentage of those with chronic bronchitis are smokers?

Back 25

90%

Front 26

what are the macroscopic findings in asthma?

Back 26

overinflation of the lung with small areas of atelectasis

thick mucus plugs in proximal bronchioles called Curschmann spirals

Front 27

what are the microscopic findings in asthma?

Back 27

thickening of basement membrane with increased mucosal goblet cells and submucosal glands as well as smooth muscle hypertrophy along with eosinophilic infiltrate and occasional Charcot-Leyden crystals (formed from breakdown of eosinophils)