OBSTRUCTIVE & RESTRICTIVE LUNG DISEASE QUIZ

Define emphysema: – Condition of the lung characterised by irreversible enlargement of the airspaces distal to the terminal bronichiole – accompanied by destruction of walls without obvious fibrosis. Define chronic bronchitis: – Defined by having a persistant productive cough for atleast 3 months in 2 consecutive years. What 2 factors are increased on pulmonary testing of a patient with COPD. – Residual volume (air trapping) – Total lung capacity (barrell chest)

Name the 4 main classifications of emphysema: – Centriacinar (centrilobular) – Panacinar (panlobular) – Distal acinar (paraseptal) – Irregular (airspace enlargement w/ fibrosis) Most commonly associated w/ Heavy smoking + patients with chronic bronchitis? – Centriacinar Most commonly associated w/ α1- antitrypsin deficiency? – Panacinar

List 6 key pathological features seen in chronic bronchitis? (e.g. histol.) – Hyperaemia, swelling, oedema of mucus membranes – Excessive mucinous secretions – Chronic inflammation of airways (predom. Lymphocytes) – Slight increase in number of goblet cells, but more importantly they undergo hyperplasia. – Bronchial epithelium may exhibit squamous metaplasia and dysplasia – Narrowing of bronchioles by mucus plugs, inflammation and fibrosis

What is this? – Bronchiectasis Why? – Sharply dilated airways – Extend much further to pleura than normal – Airways plugged with mucus secretions What bacterial infections are most commonly associated with bronchiectasis? – Mycobacterium tuberculosis – S. aureus – H. influenzae – Pseudomonas

The development of a pneumoconiosis and its severity depends on 4 main factors. What are they? – The amount of dust retained in the lungs – The size, shape and buoyancy of the particles – Particle solubility and cytotoxicity – Presence of additional irritants (e.g. smoking)