p.42
Bronchial Asthma Types and Pathogenesis
What is the initial response in bronchial asthma after antigen challenge?
Early broncho constrictive response at point A.
What is status asthmaticus?
A severe form of asthma that can lead to death.
What occludes the bronchi and bronchioles in severe asthma?
Thick, tenacious mucus plugs.
p.22
Chronic Bronchitis Pathogenesis and Morphology
What type of secretions are excessive in chronic bronchitis?
Mucinous or mucopurulent secretions.
p.47
Diagnosis and Clinical Features of Bronchial Asthma
What are Curschmann spirals?
Mucous plugs with whorls of shed epithelium found in bronchial asthma.
p.24
Chronic Bronchitis Pathogenesis and Morphology
What is the most striking morphological change in chronic bronchitis?
Increase in the size of the mucous glands.
p.12
Pathophysiology of Emphysema
What causes the reduction in lung elastic recoil in emphysema?
Destruction of alveolar septal elements.
p.14
Clinical Features of Emphysema
How do 'pink puffers' typically sit?
They sit forward, hunched over with pursed lips.
p.22
Chronic Bronchitis Pathogenesis and Morphology
What are the gross morphological characteristics of chronic bronchitis?
Hyperemia, swelling, and edema of the mucous membranes.
p.22
Chronic Bronchitis Pathogenesis and Morphology
What fills the bronchi and bronchioles in chronic bronchitis?
Heavy casts of secretions and pus.
p.32
Respiratory Failure Types and Causes
What are common CNS effects of hypoxemia?
Headache, somnolence, or altered mental status.
p.32
Respiratory Failure Types and Causes
What severe effects can profound acute hypoxemia cause?
Convulsions, renal hemorrhages, and ischemic brain injury.
p.11
Pathophysiology of Emphysema
What does lung compliance measure?
Change in lung volume for a change in intrapulmonary pressure.
p.43
Bronchial Asthma Types and Pathogenesis
What changes occur in smooth muscle due to airway remodeling in asthma?
Smooth muscle hypertrophy and hyperplasia.
p.23
Chronic Bronchitis Pathogenesis and Morphology
What causes thickening of the bronchiolar wall in chronic bronchitis?
Smooth muscle hypertrophy.
What types of airspaces exist in Centriacinar Emphysema?
Both emphysematous and normal airspaces.
p.12
Pathophysiology of Emphysema
What is the hallmark of emphysema?
Reduction in lung elastic recoil.
p.42
Bronchial Asthma Types and Pathogenesis
What characterizes the late-phase asthmatic response?
It has a slower onset and occurs at point B.
p.39
Bronchial Asthma Types and Pathogenesis
What is occupational asthma?
A type of asthma triggered usually after repeated exposure to specific substances.
p.11
Pathophysiology of Emphysema
What is lung compliance?
The ease with which the lung can expand.
p.43
Bronchial Asthma Types and Pathogenesis
What is one component of airway remodeling in bronchial asthma?
Epithelial disruption/injury.
p.41
Bronchial Asthma Types and Pathogenesis
What are the key leukotrienes involved in the pathogenesis of atopic asthma?
Leukotrienes C4, D4, and E4.
What is the effect of chronic bronchitis on the work of breathing?
It increases airflow resistance, requiring slow, deep breathing to minimize total work.
p.29
Chronic Bronchitis Pathogenesis and Morphology
What leads to pulmonary hypertension in chronic bronchitis?
Chronic hypoxic vasoconstriction of the small pulmonary arteries.
p.4
Pathophysiology of Emphysema
What is a key characteristic of emphysema?
Destruction of the walls of air spaces.
p.29
Chronic Bronchitis Pathogenesis and Morphology
What happens to the smooth muscle in the pulmonary vasculature due to chronic bronchitis?
Smooth muscle hypertrophy.
p.41
Bronchial Asthma Types and Pathogenesis
What effect does acetylcholine have in atopic asthma?
It causes airway smooth muscle constriction by stimulating muscarinic receptors, leading to airway hyperreactivity.
p.16
Pathophysiology of Emphysema
What is compensatory hyperinflation?
A response to loss of lung substance, such as hyper expansion of residual lung parenchyma following surgical removal of a diseased lung or lobe.
p.30
Respiratory Failure Types and Causes
What is respiratory failure?
A condition where the lung fails to adequately oxygenate arterial blood and/or fails to prevent CO2 retention.
p.14
Clinical Features of Emphysema
What are the variable symptoms associated with emphysema?
Cough or wheezing and expectoration.
p.36
Bronchial Asthma Types and Pathogenesis
When do asthma symptoms typically occur?
Usually at night or early morning.
What happens to the lungs in patients dying of acute severe asthma?
The lungs are distended by overinflation and contain small areas of atelectasis.
p.42
Bronchial Asthma Types and Pathogenesis
What triggers the early broncho constrictive response in asthma?
Direct stimulation of subepithelial vagal receptors.
p.28
Chronic Bronchitis Pathogenesis and Morphology
What are the common arterial blood gas abnormalities in severe chronic bronchitis?
Hypercapnia, respiratory acidosis, and compensatory metabolic alkalosis.
p.28
Chronic Bronchitis Pathogenesis and Morphology
What condition is frequently associated with chronic hypoxemia?
Polycythemia, indicated by an elevated hematocrit.
p.39
Bronchial Asthma Types and Pathogenesis
What is the mechanism behind occupational asthma?
1. Type 1 reaction 2. Direct liberation of constrictors 3. Unknown.
p.50
Diagnosis and Clinical Features of Bronchial Asthma
What condition does hypercapnia lead to?
Respiratory acidosis due to hyperventilation.
p.32
Respiratory Failure Types and Causes
What cardiovascular effects are associated with hypoxemia?
Tachycardia and mild hypertension due to catecholamine release.
p.38
Bronchial Asthma Types and Pathogenesis
What is drug-induced asthma?
A type of asthma triggered by pharmacological agents.
p.13
Chronic Obstructive Pulmonary Disease (COPD) Definition
How do patients with emphysema adapt to high V/Q ratios?
By increasing their minute ventilation.
p.43
Bronchial Asthma Types and Pathogenesis
What does airway fibrosis contribute to in bronchial asthma?
It is a component of airway remodeling.
p.17
Pathophysiology of Emphysema
What happens to chest wall compliance with aging?
It decreases due to rib calcification and the effects of osteoporosis.
p.41
Bronchial Asthma Types and Pathogenesis
How do eosinophils contribute to atopic asthma?
They release major basic protein and eosinophil cationic protein, which damage the epithelium.
p.49
Diagnosis and Clinical Features of Bronchial Asthma
What occurs during a prolonged asthma attack?
Air is trapped behind the occluded and narrowed airways.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What is goblet cell hyperplasia?
An increase in goblet cells in the bronchus, often seen in bronchial asthma.
p.36
Bronchial Asthma Types and Pathogenesis
Is the airflow obstruction in asthma reversible?
Yes, at least partly reversible, either spontaneously or with treatment.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What type of inflammation is characteristic of bronchial asthma?
Eosinophilic inflammation.
p.25
Pulmonary Function Tests in COPD
What happens to FVC and FEV1 in airflow obstruction?
Both FVC and FEV1 are decreased.
p.17
Pathophysiology of Emphysema
What happens to diffusion capacity with aging?
It decreases significantly.
p.33
Respiratory Failure Types and Causes
What is another cause of hypercapnia?
Ventilation-perfusion mismatch.
p.31
Respiratory Failure Types and Causes
What does a shunt refer to in the context of hypoxemia?
A condition where blood bypasses the lungs, leading to low oxygen levels.
p.14
Clinical Features of Emphysema
What percussion finding is associated with emphysema?
Hyperresonance and loss of cardiac dullness.
p.10
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is the primary function of α1-antitrypsin?
It is a major inhibitor of proteases, particularly elastase.
p.24
Chronic Bronchitis Pathogenesis and Morphology
What is the Reid index in chronic bronchitis?
Increased compared to the normal value of 0.4.
p.24
Chronic Bronchitis Pathogenesis and Morphology
How is the Reid index related to chronic bronchitis?
It usually increases in proportion to the severity and duration of the disease.
p.24
Chronic Bronchitis Pathogenesis and Morphology
What does the Reid index measure?
The maximum thickness of the bronchial mucus glands divided by the bronchial wall thickness.
p.50
Diagnosis and Clinical Features of Bronchial Asthma
What does increased PaCO2 indicate in asthma?
Worsening airflow obstruction or fatigue of the respiratory muscles.
p.34
Respiratory Failure Types and Causes
What physiological condition occurs in Type I respiratory failure?
Fluid filling of alveoli and subsequent intrapulmonary shunting.
p.1
Obstructive Lung Diseases Overview
What is a key characteristic of obstructive lung diseases?
Increase in resistance to airflow, leading to problems emptying the lung.
p.34
Respiratory Failure Types and Causes
What are some causes of Type I respiratory failure?
Pulmonary edema, lung injury, pneumonia, ARDS, or alveolar hemorrhage.
p.32
Respiratory Failure Types and Causes
What can occur in severe cases of hypoxemia?
Bradycardia, hypotension, and potentially cardiac arrest.
p.2
Chronic Obstructive Pulmonary Disease (COPD) Definition
What are the characteristics of COPD?
Persistent respiratory symptoms and airflow limitation.
Name one type of emphysema other than centriacinar.
Panacinar, Distal acinar, or Irregular.
Who is commonly affected by Centriacinar Emphysema?
Heavy cigarette smokers and coal mine workers.
p.11
Pathophysiology of Emphysema
What conditions are associated with decreased lung compliance?
Interstitial lung diseases.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What are the key microscopic features of bronchial asthma?
Edema and cellular infiltrates within the bronchial wall, including eosinophils and lymphocytes.
p.49
Diagnosis and Clinical Features of Bronchial Asthma
What defines bronchial reversibility?
A 12% or greater increase in FEV1 in response to an inhaled bronchodilator.
p.31
Respiratory Failure Types and Causes
What are common clinical findings associated with hypoxemia?
Cyanosis, tachycardia, and altered mental status.
p.31
Respiratory Failure Types and Causes
How is the degree of hypoxemia determined?
By measuring PO2 through arterial blood gas analysis.
What breathing pattern minimizes total work in diseases that increase elastic forces?
Rapid, shallow breathing.
What defines bullous emphysema?
Presence of subpleural blebs larger than 1 cm.
p.18
Chronic Obstructive Pulmonary Disease (COPD) Definition
What chronic condition can result from emphysema affecting breathing?
Chronic respiratory failure.
p.9
Pathophysiology of Emphysema
What role does oxidative stress play in emphysema?
It contributes to the disease process.
p.18
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is cor pulmonale?
Right-sided heart failure due to lung disease.
p.30
Respiratory Failure Types and Causes
What is acute on chronic respiratory failure?
A situation where an acute episode occurs in a patient with chronic respiratory failure.
p.47
Diagnosis and Clinical Features of Bronchial Asthma
What are Charcot-Leyden crystals?
Collections of crystalloids made up of eosinophil proteins, indicating inflammation and mucus production.
p.3
Chronic Obstructive Pulmonary Disease (COPD) Definition
What are the two main conditions associated with Chronic Obstructive Pulmonary Disease (COPD)?
Emphysema and chronic bronchitis.
p.34
Respiratory Failure Types and Causes
What characterizes Type I respiratory failure?
Hypoxemia (PO2 < 60 mmHg) without hypercapnia (PCO2 < 50 mmHg).
p.13
Chronic Obstructive Pulmonary Disease (COPD) Definition
What are the typical PO2 and PCO2 levels in advanced emphysema?
Nearly normal levels despite advanced disease.
What is the most common type of emphysema?
Centriacinar (Centrilobular) Emphysema.
p.2
Chronic Obstructive Pulmonary Disease (COPD) Definition
Is airflow limitation in COPD fully reversible?
No, airflow limitation is not fully reversible.
p.29
Chronic Bronchitis Pathogenesis and Morphology
What are the signs of cor pulmonale?
Raised JVP, tender hepatomegaly, and pedal edema.
p.41
Bronchial Asthma Types and Pathogenesis
What role does Prostaglandin D2 play in atopic asthma?
It contributes to bronchoconstriction, increased vascular permeability, and increased mucus secretion.
p.43
Bronchial Asthma Types and Pathogenesis
How does airway vascularity change in bronchial asthma?
There is increased airway vascularity.
p.1
Pathophysiology of Emphysema
What happens to total lung capacity (TLC) and residual volume (RV) in obstructive lung diseases?
Both TLC and RV increase.
p.38
Bronchial Asthma Types and Pathogenesis
What is the effect of increased cysteinyl leukotrienes in asthma?
They promote inflammation, submucosal edema, and airway obstruction.
p.40
Bronchial Asthma Types and Pathogenesis
What role do environmental factors play in atopic asthma?
They contribute to the development in genetically susceptible individuals.
p.31
Respiratory Failure Types and Causes
What is hypoxemia?
A condition characterized by low oxygen saturation in the blood.
What components affect the total work of breathing at the same minute ventilation?
Elastic and resistive components.
p.48
Clinical Features of Emphysema
What are the episodic symptoms of bronchial asthma?
Chest tightness, prolonged expiration, dyspnea with wheezing, and cough.
How can total work of breathing be minimized in conditions with increased airflow resistance?
By practicing slow, deep breathing.
p.25
Pulmonary Function Tests in COPD
What is observed in residual volume (RV) and total lung capacity (TLC) due to air trapping?
Both RV and TLC are increased.
p.14
Clinical Features of Emphysema
What do patients with emphysema use during respiration?
Accessory muscles of respiration.
p.30
Respiratory Failure Types and Causes
What are the types of respiratory failure?
Acute, chronic, and acute on chronic.
p.37
Bronchial Asthma Types and Pathogenesis
What characterizes nonatopic asthma?
No allergen sensitization and usually negative skin tests.
p.30
Respiratory Failure Types and Causes
What characterizes chronic respiratory failure?
It persists for months to years, commonly seen in conditions like COPD and IPF.
p.31
Respiratory Failure Types and Causes
Which diseases can cause ventilation-perfusion mismatch?
Obstructive diseases, restrictive diseases, pulmonary vascular diseases, and ARDS.
p.19
Pathophysiology of Emphysema
What is the initial event leading to complications in emphysema?
Damage to the capillary bed.
p.13
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is the V/Q mismatch in emphysema?
Matched, with adaptations to high V/Q ratios by increasing minute ventilation.
What are the two components that the total work of breathing depends on?
Elastic and resistive components.
p.2
Chronic Obstructive Pulmonary Disease (COPD) Definition
What causes COPD?
Exposure to noxious particles or gases, typically from smoking.
p.39
Bronchial Asthma Types and Pathogenesis
What substances can trigger occupational asthma?
Fumes, organic and chemical dusts, gases, and various chemicals.
p.38
Bronchial Asthma Types and Pathogenesis
What is aspirin-sensitive asthma?
An uncommon type of asthma associated with urticaria and characterized by Samter’s Triad.
p.38
Bronchial Asthma Types and Pathogenesis
What is Samter’s Triad?
A combination of asthma, aspirin sensitivity, and nasal polyposis.
p.40
Bronchial Asthma Types and Pathogenesis
What type of hypersensitivity reaction is associated with atopic asthma?
Type 1 hypersensitivity reaction.
What is a characteristic feature of distal acinar emphysema?
It is associated with spontaneous pneumothorax in young adults.
p.43
Bronchial Asthma Types and Pathogenesis
What happens to mucous glands in the context of airway remodeling in asthma?
Mucous gland hyperplasia occurs.
p.41
Bronchial Asthma Types and Pathogenesis
What is the role of Platelet-activating factor in atopic asthma?
It causes aggregation of platelets and the release of serotonin.
p.36
Bronchial Asthma Types and Pathogenesis
What causes bronchoconstriction in asthma?
Widespread but variable bronchoconstriction and airflow limitation.
In which part of the lungs is distal acinar emphysema more severe?
In the upper half of the lungs.
p.49
Diagnosis and Clinical Features of Bronchial Asthma
What is bronchial hyperresponsiveness?
A 20% or greater decrease in FEV1 in response to a provoking factor during a methacholine challenge test.
p.49
Diagnosis and Clinical Features of Bronchial Asthma
What change does methacholine cause in a healthy individual?
Less than a 5% change in FEV1.
Is irregular emphysema clinically significant?
No, it is clinically insignificant.
p.18
Chronic Obstructive Pulmonary Disease (COPD) Definition
What are acute exacerbations in the context of emphysema?
Sudden worsening of symptoms.
p.31
Respiratory Failure Types and Causes
What is diffusion impairment?
A cause of hypoxemia where gas exchange is hindered in the alveoli.
p.37
Bronchial Asthma Types and Pathogenesis
What test is used to identify specific IgE antibodies in atopic asthma?
Serum radio-allergosorbent test (RASTs).
p.30
Respiratory Failure Types and Causes
What characterizes acute respiratory failure?
It lasts from a few minutes to several days, often due to infections or asthma exacerbation.
p.31
Respiratory Failure Types and Causes
What is ventilation-perfusion mismatch?
A cause of hypoxemia where ventilation and blood flow in the lungs are not properly matched.
p.37
Bronchial Asthma Types and Pathogenesis
What is a common trigger for nonatopic asthma?
Viral respiratory infections (e.g., rhino, parainfluenza, respiratory syncytial virus).
p.10
Chronic Obstructive Pulmonary Disease (COPD) Definition
Which cells secrete α1-antitrypsin during inflammation?
Neutrophils and macrophages.
p.20
Pathophysiology of Emphysema
What type of vasoconstriction is mediated by calcium influx?
Pulmonary vasoconstriction.
p.10
Chronic Obstructive Pulmonary Disease (COPD) Definition
What does PiMZ indicate?
Heterozygotes with α1-antitrypsin levels at 60% of normal and are asymptomatic.
p.42
Diagnosis and Clinical Features of Bronchial Asthma
What measurement is used to assess the response in bronchial asthma?
Forced expiratory volume in 1 second (FEV1).
p.26
Chronic Bronchitis Pathogenesis and Morphology
Why is the pressure-volume curve nearly normal in chronic bronchitis?
Because the parenchyma is little affected.
p.2
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is the WHO definition of COPD?
A common public health problem that is preventable and treatable, characterized by persistent respiratory symptoms and airflow limitation.
p.11
Pathophysiology of Emphysema
What factors determine lung compliance?
Elastic properties of the lung, water content, and surface tension.
p.43
Bronchial Asthma Types and Pathogenesis
What is the primary cause of airway remodeling in bronchial asthma?
Chronic airway inflammation and the release of mediators including growth factors.
p.35
Respiratory Failure Types and Causes
What characterizes Type II respiratory failure?
Hypoxemia (PO2 < 60 mmHg) with hypercapnia (PCO2 > 50 mmHg).
In which condition is total work of breathing minimized by rapid, shallow breathing?
In disease states that increase elastic forces, such as pulmonary fibrosis.
p.32
Respiratory Failure Types and Causes
What happens to tissue PO2 during hypoxemia?
It falls below a critical level, leading to cessation of aerobic oxidation and increased lactate levels.
p.35
Respiratory Failure Types and Causes
What are some extrapulmonary diseases that can cause Type II respiratory failure?
CNS suppression, neuromuscular diseases (like Myasthenia gravis, Guillain-Barre syndrome, and amyotrophic lateral sclerosis), and skeletal abnormalities (like myopathies and kyphoscoliosis).
p.38
Bronchial Asthma Types and Pathogenesis
How do NSAIDs affect asthma?
They inhibit Cyclooxygenase 1 (COX1), leading to decreased Prostaglandin E2 (PGE2) and increased cysteinyl leukotrienes.
p.35
Respiratory Failure Types and Causes
What is the significance of the alveolar-arterial diffusion gradient (AaDO2)?
It helps differentiate intrapulmonary causes (>15-20 in young) from extrapulmonary causes (<10).
What is interstitial emphysema?
The entrance of air into the connective tissue stroma of the lung, mediastinum, or subcutaneous tissue.
p.1
Pathophysiology of Emphysema
What is a consequence of obstructive lung diseases related to airflow?
Air trapping and hyperinflation.
p.5
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is the anatomical definition of emphysema?
Irreversible enlargement of air spaces distal to terminal bronchiole with destruction of their walls.
p.16
Pathophysiology of Emphysema
What is obstructive overinflation?
The lung expands because air is trapped within it but no destruction occurs.
p.16
Pathophysiology of Emphysema
What causes obstructive overinflation?
Subtotal obstruction of the airways by a tumor or foreign object.
p.14
Clinical Features of Emphysema
What physical characteristic is often observed in patients with emphysema?
Asthenic build with evidence of recent weight loss.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What is muscle hypertrophy in the context of bronchial asthma?
An increase in muscle mass in the bronchial walls, contributing to airway obstruction.
p.17
Pathophysiology of Emphysema
What is senile emphysema?
Emphysema that occurs due to the physiologic atrophy of old age with destruction of the alveolar wall.
p.48
Clinical Features of Emphysema
What is pulsus paradoxus and its significance in asthma?
A drop in blood pressure (≥10 mm Hg) that accompanies pulmonary hyperinflation.
What is Panacinar (Panlobular) Emphysema?
A type of emphysema where the entire acinus is involved.
p.48
Clinical Features of Emphysema
What is status asthmaticus?
A severe paroxysm of asthma that does not respond to therapy and persists for days.
What deficiency is associated with Panacinar Emphysema?
α1-antitrypsin deficiency.
p.21
Chronic Bronchitis Pathogenesis and Morphology
What happens to goblet cells and mucous glands in chronic bronchitis?
There is a marked increase in goblet cells and mucous glands, leading to excessive mucus production.
p.39
Bronchial Asthma Types and Pathogenesis
What are common triggers for occupational asthma?
Fumes (epoxy resins, plastics), organic and chemical dusts (wood, cotton, platinum), gases (toluene), and other chemicals (formaldehyde, penicillin products).
p.3
Chronic Obstructive Pulmonary Disease (COPD) Definition
Do most patients with COPD exhibit features of both emphysema and chronic bronchitis?
Yes, the majority of patients have features of both.
p.4
Chronic Obstructive Pulmonary Disease (COPD) Definition
What is the anatomical definition of emphysema?
Irreversible enlargement of air spaces distal to terminal bronchiole with destruction of their walls.
p.23
Chronic Bronchitis Pathogenesis and Morphology
What type of inflammation is predominant in chronic bronchitis?
Chronic inflammation predominantly involving lymphocytes and macrophages.
p.2
Chronic Obstructive Pulmonary Disease (COPD) Definition
What role do genetic factors play in COPD?
Certain genetic polymorphisms can contribute to the disease.
p.17
Pathophysiology of Emphysema
How does lung compliance change with aging?
It increases due to loss of elastin, without destruction of alveoli.
p.36
Bronchial Asthma Types and Pathogenesis
What type of disease is bronchial asthma?
Chronic Obstructive airway disease with variable expiratory airflow obstruction.
Where is distal acinar emphysema typically seen?
Adjacent to the pleura and areas of fibrosis, scarring, or atelectasis.
p.17
Pathophysiology of Emphysema
What happens to Residual Volume (RV) with aging?
It increases significantly.
p.17
Pathophysiology of Emphysema
How do Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) change with aging?
Both decrease significantly.
p.33
Respiratory Failure Types and Causes
Can CO2 be eliminated even with ventilation-perfusion mismatch?
Yes, by increasing ventilation.
p.37
Bronchial Asthma Types and Pathogenesis
What are other triggers for nonatopic asthma?
Inhalants, cold, and exercise.
p.19
Pathophysiology of Emphysema
What condition can develop as a result of hypoxic vasoconstriction?
Secondary pulmonary hypertension.
p.19
Pathophysiology of Emphysema
What is the final outcome of the complications stemming from emphysema?
Congestive heart failure.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What type of epithelial damage is observed in bronchial asthma?
Fragile epithelium with detachment of surface epithelial cells from basal cells.
p.49
Diagnosis and Clinical Features of Bronchial Asthma
What is the DLCO often like during an asthma attack?
It is often increased due to increased lung and lung capillary blood volume.
p.45
Diagnosis and Clinical Features of Bronchial Asthma
What is subbasement membrane fibrosis?
Fibrosis occurring beneath the basement membrane in the bronchus, associated with asthma.
p.37
Bronchial Asthma Types and Pathogenesis
What are common triggers for atopic asthma?
Dusts, pollens, cockroach or animal dander, and food.
What characterizes irregular emphysema?
The acinus is irregularly involved and almost invariably associated with scarring.
p.33
Respiratory Failure Types and Causes
What is hypercapnia?
An increase in carbon dioxide (CO2) levels in the blood.
p.48
Clinical Features of Emphysema
What happens during the intervals between asthma attacks?
Patients are free from respiratory difficulty.
p.48
Clinical Features of Emphysema
What is the typical FEV1 level in bronchial asthma?
Usually below 30% of predicted normal.
p.14
Clinical Features of Emphysema
What auscultation findings are common in emphysema?
Decreased breath sounds and prolonged expiration.
p.25
Pulmonary Function Tests in COPD
What does a decreased DLCO in emphysema reflect?
Progressive loss of alveoli and their capillary beds.
p.9
Pathophysiology of Emphysema
What is the consequence of a relative deficiency of antiproteases in emphysema?
Destruction of the elastic wall of the lungs.
p.21
Chronic Bronchitis Pathogenesis and Morphology
What is the Reid index and how is it affected in chronic bronchitis?
The Reid index increases due to excessive mucus production.
p.10
Chronic Obstructive Pulmonary Disease (COPD) Definition
Why do null variants of α1-antitrypsin lead to lung disease but not liver disease?
This is a complex question related to the distribution and function of α1-antitrypsin in different organs.
p.46
Bronchial Asthma Types and Pathogenesis
What changes occur in bronchial smooth muscle in chronic asthma?
Hypertrophy and/or hyperplasia of the bronchial smooth muscle.
p.48
Clinical Features of Emphysema
What is a characteristic feature of dyspnea in bronchial asthma?
Wheezing due to airway caliber reduction and prolonged turbulent airflow.
p.20
Pathophysiology of Emphysema
What is the result of K+ accumulation in the cells?
Depolarization of the cells.
p.20
Pathophysiology of Emphysema
What opens as a consequence of cell depolarization?
Voltage-gated calcium channels.
p.19
Pathophysiology of Emphysema
What physiological response occurs after damage to the capillary bed?
Hypoxic vasoconstriction.
p.21
Chronic Bronchitis Pathogenesis and Morphology
What is a primary cause of chronic bronchitis?
Exposure to noxious or irritating inhaled substances such as tobacco smoke.
p.18
Chronic Obstructive Pulmonary Disease (COPD) Definition
What type of heart failure can result from emphysema?
Right-sided heart failure.
p.10
Chronic Obstructive Pulmonary Disease (COPD) Definition
What condition do PiZZ individuals develop?
Symptomatic panacinar emphysema.
p.46
Bronchial Asthma Types and Pathogenesis
What change occurs in the size of submucosal glands in chronic asthma?
An increase in size of the submucosal glands.
p.19
Pathophysiology of Emphysema
What is indicated by increased P2 in the second heart sound?
Increased pressure in the pulmonary component due to pulmonary hypertension.
p.46
Bronchial Asthma Types and Pathogenesis
What type of fibrosis occurs in the subbasement membrane in chronic asthma?
Subbasement membrane fibrosis.
p.46
Bronchial Asthma Types and Pathogenesis
What is airway remodeling in chronic bronchial asthma?
Structural changes in the airways that occur over time.
p.46
Bronchial Asthma Types and Pathogenesis
What happens to the number of airway goblet cells in chronic asthma?
Increase in number of airway goblet cells.
p.46
Bronchial Asthma Types and Pathogenesis
What happens to the airway wall in chronic asthma?
Thickening of the airway wall.
