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511 Patho (Disease Physiology) Exam
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511 Patho (Disease Physiology) Exam 511 Patho (Disease Physiology) Exam 511 Patho (Disease Physiology) Exam
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511 Patho (Disease Physiology) ExamCONDUCTING AIRWAY - ANS -----------
Irreversible dilation of the conducting airway is what?
What is it called when this only impacts one area of the lung?
What is it called when there are widespread changes throughout the lung fields? - ANS
Bronchiectasis
Focal bronchiectasis
Diffuse bronchiectasis
Focal bronchiectasis is typically caused by what?
Diffuse bronchiectasis is typically caused by what? - ANS Obstruction (extrinsic, intrinsic)
Systemic disease (genetics, infection, idiopathic)
What is the Vicious Cycle Hypothesis in infectious bronchiectasis? - ANS Patients with poor
mucociliary clearance are prone to colonization of the bronchi by pathogens which leads to
inflammation and damage -> more inflammation and damage aggravates the airway and leads to
more inflammation and further susceptibility to pathogens
Impaired mucociliary clearance leading to the vicious cycle hypothesis can be due to what two
things? - ANS Genetic -> CF
Infection -> B. pertussis, M. pneumoniae
How do the inflammatory cells attracted to colonized microbes worsen bronchiectasis?
,How does "inflammatory stuff" such as dead bacteria, cellular debris, mucus, and immune cells
worsen bronchiectasis? - ANS Release proteases -> airway wall damage -> bronchospasm, mucus
Block small airways -> traction (fibrosis) -> permanent dilation
What is protective against the inflammatory response seen in bronchiectasis?
Who is at high risk for the development of bronchiectasis? - ANS Alpha1-antitrypsin
Genetic deficiency of alpha1-antitrypsin
What are two non-infections mechanisms in the development of bronchiectasis? - ANS Autoimmune
-> bronchial wall lining attacked
Traction -> d/t radiation or fibrosis -> permanent airway dilation
Diffuse inflammation of bronchioles leading to atelectasis or destruction of alveoli distal to the
affected airway passage is known as what? - ANS Bronchiolitis
What size airways are affected by bronchiolitis? - ANS <2 mm diameter
Bronchiolitis has what effect on ventilation perfusion ratio?
What about carbon dioxide retention? - ANS Decreased
Increased
Infiltration of neutrophils and monocytes without fibroblasts or collagen deposition causes what
type of bronchiolitis?
Patchy, chronic inflammation with concentric fibrosis of the bronchioles and smooth muscle
hypertrophy?
Exudate due to fibrosis and foamy macrophages which obstruct the lumen?
, Smokers who have an accumulation of pigmented macrophages in the bronchioles? - ANS Acute
Constrictive
Proliferative
Respiratory
MCC of bronchiolitis? - ANS RSV (respiratory syncytial virus)
When RSV enters the mucosal tissues after contact with infected secretions or fomites, what is the
incubation period?
When does viral shedding occur? - ANS 5 days
11 days
Where does RSV replicate?
Where can it spread? - ANS Nasopharynx
Bronchiolar epithelium, alveoli (lower respiratory tract infection)
Why is RSV dangerous in infants? - ANS Bronchioles are already small, so any more narrowing leads
to occlusion
What occurs when necrotic epithelial cells, T-cells, monocytes, and neutrophils accumulate in RSV?
What about when chemokines and cytokines accumulate? - ANS Obstruction
Bronchiolitis (more severe disease)
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