The document discusses two major lung diseases: obstructive airway diseases and restrictive lung diseases. Obstructive diseases include asthma, emphysema, chronic bronchitis, and bronchiectasis. They are characterized by limitations of airflow due to partial or complete airway obstruction. The causes, types, pathogenesis and clinical features of various obstructive lung diseases like asthma, emphysema and chronic bronchitis are described in detail.
1. Two major lung diseases 1. Obstructive – airway disease a) limitations of airflow i) partial or complete obstruction at any level major causes a) asthma – obstructive b) emphysema – loss of elastic recoil c) chronic bronchitis d) Bronchiectasis e) cystic fibrosis f) bronchiolitis www.freelivedoctor.com
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4. b) clinically i ) dyspnea ii) cough iii) wheezing (expiratory) - triggered via bronchospasm iv) 5% adults and 10%children v) status asthmaticus – fatal outcome vi) between attacks asymptomatic www.freelivedoctor.com
5. Classification a) extrinsic asthma – initiated by type I hypersensitivity reaction induced by exposure to extrinsic antigen b) 3 types of extrinsic asthma i) atopic (most common); 1st 2 decades; increased IgE; CD4 and T cells - type I hypersensitivity ii) occupational (many forms) iii) allergic bronchopulmonary aspergillus’s (bacterial colonization followed by IgE antibodies) www.freelivedoctor.com
24. Types of emphysema a) Panacinar (panlobular) emphysema i) uniformly enlarged acini ii) lower lung zones iii) 1-antitrypsin definciency b) Centrilacinar emphysema i) dilation upstream with normal distal portions ii) more common than panacinar (~ 95% of cases) iii) more common/severe in upper lobes - contain black pigment www.freelivedoctor.com
25. Centriacinar (con’t) iv) in severe disease distal acini may be involved differentialte from panacinar difficult v) seen in heavy smokers, often in association with chronic bronchitis c) Distal Acinar (paraseptal) emphysema i) proximal acini normal and distal part most involved ii) upper half of lungs/near pleura iii) associated with spontaneous pneumothorax in the young www.freelivedoctor.com
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