First Aid, Chapter 5, Anatomy, Physiology, and Pathology, Remodeling of the lower airway Flashcards Preview

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Flashcards in First Aid, Chapter 5, Anatomy, Physiology, and Pathology, Remodeling of the lower airway Deck (13)
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1
Q

What causes airway thickening in asthma and COPD?

A

With remodeling, the airway wall is thickened by cellular infiltration, extracellular matrix deposition, and expansion of airways smooth muscle. There is also pronounced neovascularization.

2
Q

What is present in sputum of asthmatics?

A
  • Curschmann’s spirals: Corkscrew-shaped twists of condensed mucus (Figure 5-9)
  • Creola bodies: Clusters of surface epithelial cells (Figure 5-9)
  • Charcot-Leyden crystals: Eosinophil cell and granule membrane lysophospholipase (Figure 5-9)
  • Eosinophils
  • Metachromatic cells
3
Q

What is present in the sputum of COPD patients?

A
  • Though eosinophils may be present, eosinophilia is NOT predominant in sputum of patients with COPD.
  • Sputum macrophages and neutrophils during exacerbations are caused by infections.
4
Q

What is the surface epithelium like in asthma? COPD?

A

Asthma: fragile or denuded
COPD: usually not fragile

5
Q

What is the reticular basement membrane like in asthma? COPD?

A

Asthma: Thickened and hyaline
COPD: variable or normal

6
Q

What are the bronciolar mucous cells like in asthma? COPD?

A

Asthma: possible mucous metaplasia

COPD: metaplasia or hyperplasia

7
Q

What is bronchial smooth muscle like in asthma? COPD?

A

Asthma: Enlarge in large airways.

COPD: Enlarged in small airways

8
Q

What is mucus histochemistry characterized by in asthma? COPD?

A

Asthma: no change
COPD: Increased acidic glycoprotein

9
Q

What is the cellular infiltrate like in asthma? COPD?

A

Asthma: Predominantly CD3, CD4, CD25 (IL-2R) positive, marked eosinophilia, and increase in mast cells

COPD:
Predominantly CD3, CD8, CD68, CD25, VLA-1 positive, HLA-DR positive, mild eosinophilia, and mast cell increas

10
Q

What cytokines are increased in asthma? COPD?

A

Asthma: Increase in IL-4 and IL-5 gene expression

COPD: GM-CSF protein, ±IL-4; No increase in IL-5

11
Q

What is the airflow obstruction like in asthma? COPD?

A

Asthma: Variable, reversible; Nonreversible after remodeling

COPD: Usually progressive deterioration of lung function

12
Q

What are the postmortem findings in asthma? COPD?

A

Asthma: Hyperinflation, airway plugs; Usually no emphysema

COPD: Excessive mucus, more small airway involvement; Emphysema prominent

13
Q

What are the pathologic features of airway remodeling?

A

Airway wall thickening with increased collagen deposition and airway smooth muscle, goblet cell hyperplasia, subepithelial fibrosis, and angiogenesis

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