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Respiratory tract pathology. Premed 2 Pathophysiology. Common Upper respiratory tract Disorders. Acute rhinitis -common cold -adenovirus Allergic rhinitis -type I hypersensitivity reaction -mast cells, basophils Bacterial infection -superimposed infection
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Respiratory tract pathology Premed 2 Pathophysiology
Common Upper respiratory tract Disorders • Acute rhinitis -common cold -adenovirus • Allergic rhinitis -type I hypersensitivity reaction -mast cells, basophils • Bacterial infection -superimposed infection -common bacteria: Staphylococcus, Streptococcus, Hemophilus
Sinusitis -inflammation of the paranasal sinuses • Laryngitis -edema, inflammation, hoarseness • Acute epiglotitis -severe, children -Hemophilus influenzae
Acute laryngotracheobronchitis -croup -inflammation of the larynx, trachea and epiglottis -viral infection
Malignancies of the URT • Nasopharyngeal carcinoma -SEA and Africa -Epstein-Barr virus • Squamous cell carcinoma -most frequently occurring tumor
Chronic Obstructive Pulmonary disease • Airflow obstruction • Decrease in 1-minute forced expiratory volume • Increased/normal forced vital capacity • Bronchial asthma • Chronic bronchitis • Pulmonary emphysema • Bronchiectasis
Bronchial asthma • Episodes of dyspnea • Wheezing on expiration • Smooth muscle hypertrophy • Hyperplasia of the bronchial submucosal glands and goblet cells • Viscid mucus with Curschmann spirals and Charcot-Leyden crystals
Chronic bronchitis • Productive cough that occurs for 3 consecutive months in 2 consecutive years • Hyperplasia of the bronchial submucosal glandsincreased Reid index • Reid index: ratio of the thickness of the gland layer to that of the bronchial wall • Cigarette smoking • Air pollution • Infection • Complication: cor pulmonale
Emphysema • Dilatation of the air spaces • Destruction of the alveolar walls • Lack of elastic recoil • Increased antero-posterior diameter of the chest • Hypoxia, cyanosis, respiratory acidosis • Cigarette smoking • Hereditary alpha-antitrypsin deficiency
Bronchiectasis • Permanent abnormal bronchial dilatation • Chronic infection • Inflammation and necrosis of the bronchial wall • Copious pururlent sputum • Hemoptysis • Lung abscess
Predisposing factor: -bronchial tumor -Kartagener syndrome: sinusitis, bronchiectasis, situs inversus
Respiratory Distress Syndrome • Surfactant • decreases the surface tension of the alveoli • needed for alveoli to fill with air and expand (compliance) • Infant respiratory distress syndrome (hyaline membrane disease) • Adult respiratory distress syndrome
Neonatal respiratory distress syndrome • Hyaline membrane disease • Most common cause of death in premature infants • Dyspnea, cyanosis, tachynea after birth • Deficiency of surfactant: dipalmitoyl lecithin; from type II pneumocytes
HMD • Predisposing factors prematurity maternal diabetes caesarean section
Pneumoconiosis • Anthracosis: carbon dust • Coal worker’s pneumoconiosis: coal dust • Silicosis: free silica dust • Asbestosis: asbestos fibers ferruginous bodies -brochogenic carcinoma -malignant mesothelioma
Bronchogenic carcinoma • Directly proportional to the number of cigarettes smoked daily and the number of years • Air pollution • Radiation: radium, uranium • Asbestos • Nickel, chromates
Bronchogenic carcinoma • 5-year survival rate: 10 % • Cough hempotysis bronchial obstruction • Local extension: pleura, pericardium, ribs