Which of the following types of emphysema is most commonly associated with smoking and chronic bronchitis?
A Centriacinar
B Panacinar
C Irregular
D Paraseptal
Centriacinar
Centrilobular or centriacinar emphysema is associated with smoking and chronic bronchitis.
what is panacinar or panlobular emphysema associated with
Panacinar or panlobular emphysema is associated with alpha 1 anti-trypsin deficiency.
what is irregular emphysema or airspace enlargement associated with
fibrosis
what is paraseptal or ductal emphysema associated with
spontaneous pneumothorax
Definition of emphysema
Abnormal permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by destruction of alveolar walls without obvious fibrosis.
Pathological features of emphysema
Loss of elastic recoil → airway collapse during expiration
Air trapping → hyperinflation of lungs
↓ Gas exchange surface area
Bullae formation (large air spaces)
pathogenesis of emphysema caused by Ciagrette smoke/pollutants
→ recruits neutrophils & macrophages
→ ↑ release of proteases (e.g. elastase)
→ oxidative stress inactivates α1-antitrypsin (AAT)
→ destruction of alveolar walls
pathogenesis of emphysema caused by alpha-1antitrypsin deficiency
↓ inhibition of neutrophil elastase
→ unchecked elastase activity
→ early-onset emphysema (especially panacinar type)
spirometry findings of emphysema
↓ FEV₁
↓ FEV₁/FVC ratio
↑ TLC, ↑ RV (due to air trapping)
Which of the following statements is correct In regard to emphysema?
A A deficiency of alpha 1 antitrypsin is protective
B Centriacinar destruction leads to obstructive overinflation
C The protease-antiprotease mechanism is the most plausible explanation for the disease
D Elastase activity is unaffected by oxygen free radicals
C The protease-antiprotease mechanism is the most plausible explanation for the disease
