Chronic Bronchitis
The "Blue Bloater" Phenotype
The Reid Index
Ratio of mucous gland thickness to wall thickness between epithelium and cartilage.
Cellular Change
Hyperplasia & Hypertrophy of mucous glands.
Blood Response
Hypoxemia triggers Secondary Polycythemia (↑ Hematocrit).
- • Primary Goal: Smoking cessation (reduces progression).
- • Medical: Long-acting anticholinergics & β2-agonists.
- • Prevention: Annual Influenza and Pneumococcal vaccines.
• Chronic Bronchitis is a clinical diagnosis, while Emphysema is structural.
• V/Q Mismatch leads to early hypoxemia and hypercapnia.
• Severe cases may progress to Cor Pulmonale (RV failure).
1. What is the clinical definition of chronic bronchitis?
Answer: Productive cough ≥ 3 months/year for ≥ 2 consecutive years.
2. What histological ratio is used to measure mucous gland hypertrophy?
Answer: The Reid Index.
3. A Reid Index of what percentage confirms chronic bronchitis?
Answer: > 50%.
4. Why do chronic bronchitis patients develop secondary polycythemia?
Answer: Chronic hypoxemia triggers EPO production by the kidneys.
5. How does the DLCO in chronic bronchitis compare to emphysema?
Answer: It is typically normal (whereas it's decreased in emphysema).
6. What phenotype description is classically applied to chronic bronchitis?
Answer: "Blue Bloater" (due to cyanosis and edema).
7. Which intervention is most effective at slowing the decline of FEV1?
Answer: Smoking cessation.
8. What acid-base disturbance is seen in advanced chronic bronchitis?
Answer: Respiratory Acidosis (due to CO2 retention).
9. What is the cause of edema in the "Blue Bloater"?
Answer: Cor pulmonale (right-sided heart failure) leading to systemic congestion.
10. What cellular change occurs in the bronchial mucous glands?
Answer: Hypertrophy and hyperplasia.
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