Obstructive Airway Disease
Air Trapping & Expiratory Limitation
Asthma
Reversible obstruction, bronchial hyperresponsiveness, eosinophilic inflammation.
COPD
Progressive, irreversible; includes chronic bronchitis and emphysema (alveolar destruction).
Bronchiectasis
Permanent dilatation of bronchi; chronic productive cough, recurrent infections.
- • Inflammation: Mucus plugging (Asthma, Chronic Bronchitis).
- • Elastic Recoil Loss: Airway collapse during expiration (Emphysema).
- • Structural: CFTR mutations in Cystic Fibrosis → thick mucus.
• Reversibility with bronchodilators is the hallmark of Asthma.
• Barrel chest results from chronic hyperinflation.
• Pursed-lip breathing increases airway pressure to prevent collapse.
1. What is the defining spirometry ratio for obstructive lung disease?
Answer: FEV1/FVC < 0.7 (or < 70%).
2. Which OAD is characterized by "permanent dilatation" of the bronchi?
Answer: Bronchiectasis.
3. What happens to Residual Volume (RV) in obstructive disease?
Answer: It increases (↑ RV) due to air trapping.
4. Which specific condition involves alveolar wall destruction and loss of elastic recoil?
Answer: Emphysema.
5. Defining criteria for chronic bronchitis: Productive cough for ___ months over ___ years.
Answer: 3 months / 2 consecutive years.
6. In Asthma, which inflammatory cell type is classically elevated?
Answer: Eosinophils.
7. What genetic mutation leads to thick mucus and OAD in Cystic Fibrosis?
Answer: CFTR (Cystic Fibrosis Transmembrane Conductance Regulator).
8. Why do patients with OAD use "pursed-lip breathing"?
Answer: To create back-pressure and keep small airways open during exhalation.
9. What finding on CXR suggests severe emphysema?
Answer: Flattened diaphragms and hyperinflated (lucent) lung fields.
10. True or False: COPD airway obstruction is typically reversible with bronchodilators.
Answer: False (It is progressive and largely irreversible).
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