Page 381 - Concise Pathology for Exam Preparation ( PDFDrive )

366 SECTION II Diseases of Organ Systems

Q. Differentiate between centriacinar and panacinar emphysema.

Ans. Differences between centriacinar and panacinar emphysema are shown in Table 13.1.

TABLE 13.1. Differences between centriacinar and panacinar emphysema

Features Centriacinar emphysema Panacinar emphysema
Distribution Central or proximal part of acini affected and Acini uniformly enlarged from the level of
distal acini spared respiratory bronchiole to terminal blind
alveolar sac
Part of lung More common in upper lobes More common in lower zones and anterior
involved margin of lungs. Most severe at the bases
Aetiology Predominantly seen in heavy smokers, often Associated with a-1 AT deficiency
in association with chronic bronchitis
Pigment depo- Walls of emphysematous spaces contain No such findings or association
sition large amounts of pigment (associated with
coal worker’s pneumoconiosis)
Inflammation Inflammation around bronchi and bronchi- Not seen
oles is commonly encountered
Frequency of More common Less common
occurrence

Q. Differentiate between chronic bronchitis and emphysema.
Ans. Differences between chronic bronchitis and emphysema are shown in Table 13.2.

TABLE 13.2. Differences between chronic bronchitis and emphysema
Features Chronic bronchitis Emphysema
Age 40–45 years 50–75 years
Dyspnoea Mild and late Severe and early
Cough Early onset with copious sputum Late onset with scanty sputum
Infections Common Occasional
Respiratory insufficiency Repeated Terminal
Cor pulmonale Common Rare and terminal
Airway resistance Increased Normal or slightly increased
X-ray chest Large heart Small heart
Physical appearance Blue bloater Pink puffer

Q. Differentiate between extrinsic and intrinsic asthma.

Ans. Differences between extrinsic and intrinsic asthma are shown in Table 13.3.

TABLE 13.3. Differences between extrinsic and intrinsic asthma
Features Extrinsic asthma Intrinsic asthma
Evolution Induced by a Type I hypersensitivity Immune mechanism not involved; precipi-
reaction due to an extrinsic antigen; tated by some variable idiosyncratic reac-
positive skin hypersensitivity tests tions; negative skin hypersensitivity tests
Family history Present Absent
Age group affected Childhood Adults
Other allergies, eg, rhini- Present Absent
tis, urticaria, eczema
Serum IgE Increased Normal
Associated emphysema Rare Common
Associated bronchitis Absent Present

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