Chronic cough and dyspnoea

The aim of this topic is to gain familiarity with the common causes of chronic airflow limitation and its clinical consequences. Interstitial lung disease should also be considered.

Learning objectives:

At the completion of this topic you should be able to:

1. Describe the anatomical and physiological basis of gas exchange across the pulmonary vascular bed.
2. Define terms used in relation to chronic cough and dyspnoea, including emphysema, chronic bronchitis, chronic bronchiolitis and chronic airflow limitation. For each of these disorders, describe the concomitant pathological, physiological and/or clinical changes, as well as common causative factors.
3. Describe the common forms of emphysema, and their characteristic features.
4. Outline what is known of the pathophysiology of emphysema, particularly with respect to its causation by cigarette smoking.
5. Outline the physiological consequences of chronic airflow limitation, especially on gas exchange and pulmonary arterial resistance.
6. Describe the typical histological features of interstitial lung disease, and relate these to their physiological effects in terms of gas exchange and pulmonary function tests.
7. List factors known to be associated with the development of interstitial lung disease.
8. Delineate groups at risk of inhalation of inorganic dusts such as asbestos, silica and coal, and compare the pathological, radiographic and clinical effects of these agents.

Trial exam questions:

1. Explain the relationship between the inhalation of cigarette smoke and the destruction of alveolar walls.
2. Outline the adverse effects of cigarette smoking on organs other than the lung.

Other relevant protocol - 44

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