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Pulmonology > 08.18 - Obstructive, Restrictive Dz (Nichols) - Questions > Flashcards

08.18 - Obstructive, Restrictive Dz (Nichols) - Questions Flashcards

1
Q

Bronchiectasis: Obstructive or Restrictive?

A

Obstructive

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2
Q

Pneumoconiosis: Obstructive or Restrictive?

A

Restrictive

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3
Q

Sarcoidosis: Obstructive or Restrictive?

A

Restrictive

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4
Q

4 types of Non-infectious interstitial lung disease

A

Usual Interstitial Pneumonia; Crytogenic Organizing Pneumonia; Nonspecific Interstitial Pneumonia; Radiation Pneumonitis

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5
Q

3 cytokines involved in pathogenesis of emphysema

A

IL-8, TNF, and LeukotrieneB4

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6
Q

What causes pulmonary HTN in emphysema

A

Decr pulmonary vascular capacitance –> Same blood thru smaller vessels –> Incr pulmonary arterial pressure

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7
Q

Pulmonary arterial pressure in Emphysema

A

Increased –> Cor Pulmonale

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8
Q

Emphysema due to smoking is usually ___-acinar

A

Centri-

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9
Q

Type of emphysema in young male smokers with spontaneous pneumothorax

A

Distal Acinar

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10
Q

Most typical symptom of pure emphysema

A

Insidious onset of progressive dyspnea

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11
Q

Mucus hypersecretion thought to be mediated by what cytokine and incr transcription of what gene

A

IL-13; MUC5AC

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12
Q

From where do the cytokines originate that cause mucus hypersecretion in CB

A

T Cells –> IL-13

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13
Q

Symptom of CB

A

Productive Cough

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14
Q

Distinctive, defining feature of CB

A

Bronchial hypersecretion of mucus

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15
Q

Bronchiectasis is permanent dilation of bronchi due to ____ by ___

A

destruction of muscle and elastic tissue by necrotizing infection

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16
Q

3 underlying states leading to infection causing Bronchiectasis

A

(1) CF; (2) Immunodeficiency; (3) Kartagener Syndrome

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17
Q

What is Kartaganer Syndrome

A

Ciliary impairment

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18
Q

Localized bronchiectasis can occur

A

distal to a bronchial tumor or from necrotizing pneumonia

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19
Q

Symptoms of Bronchiectasis

A

Chronic persistent cough productive of copious purulent sputum

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20
Q

Signs of Bronchiectasis

A

Expiratory Rhonchi

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21
Q

Early acute phase asthma

A

IgE, Mast Cells, Histamine, Leukotriene B4, Vagus Nerve

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22
Q

Late Acute Phase Asthma

A

Eosinophils, Neutrophils, Lymphs, IL-1, TNF, IL-6, Leukotrienes C4, D4, E4, PGD2, PAF

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23
Q

Asthma exhibits ___-type inflammation

A

TH2-type

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24
Q

Three C’s of Asthma

A

Curschmann’s Spirals; Charcot-Leyden Crystals; Creola Bodies

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25
Q

Curschmann’s Spirals

A

Small whorled mucus strands

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26
Q

Creola Bodies

A

Fragments of degenerated sloughed respiratory epithelium

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27
Q

Presence of goblet cells in bronchioles

A

Not normally present –> Appear in Asthma

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28
Q

Pneumoconioses

A

Fibrosing restrictive lung diseases caused by inhalation of particles

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29
Q

Fibrosing restrictive lung diseases caused by inhalation of particles

A

Pneumoconioses

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30
Q

Coal Worker’s: Activation of __ and __ production leads to fibrosis

A

Activation of Inflammasome and IL-1 production

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31
Q

What percent of Coal Worker’s results in progressive massive fibrosis

A

Less than 10%

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32
Q

Most prevalent chronic occupational disease in the world

33
Q

Ingestion of Silica by alveolar macrophages leads to release of

A

TNF, IL-1, Fibronectin, ROS, and TGF-B –> Fibrosing chronic inflammation

34
Q

Gross pathology of Silicosis

A

Discrete, palpable grey-tan nodules w/ or w/out anthracotic pigment

35
Q

Microscopic pathology of Silicosis

A

Nodules of concentrically arranged hyalinized collagen

36
Q

Tissue response to asbestos

A

Coated with iron and elicit fibrosis

37
Q

Signs of Asbestosis

A

Basal pulmonary crackles

38
Q

Symptoms of Asbestosis

A

Dyspnea and persistent dry cough

39
Q

4 most common sites of sarcoidosis

A

Lung, Lymph Node, Eye, Skin

40
Q

Sarcoid: stimuli cause ___ response, mediated by ___

A

TH1 CD4 response, mediated by IL2, IFN-g, and TNF-A

41
Q

Role of IL-8 in Sarcoid

A

attract neutrophils

42
Q

Sarcoid: IL-4 mediates

A

later transition to fibrosing inflammation; chemoattractant to fibroblasts

43
Q

later transition to fibrosing inflammation; chemoattractant to fibroblasts

44
Q

Type of granulomas in Sarcoidosis

A

Non-caseating; Non-necrotic; Tight naked

45
Q

Pulmonary signs of Sarcoidosis

A

Usually none

46
Q

Classic CXR of Sarcoidosis

A

Reticulonodular pulmonary infiltrates and bilateral hilar lymphadenopathy

47
Q

Reticulonodular pulmonary infiltrates and bilateral hilar lymphadenopathy

A

Sarcoidosis, Histoplasmosis, Tuberculosis

48
Q

Distribution of granulomas in Sarcoidosis

A

Lympharangitic distribution along bronchovascular bundles and in bilateral hilar lymph nodes

49
Q

Symptoms and Signs of UIP/IPF

A

Insidious onset of dyspnea; Pulmonary crackles

50
Q

Gross pathology of UIP/IPF

A

Large discrete scars, making lung firmer and more gray than usual; Visceral pleura has nodularity

51
Q

Microscopic Hallmark of UIP/IPF

A

Fibroblast foci of immature fibrosis bulging into alveoli from interstitium

52
Q

Definitive dx of UIP/IPF is made by

A

lung biopsy

53
Q

Treatment of UIP/IPF

A

Transplantation

54
Q

Why is it important to differentiate UIP from COP and NSIP

A

COP and NSIP respond to steroid therapy

55
Q

Epidemiology of COP

A

Late middle age non-smokers

56
Q

Histologic Hallmark of COP

A

Masson Bodies: Plugs of fibrosing granulation tissue in the alveoli

57
Q

Masson Bodies

A

Plugs of fibrosing granulation tissue in the alveoli: COP

58
Q

Symptoms and Signs of COP

A

Present with cough, sometimes productive; Dry inspiratory crackles

59
Q

CXR of COP

A

Ground Glass Bilateral Opacities

60
Q

Tx of COP

61
Q

Epidemiology of NSIP

A

Middle age women non-smokers

62
Q

Presentation of NSIP

A

Dyspnea and Cough

63
Q

CXR of NSIP

A

Bilateral Ground Glass Opacities

64
Q

Microscopic features of Radiation Pneumonitis

A

Atypical Type 2 Pneumocyte Hyperplasia and blood vessel injury

65
Q

Young male smoker with spontaneous pneumothorax

A

Distal Acinar Emphysema

66
Q

Top relevant Interleukin in Asthma vs COPD

A

IL-5; IL-8

67
Q

Charcot-Leyden crystals are composed of

A

Galectin-10

68
Q

UIP is usually due to

A

Genetically-determined aberrant healing from aspiration of gastric contents, smoking, exposure to toxins

69
Q

Temporality of UIP

A

Heterogenous

70
Q

Lobar location of UIP

A

Worse in peripheral lower lobes

71
Q

UIP genetic predisposition in many patients

A

TERT or TERC genes

72
Q

Fibroblast Foci

A

Histologic Hallmark of UIP

73
Q

Masson Bodies are found in

74
Q

Temporality of NSIP vs UIP

A

Homogenous vs Heterogenous

75
Q

Number of infections/injuries in NSIP, UIP, COP

A

1 in NSIP and COP; repeated in UIP

76
Q

Patients with Silicosis are more prone to __ due to ___

A

Tuberculosis, paralyzed macrophages

77
Q

Tight, well-formed, non-caseating granulomas

A

Sarcoidosis

78
Q

Caseating Granulomas =

A

Tuberculosis

Pulmonology (31 decks)

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