3.6.3. Lung Pathology - ADDITIONAL STUFF NOT IN PATHOMA Flashcards
Subclassifications of pulmonary edema
Can be subclassified into cardiogenic or non-cardiogenic
Non-cardiogenic → due to _______.
Non-cardiogenic → due to alveolar wall injury
injury to capillary endothelial cells and/or alveolar epithelial cells
Recall: Edema caused by __________________.
Recall: Edema caused by a change in pressure differential at exchange points
congestion of capillaries create a ___ ____ appearance
congestion of capillaries create a foggy red appearance
For ARDS, xray signs tend to be more prominent in the ____ portion of the lungs
lower
What is DAD
Diffuse alveolar Damage
Seen in ARDS
What is paraseptal emphysema?
A magical third type that the boards don’t care about but USUHS does.
Occurs in young adults with spontaneous pneumothorax (this is the emphysema related to the rupturing bleb we heard about)
That “bleb” can be a large bullae greater than 1cm in diamter and is more severe in the upper lung
Sarcoidosis is an example of this type of hypersensitivity
Type IV
80% of mesothelioma cases have this genetic abnormality
80% of cases have homozygous deletion of CDKN2A/INK4a on Chrom 9p
Asbestos vs. Silicon and coal
Asbestos is from the roof (common in insulation) but affects the base (lower lobes). Silica and coal are from the base (earth) but affect the roof (upper lobes)
What is rhinosinusitis and how does it present?
obstructive sinus drainage into nasal cavity -> inflammation and pain over affected area (typically maxillary sinus in adults)
Most common cause of rhinosinusitis
most common cause is viral URI; may cause superimposed bacterial infection caused by S. pneumoniae, H. influenzae, or M. catarrhalis
Virchow Triad
stasis
hypercoagulability (e.g. defect in coagulation cascade proteins, most commonly factor V Leiden)
endothelial damage (exposed collagen triggers clotting cascade)
What does Virchow Triad predispose people to?
DVT
What is the Homan sign?
Homan sign - dorsiflexion of foot -> calf pain
Drugs used for a DVT
use heparin for prevention and acute management; use warfarin for long-term prevention of DVT clearance
Types of emboli that can lead to DVT
FAT BAT (Thank you FA)
fat: associated with long bone fractures and liposuction: presents as triad of hypoxemia, neurologic abnormalities, and petechial rash
amniotic fluid: fluid emboli that can lead to DIC esp. postpartum
thrombus
bacteria
air: nitrogen bubbles precipitate in ascending divers; treat with hyperbaric oxygen
Tumor
Presentation for sleep apnea
repeated cessation of breathing > 10 sec. during sleep -> disrupted sleep -> daytime somnolence. Normal PaO2 during the day.
Nocturnal hypoxia
Nocturnal hypoxia -> systemic/pulmonary hypertension, arrhythmias (atrial fibrillation/flutter), and sudden death
What is central sleep apnea
Central sleep apnea: no respiratory effort
Obstructive sleep apnea
Obstructive sleep apnea: respiratory effort against airway obstruction. Associated with obesity and loud snoring
Obesity hypoventilation
Obesity hypoventilation syndrome: obesity (BMI > 30 kg/m^2)-> hypoventilation -> decreased PaO2 and increased PaCO2 on waking hours
What paraneoplastic syndromes can be caused by Small Cell Carcinoma?
Cushings
Hyponatremia
What is a pancoast tumor and what does it cause?
Carcinoma that occurs in the apex of lung and may affect cervical sympathetic plexus, causing Horner syndrome (ipsilateral ptosis, miosis, and anhidrosis), SVC syndrome, sensorimotor deficits, and hoarseness.
