9. Respiratory Tract Pathoma Flashcards
main cause of rhinitis
what is a major consequence it can lead to
adenovirus
nasal polyps
when a child has nasal polyps what should you be thinking?
Cystic fibrosis
ASA (asprin) intolerant asthma
main cause of epiglottitis
H. influenza
Pneumonia
what does the sputum look like?
percusion?
3 types of pneumonia?
Infection of lung parenchyma
- yellow green or rusty colored sputum
- dull percusion
- Lobar, Bronchopneumonia, Interstitial
Lobar Pneumonia
which are the two most common causes
consolidation of an entire lobe
usually bacteria
S. Pnuemonia (95%) & Klebsiella Pneumoniae
Bronchopneumonia
which bacteria causes this
scattered patchy pneumonia cetered around the bronchioles
-S. A, H. influ, S. pneumonia, klebsiella
interstitial (atypical) pneumonia
why is it called Walking Pneumonia
What causes it
diffuse interstitial infiltrates
- has very mild symptoms
- Mycoplasma pneumonia (military recruits or college kid), Chlamydia Pnuemonia, RSV (infants) , CMV (post transplant)
Tuberculosis
whats the PPD
primary/secondary?
inhalation of Mycobacterium Tuberculosis
- caseating necrosis of lower lobe
- Ghon complex (fibrosis and calcification)
- PPD (+)
Secondary- reactivation of TB due to AIDs (APEX) of lung. CASEATING granulomas
COPD
whats the spirometry readings
types
obstruction of getting air OUT of the lung
ForcedVC (down), FExpiratoryV1(down-down)
TLC(up) due to lung trapping of air
-Chronic Bronchitis, Emphysema, Asthma, Bronchiectasis
Chronic Bronchitis
how does one get it
Whats the Reid index and whats the value for CB
How do they present
whats a bad thing this can lead to
Hyperplasia of mucus secreted glands as a result of smoking
Reid index is the thickness of mucosal gland layer to the thickness of wall btwn epithelium and cartilage. For CB its >50%
- presents with Productive Cough, Cyanosis
- -Cor Pulmonale (*hypoxia leads to vasoconstriction to area and shunting to other areas in lung–> failure of right heart)
Emphysema
what imbalnace/deficiency causes this?
most common cause of this?
what are the two types? which lobes are they associated with?
whats a nickname for this?
Destruction of alveolar sacs
loss of elastic fibers, increased compliance, “Shopping bag’, AIrway collapse
Lack of Alpha 1 AntiTrypsin (A1AT)
-SMOKING (duh bruh)
Centriacinar (smoking-upper lobes)
Panacinar (A1AT deficiency- lower lobes)
-PINK PUFFER (barrel chest)
Asthma
Reversible Bronchospasm most often due to allergic stimulus
IgE Hypersensitiviy type 1 mediated
IL-4
IL-5
IL-10
4 - IG class switching
5 - calls in eosinophils
10 - stimulates th2 T cells
Bronchiectasis
what causes it?
Permanant dilation of the bronchioles and bronchi
loss of tone leads to air trapping
(think of blowing throught a big pipe)
-necrotizing granulation of airway wall
secondary amyloidosis
Restrictive respiratory DZ
whats the FEV:FVC ratio?
Restricted filling of the lung mostly due to FIBROSIS
Ratio is INCREASED >80%
Idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis
what does lung look like?
Treatment?
repeated wound healing with collagen deposition
Honeycomb lung appearance
lung transplant
Pneumonconioses
Interstitial fibrosis due to occupational exposure
coal worker, silicosis, abestosis
coal workers pneumoconioses
whats caplan syndrome?
Anthracosis?
Restricitve lung dz (fibrosis)
Black lung
macrophages laden with carbon lead to inflammation and fibrosis
caplan: rheumatoid arthritis and penumonconioses
Antrhacosis: carbon in the lung thats assymptomatic
Silicosis
how does it affect macrophages?
whats special solely about this pneumocon.?
what part of lung does it affect? (roof and base)
Restrictive lung dz (pneumoconioses)
- sandblasting, mines
- it impairs the phagolysosome
- its the only wone that increases chance of TB
“silica and coal are on the base, but affect the roof”
(upper lobe)
beryliosis
restrictive lung dz (pneumoncon.)
exposure to beryllium in aerospace
non-caseating granulomas
Asbestosis
where does it affect the lung
what do you look for to confirm diagnosis
restrictive lung dz (pneumocon)
Associated w/ shipbuilding, roofing, plumbing.
lower lobe
-asbestos (ferrunginous) bodies: golden brown rods
Sarcoidosis
which type of lesion and where will you find them
who gets it?
what else type of cell can you see in this histo?
what values are elevated?
why does this cause hypercalcemia?
Restrictive lung dz
“noncasesating granuloma” in multiple organs (speccifically lung and hilar lymp nodes)
African american femal under 40yrs old
- asteroid body
- elevated ACE levels, CD4/8 ratio
- due to incr. 1Alpha-hydroxylase vit D activation in macrophages
Lung cancer
Small cell carcinoma
who gets it, where is it located, what does it produce
poorly differentiated small cells
Male smokers, Centrally,
may produce ACTH or antibodies against PRESYNAPTIC Ca+2 channels (lambert-eaton)
lung cancer
Squamos cell carcinoma
Whats the big clue on histo
where is it? what symdrome?
Keratin pearls and Intercelluar bridging
- Central
- produces PTHrP (hyperCalcemia)
