Block 1 Pulmonary (nasopharynx, larynx, & cancers) Flashcards
Describe the following for Rhinitis:
What is it?
What causes it?
What are the symptoms?
Patho:
Inflammation in the nasal mucosa
Causes:
Rhinovirus
Symptoms:
1) Sneezing
2) Congestion
3) Runny nose
Patho:
Inflammation in the nasal mucosa
Causes:
Rhinovirus
Symptoms:
1) Sneezing
2) Congestion
3) Runny nose
Describes which condition?
Rhinitis
Describe the following for Allergic Rhinitis:
What is it?
What causes it?
What are the symptoms?
What are the lab findings?
What are the associated conditions?
Patho/causes
A subtype of rhinitis typically triggered by allergens (pollen) causing a type 1 hypersensitivity reaction
Symptoms = Same as rhinitis
Labs:
Inflammatory infiltrate with eosinophils
Ass:
Asthma
Eczema
Chrug-strauss syndrome
Patho/causes
A subtype of rhinitis typically triggered by allergens (pollen) causing a type 1 hypersensitivity reaction
Symptoms = Same as rhinitis
Labs:
Inflammatory infiltrate with eosinophils
Ass:
Asthma
Eczema
Chrug-strauss syndrome
Describes which condition?
Allergic Rhinitis
Describe the following for nasal polyps:
What is it?
What causes it?
Patho:
When the nasal mucosal becomes inflamed & swollen (edematous) to the point that it protrudes out
Causes:
#1 Repeated bouts of rhinitis
Cystic fibrosis
Aspirin-tolerant asthma
Patho:
When the nasal mucosal becomes inflamed & swollen (edematous) to the point that it protrudes out
Causes:
#1 Repeated bouts of rhinitis
Cystic fibrosis
Aspirin-tolerant asthma
Describes which condition?
Nasal polyps
What is the triad of aspirin-tolerant asthma?
1) Asthma
2) Aspirin induced bronchospasms
3) Nasal polyps
1) Asthma
2) Aspirin induced bronchospasms
3) Nasal polyps
Are the triad of which condition
Aspirin tolerant asthma
Describe the following for Angiofibroma:
What is it?
Who does it appear in most?
What are the symptoms?
Patho:
A benign tumor of the nasal mucosa that is made up of large blood vessels & fibrous tissue
Etiology:
Teen boys
Symptoms:
1) Profuse epistaxis (nosebleeds)
Patho:
A benign tumor of the nasal mucosa that is made up of large blood vessels & fibrous tissue
Etiology:
Teen boys
Symptoms:
1) Profuse epistaxis (nosebleeds)
Describes which condition?
Angiofibroma
Describe the following for nasopharyngeal carcinomas:
What is it?
What are the associated conditions?
What are the lab findings?
What are the symptoms?
Patho:
A malignant tumor of the nasopharyngeal epithelium
Ass:
EBV (African kids & Chinese adults)
Labs:
- Biopsy shows pleomorphic keratin =ve epithelial cells that are poorly differentiated squamous cell cancer
Symptoms:
1) Cervical lymph node involvement
Patho:
A malignant tumor of the nasopharyngeal epithelium
Ass:
EBV (African kids & Chinese adults)
Labs:
- Biopsy shows pleomorphic keratin =ve epithelial cells that are poorly differentiated squamous cell cancer
Symptoms:
1) Cervical lymph node involvement
Describes which condition?
Nasopharyngeal carcinoma
Describe the following for acute epiglottitis:
What is it?
What causes it?
What are the symptoms?
What is a complication/risk?
Patho:
Inflammation of the epiglottis
Causes:
#1 H. Influenzae type B (especially in kids without immunization)
Symptoms:
1) High fever
2) Sore throat
3) Drooling & dysphagia
4) Muffled voice
5) Inspiratory stridor
Risk:
Airway obstruction
Patho:
Inflammation of the epiglottis
Causes:
#1 H. Influenzae type B (especially in kids without immunization)
Symptoms:
1) High fever
2) Sore throat
3) Drooling & dysphagia
4) Muffled voice
5) Inspiratory stridor
Risk:
Airway obstruction
Describes which condition?
acute epiglottitis
Describe the following for Laryngotracheobronchitis (Croup):
What is it?
What is the cause?
What are the symptoms?
Patho:
Inflammation of the upper of upper airway
Causes:
#1 Parainfluenza
Symptoms:
1) Hoarse “barking” cough
2) Inspiratory stridor
Patho:
Inflammation of the upper of upper airway
Causes:
#1 Parainfluenza
Symptoms:
1) Hoarse “barking” cough
2) Inspiratory stridor
Describes which condition?
Laryngotracheobronchitis (Croup)
Describe the following for vocal cord nodules:
What are they?
What causes them?
What are the lab findings?
What are the symptoms?
How do you treat it?
Path/cause:
Nodules on the vocal cords (bilateral) that happen due to excessive use
Labs/biopsy:
Show the nodes are made of degenerative (myxoid) connective tissue
Symptoms:
1) Hoarseness
Rx: Rest
Path/cause:
Nodules on the vocal cords (bilateral) that happen due to excessive use
Labs/biopsy:
Show the nodes are made of degenerative (myxoid) connective tissue
Symptoms:
1) Hoarseness
Rx: Rest
Describes which condition?
Vocal cord nodes
Describe the following for a laryngeal carcinoma:
What is it?
What causes it?
-risks
What are the symptoms?
Patho:
A squamous cell cancer of the epithelial lining of the vocal cords
Causes/risks
Alcohol
Tobacco #1
Laryngeal papilloma (rare)
Symptoms:
1) Hoarseness
2) Cough
3) Stridor
Patho:
A squamous cell cancer of the epithelial lining of the vocal cords
Causes/risks
Alcohol
Tobacco #1
Laryngeal papilloma (rare)
Symptoms:
1) Hoarseness
2) Cough
3) Stridor
Describes which condition?
laryngeal carcinoma
Describe the following for a laryngeal papilloma:
What is it?
What causes it?
What are the symptoms?
Patho:
A benign papillary tumor on the vocal cords that is single in adults or can be multiple in children
Causes:
HVP-6 & 11 viruses
Symptoms:
1) Hoarseness
Patho:
A benign papillary tumor on the vocal cords that is single in adults or can be multiple in children
Causes:
HVP-6 & 11 viruses
Symptoms:
1) Hoarseness
Describes which condition?
laryngeal papilloma
Describe the following for pneumonia:
What is it?
What causes it?
What are the symptoms?
What are the lab findings?
Patho:
An infection of the lung parenchyma that happens when our normal respiratory defenses fail
Causes:
Impaired cough reflex from either a mucociliary escalator or mucus plug
Symptoms:
1) Fever & chills
2) Productive cough (yellow-green or rusty sputum)
3) Tachypnea with pleuritic chest pain
4) Decreased breath sounds
5) Dullness to percussion
Labs:
Elevated WBC
Chest x-ray (infiltrates)
+ve sputum & blood gram staining
Patho:
An infection of the lung parenchyma that happens when our normal respiratory defenses fail
Causes:
Impaired cough reflex from either a mucociliary escalator or mucus plug
Symptoms:
1) Fever & chills
2) Productive cough (yellow-green or rusty sputum)
3) Tachypnea with pleuritic chest pain
4) Decreased breath sounds
5) Dullness to percussion
Labs:
Elevated WBC
Chest x-ray (infiltrates)
+ve sputum & blood gram staining
Describes which condition?
Pneumonia
What is the classical triad seen in pneumonia?
1) Lobar pneumonia
2) bronchopneumonia
3) interstitial pneumonia
1) Lobar pneumonia
2) bronchopneumonia
3) interstitial pneumonia
Is a triad of which condition?
Pneumonia
Describe the following for lobar pneumonia:
What is it?
What are the causes
- 1st & other
What are the phases of this type of pneumonia?
Patho:
A lung infection that causes consolidation of the entire lung lobe
Causes:
#1 S. pneumoniae
Klebsiella pneumoniae
Phases:
1) congestion (from blood vessels & edema)
2) Red hepatization
(from exudate, neutrophils, & hemorrhages in the alveolar spaces that make the lung texture more firm)
3) Gray hepatization (there is degeneration of the red cells within the exudate)
4) Resolution
Patho:
A lung infection that causes consolidation of the entire lung lobe
Causes:
#1 S. pneumoniae
Klebsiella pneumoniae
Phases:
1) congestion (from blood vessels & edema)
2) Red hepatization
(from exudate, neutrophils, & hemorrhages in the alveolar spaces that make the lung texture more firm)
3) Gray hepatization (there is degeneration of the red cells within the exudate)
4) Resolution
Describes the lobar pneumonia?
Lobar pneumoniae
Describe the following for bronchopneumonia:
What is it?
What causes it?
An infection that causes scattered & patchy consolidation around bronchioles (usually presents multifocally & bilaterally)
Causes:
Bacterial infection
An infection that causes scattered & patchy consolidation around bronchioles (usually presents multifocally & bilaterally)
Causes:
Bacterial infection
Describes which condition?
bronchopneumonia
Describe the following for Interstitial (atypical) pneumonia:
What is it?
What are the symptoms?
What are the causes?
Patho:
Infected lungs have diffuse interstitial infiltrates
Symptoms:
1) mild upper respiratory symptoms (minimal sputum & low fever)
Causes:
Bacteria & viruses
Patho:
Infected lungs have diffuse interstitial infiltrates
Symptoms:
1) mild upper respiratory symptoms (minimal sputum & low fever)
Causes:
Bacteria & viruses
Describes which condition?
Interstitial (atypical) pneumonia
Describe the following for aspiration pneumonia:
What is it?
- who is at risk?
What causes it?
What is a complication?
Patho:
Happens in patients that are likely to choke or have inhaled food into lungs i.e Alcoholics or comatose patients
Causes:
Anaerobic bacteria in the oropharynx (bacteriodes, fusobacterium, & peptococcus)
Comp:
Right-lower lobe abscess
Patho:
Happens in patients that are likely to choke or have inhaled food into lungs i.e Alcoholics or comatose patients
Causes:
Anaerobic bacteria in the oropharynx (Bacteroides, fusobacterium, & peptococcus)
Comp:
Right-lower lobe abscess
Describes which condition?
Aspiration pneumonia
What are the causal agents of lobar pneumonia & for each one who is most at risk & why?
S. pneumoniae:
most common in community acquired pneumoniae & secondary pneumoniae in middle-aged to elderly people
S. klebsiella:
Mostly effects malnourished & debilitated individuals like the elderly (nursing homes), alcoholics, & diabetics
What are the bacteria specifically causing bronchopneumonia?
S. aureus
H. influenzae
Pseudomonas aeruginosa
Moraxella catarrhalis
Legionella pneumophilla
Which bacteria most commonly causing bronchopneumonia cause exasperation of COPD?
Legionella. H. influenzae, & Moraxella
Which bacteria most commonly causing bronchopneumonia in patients with cystic fibrosis?
Pseudomonas aeruginosa
Which bacteria most commonly causing bronchopneumonia are often complicated by abscess or empyema
S. aureus
What are the organisms that cause atypical/interstitial pneumoniae?
-Most common
- Other
Most common:
Mycoplasma pneumoniae
Other:
Chlamydia pneumoniae (young adults)
RSV (infants)
CMV (Posttransplant immunosuppressive therapy)
Influenza (Elderly, immunocompromised, & those with pre-existing lung conditions)
Coxiella (Atypical pnuemonia with Q fever in farmers & vetrenarians)
What are the complications of atypical/interstitial pneumonia infected with mycoplasma ?
Autoimmune hemolytic anemia & erythema multiforme
Describe the following for TB:
What is the major cause?
Inhaling aerosolized mycobacterium TB
Describe the following for primary TB?
What is the pathophysiology?
What are the symptoms?
What complications?
Patho:
Initial exposure to aerosolized mycobacterium TB causes focal caseating necrosis in the lower lobe & hilar lymph nodes that results in fibrosis & calcification to form a Ghon complex in the lung
Symptoms:
Asymptomatic
Comps:
It can to a +ve PPD
Patho:
Initial exposure to aerosolized mycobacterium TB causes focal caseating necrosis in the lower lobe & hilar lymph nodes that results in fibrosis & calcification to form a Ghon complex in the lung
Symptoms:
Asymptomatic
Comps:
It can to a +ve PPD
Describes which condition?
primary TB
Describe the following for secondary TB?
What is the pathophysiology?
What are the symptoms?
What are the lab findings?
What complications?
Patho:
Reactivation of Mycobacterium TB in AIDs patients of elderly causes cavitary foci of caseous necrosis in the apex of the lung
Symptoms:
1) fevers
2) night sweats
3) hemoptysis + cough
4) weight loss
Labs/biopsy:
Biopsy will show caseating granulomas
AFB stain will show acid fast bacilli
Comps:
Miliary pulmonary TB
TB bronchopneumonia
Systemic spread
- Meninge (meningitis)
- Cervical lymph node
- Kidneys (sterile polyuria)
- Lumbar spine (pott’s disease)
Patho:
Reactivation of Mycobacterium TB in AIDs patients of elderly causes cavitary foci of caseous necrosis in the apex of the lung
Symptoms:
1) fevers
2) night sweats
3) hemoptysis + cough
4) weight loss
Labs/biopsy:
Biopsy will show caseating granulomas
AFB stain will show acid fast bacilli
Comps:
Miliary pulmonary TB
TB bronchopneumonia
Systemic spread
- Meninge (meningitis)
- Cervical lymph node
- Kidneys (sterile polyuria)
- Lumbar spine (pott’s disease)
Describe which condition?
Secondary TB
Comps:
Miliary pulmonary TB
TB bronchopneumonia
Systemic spread
- Meninge (meningitis)
- Cervical lymph node
- Kidneys (sterile polyuria)
- Lumbar spine (pott’s disease)
aRE COMPLICATIONS OF WHICH CONDITION?
Secondary TB
Describe the following for Emphysema:
What is it?
What are the symptoms?
What causes it?
- Most common & others
What are the late complications?
Patho:
It’s when there is destruction of the alevolar air sacs which results in a loss of elastic recoil & collapse of the airways during exhalation causing obstruction & trapped air
Symptoms:
1) Dyspnea + cough
2) Pink puffer (long expiration with pursed lips)
3) Weight loss
4) Barrel Chest
Causes:
Imbalances in proteases & antiprotease levels
Smoking (most common!!)
A1AT deficiency
Late comps:
Hypoxemia
Cor pulmonale
Patho:
It’s when there is destruction of the alevolar air sacs which results in a loss of elastic recoil & collapse of the airways during exhalation causing obstruction & trapped air
Symptoms:
1) Dyspnea + cough
2) Pink puffer (long expiration with pursed lips)
3) Weight loss
4) Barrel Chest
Causes:
Imbalances in proteases & antiprotease levels
Smoking (#1)
A1AT deficiency
Late comps:
Hypoxemia
Cor pulmonale
Describes which condition?
Emphysema
How does protease & antiprotease imbalance lead to emphysema?
Normally inflammation in the lungs would trigger a cascade where neutrophils & macrophages would release proteases & then A1AT would neutralize them.
In emphysema there’s either too much protease or too little A1AT from the excessive inflammation resulting in alveolar air sacs being destroyed
How does smoking lead to emphysema?
The most common cause of emphysema it leads to excessive inflammation of the lungs& too little A1AT levels resulting in centriacinar emphysema that is worse in the UPPER LOBES
How does an A1AT deficiency lead to emphysema?
It’s a rare cause of emphysema, where A1AT antiproteases are misfolded resulting in lower circulating levels worst in the LOWER lobes & accumulation of the misfolds in the liver (cirrhosis)
PiMM normal
PiZ most common mutation = low A1AT
PiZZ worst kind with a risk of panacinar emphysema & cirrhosis
Which genotype of the A1AT mutation causes panacinar emphysema & liver cirrhosis?
PiZZ
Describe the following for Asthma (allergy induced):
What is it?
What are the symptoms (during an attack)?
What conditions are associated with it?
What are the complications if left untreated?
Patho:
It usually presents in childhood,
- Initial exposure to an allergen triggers CD4+T cells to switch to a TH2 phenotype. These secrete:
- IL4 (increase class switching to IgE)
- IL5 (recruit eosinophils)
- IL10 (stimulate more TH2 cells & inhibit TH1) - During re-exposure to the same allergen, there is a type 1 hypersensitivity reaction mediated by IgE. It causes mast cells to release preformed histamine & leukotrienes (C4, D4, & E4) resulting in bronchospasms, inflammation, & edema
Symptoms:
1) Dyspnea + wheezing
2) Productive cough (Crushmann spiral mucus plugs & Charcot Leyden (eosinophil) crystals)
Ass cond:
Allergic rhinitis
Eczema
Family history of atopy
Chrug-strauss syndrome
Comp of severe attack untreated:
Status asthmaticus & death
Patho:
It usually presents in childhood,
- Initial exposure to an allergen triggers CD4+T cells to switch to a TH2 phenotype. These secrete:
- IL4 (increase class switching to IgE)
- IL5 (recruit eosinophils)
- IL10 (stimulate more TH2 cells & inhibit TH1) - During re-exposure to the same allergen, there is a type 1 hypersensitivity reaction mediated by IgE. It causes mast cells to release preformed histamine & leukotrienes (C4, D4, & E4) resulting in bronchospasms, inflammation, & edema
Symptoms:
1) Dyspnea + wheezing
2) Productive cough (Crushmann spiral mucus plugs & Charcot Leyden (eosinophil) crystals)
Ass cond:
Allergic rhinitis
Eczema
Family history of atopy
Chrug-strauss syndrome
Comp of severe attack untreated:
Status asthmaticus & death
Describes which condition?
Allergy-induced asthma
Describe the following for bronchiectasis:
What is it?
What causes it?
Patho:
Permanent dilation of the bronchioles & bronchi resulting in lost airway tone with air being trapped
Causes:
Necrotizing inflammation & damaged airways in conditions like
- Cystic fibrosis
- Kartagener syndrome
Patho:
Permanent dilation of the bronchioles & bronchi resulting in lost airway tone with air being trapped
Causes:
Necrotizing inflammation & damaged airways in conditions like
- Cystic fibrosis
- Kartagener syndrome
Describes which condition?
Bronchiectasis
Describe the following for chronic bronchitis:
What is it?
What are they symptoms?
What are the lab findings?
What is an associated condition?
- risk
Patho:
A chronic productive cough lasting 3 months over a minimum 2yr period
Symptoms:
1) productive cough (lots of mucus)
2) Cyanosis
3) Higher risk of infections & cor pulmonale
Labs:
Hypertrophied mucinous glands (mucus traps CO2)
- Increased PaCO2
- Decreased PaO2
Reid INDEX > 50% (normal is 40%)
Ass/risk:
smoking
Describe the following for Idiopathic pulmonary fibrosis:
What is it?
What possibly causes it?
- primary
What are the symptoms?
What are the lab findings?
What is the treatment?
Patho:
Fibrosis of the lung interstitium
Causes (primary)
Cyclical lung injury (releases TGF-B from injured pneumocytes which induce fibrosis)
Symptoms:
1) Progressive dyspnea + cough
Labs:
Show fibrosis of the lung in a honeycomb pattern (late stage)
Rx: Lung transplant
Patho:
Fibrosis of the lung interstitium
Causes (primary)
Cyclical lung injury (releases TGF-B from injured pneumocytes which induce fibrosis)
Symptoms:
1) Progressive dyspnea + cough
Labs:
Show fibrosis of the lung in a honeycomb pattern (late stage)
Rx: Lung transplant
Describes which condition?
Idiopathic pulmonary fibrosis
How does Pneumoconiosis due to exposure to asbestos (construction workers, plumbers, & shipyard workers) present?
causes fibrosis of the lungs & pleura, & it increases the risk of lung cancer & mesothelioma
Describe the following for sarcoidosis:
What is it?
What causes it?
What are the symptoms?
What are the lab findings?
How would you treat it?
Patho:
A systemic disease with non-caseating granulomas in multiple organs (usually in afro-american women). The granulomas usually involve the hilar LN or lungs resulting in restrictive lung disease
Causes:
Likely from a CD4+T helper response to an unknown antigen
Symptoms
1) Dyspnea or Cough
Labs:
Elevated serum ACE
Stellate inclusions (asteroid bodies) within GC granulomas
Hypercalcemia
Rx:
Steroids
Patho:
A systemic disease with non-caseating granulomas in multiple organs (usually in afro-american women). The granulomas usually involve the hilar LN or lungs resulting in restrictive lung disease
Causes:
Likely from a CD4+T helper response to an unknown antigen
Symptoms
1) Dyspnea or Cough
Labs:
Elevated serum ACE
Stellate inclusions (asteroid bodies) within GC granulomas
Hypercalcemia
Rx:
Steroids
sarcoidosis
In sarcoidosis what are the infiltrates you would see within the GC granulomas?
Stellate inclusions (asteroid bodies)
Describe the following for primary pulmonary HTN:
What is it?
What causes it?
What are the symptoms?
What are the complications?
Patho/causes:
Usually in young women it can be from either:
1) Atherosclerosis of the pulmonary trunk & smooth muscle hypertrophy of the pulmonary arteries with intimal fibrosis
OR
2) BMPR2 mutation (increase smooth muscle proliferation in pulmonary arteries)
Symptoms:
1) Exertional dyspnea or right sided heart failure
Comps:
It can lead to right ventricular hypertrophy with eventual cor pulmonale
Patho/causes:
Usually in young women it can be from either:
1) Atherosclerosis of the pulmonary trunk & smooth muscle hypertrophy of the pulmonary arteries with intimal fibrosis
OR
2) BMPR2 mutation (increase smooth muscle proliferation in pulmonary arteries)
Symptoms:
1) Exertional dyspnea or right sided heart failure
Comps:
It can lead to right ventricular hypertrophy with eventual cor pulmonale
Describes which condition?
Primary pulmonary HTN
Describe the following for Secondary pulmonary HTN:
What causes it?
What are the symptoms?
What are the complications?
Can be due to a number of conditions:
1) Hypoxemia (COPD & interstitial lung disease)
2) Congenital heart diseases (that increase pulmonary congestion)
3) Recurrent pulmonary embolism
4) Atherosclerosis of the pulmonary trunk & smooth muscle hypertrophy of the pulmonary arteries with intimal fibrosis
Symptoms:
1) Exertional dyspnea or right sided heart failure
Comps:
It can lead to right ventricular hypertrophy with eventual cor pulmonale
Can be due to a number of conditions:
1) Hypoxemia (COPD & interstitial lung disease)
2) Congenital heart diseases (that increase pulmonary congestion)
3) Recurrent pulmonary embolism
4) Atherosclerosis of the pulmonary trunk & smooth muscle hypertrophy of the pulmonary arteries with intimal fibrosis
Symptoms:
1) Exertional dyspnea or right sided heart failure
Comps:
It can lead to right ventricular hypertrophy with eventual cor pulmonale
Rx:
Treat the underlying condition & give ventilation with +ve end expiration (PEEP)
Describes which condition?
Secondary pulmonary HTN
Describe the following for Acute respiratory distress syndrome:
What is it?
What are the symptoms?
What conditions is it secondary to?
Pathp:
It is diffuse damage to the alveolar-capillary interface causing protein-rich fluid leakage resulting in edema & necrotic epithelial cells to form hyaline membranes throughout the alveoli spaces (poor gas exchange)
Symptoms:
1) Hypoxemia with cyanosis
2) White-out chest xray
Ass conditions:
(Anything that causes neutrophils to release proteases & damage type I&II pneumocytes)
Sepsis/infection
Shock/trauma
DIC
Aspirations
Hypersensitivity reactions
Drugs
Rx:
Treat the underlying condition & give ventilation with +ve end expiration (PEEP)
Pathp:
It is diffuse damage to the alveolar-capillary interface causing protein-rich fluid leakage resulting in edema & necrotic epithelial cells to form hyaline membranes throughout the alveoli spaces (poor gas exchange)
Symptoms:
1) Hypoxemia with cyanosis
2) White-out chest xray
Ass conditions:
(Anything that causes neutrophils to release proteases & damage type I&II pneumocytes)
Sepsis/infection
Shock/trauma
DIC
Aspirations
Hypersensitivity reactions
Drugs
Describes which condition?
Acute respiratory distress syndrome
Describe the following for Neonatal respiratory distress syndrome:
What is it?
What causes it?
What are the symptoms?
What are the complications?
Patho:
When the is low surfactant in the lungs at birth (made by type II pneumocytes). To test for this you can test the amniotic fluid for the lethicin:sphingomyelin ratio (anything less than 2 = inadequate)
Causes:
1) premature baby (lungs develop between the 28-34 weeks anything under 34 is too early)
2) C-section (not enough stress-induced hormone)
3) Maternal diabetes (insulin decreases surfactant)
Symptoms:
1) Increasing breathing effort with tachypnea & the use of all their accessory muscles with grunting
2) Hypoxia with cyanosis
3) ground glass opacities on xray (diffuse granularity in lungs)
Comps:
Hypoxemia (risk of persisting PDA & necrotizing enterocolitis)
&
Supplemental O2 given as a treatment risks free radical damage (retina = blindness & lungs= bronchopulmonary dysplasia)
Patho:
When the is low surfactant in the lungs at birth (made by type II pneumocytes). To test for this you can test the amniotic fluid for the lethicin:sphingomyelin ratio (anything less than 2 = inadequate)
Causes:
1) premature baby (lungs develop between the 28-34 weeks anything under 34 is too early)
2) C-section (not enough stress-induced hormone)
3) Maternal diabetes (insulin decreases surfactant)
Symptoms:
1) Increasing breathing effort with tachypnea & the use of all their accessory muscles with grunting
2) Hypoxia with cyanosis
3) ground glass opacities on xray (diffuse granularity in lungs)
Comps:
Hypoxemia (risk of persisting PDA & necrotizing enterocolitis)
&
Supplemental O2 given as a treatment risks free radical damage (retina = blindness & lungs= bronchopulmonary dysplasia)
Describes which condition?
Neonatal respiratory distress syndrome
Describe the following for Small cell carcinoma:
What is it?
What usually causes it?
How do you treat it?
What are the lab findings?
What are the complications?
Patho/cause:
Poorly differentiated small cells that are centrally located & arise from neuroendocrine (Kuchinsky) cells. It grows fast & has early metastases which may produce certain endocrine hormones (ADH & ACTH). Most commonly caused by smoking in men.
Rx:
Chemo & radiation
Labs:
Chromogranin +ve
Comps:
Nervous symptoms (Lambert-Eaton Myasthenia syndrome) or paraneoplastic syndromes
Patho/cause:
Poorly differentiated small cells that are centrally located & arise from neuroendocrine (Kuchinsky) cells. It grows fast & has early metastases which may produce certain endocrine hormones (ADH & ACTH). Most commonly caused by smoking in men.
Labs:
Chromogranin +ve
Rx:
Chemo & radiation
Comps:
Nervous symptoms (Lambert-Eaton Myasthenia syndrome) or paraneoplastic syndromes
Describes which condition?
Small cell carcinoma
Describe the following for a squamous cell carcinoma:
What is it?
What are the lab findings?
What is a complication?
Patho/cause:
The most common tumor in male smokers
Labs:
Keratin pearls or intracellular bridges
Comp:
I can increase production of PTHrP
Patho/cause:
The most common tumor in male smokers
Labs:
Keratin pearls or intracellular bridges
Comp:
I can increase production of PTHrP
Describe the following for Adenocarcinoma:
What is it?
What are the lab findings?
Patho/cause:
a common tumor in non-smokers & in female smokers, it is located peripherally in the lungs & can present with pneumonia-like consolidation on imaging
Labs:
In-situ (columnar cells that grow along the existing bronchioles & alveoli)
Lots of glands or mucin
Patho/cause:
a common tumor in non-smokers & in female smokers, it is located peripherally in the lungs & can present with pneumonia-like consolidation on imaging
Labs:
In-situ (columnar cells that grow along the existing bronchioles & alveoli)
Lots of glands or mucin
Describes which condition?
Adenocarcinoma
Describe the following for Carcinoid tumor:
What is it?
What causes it?
What are the lab findings?
Patho/causes:
A well-differentiated tumor of neuroendocrine cells (nests) that can be located peripherally or centrally (form polyp-like masses in bronchus)
It has a low grade malignancy & rarely causes carcinoid syndrome
Labs:
Chromogranin +ve
Patho/causes:
A well-differentiated tumor of neuroendocrine cells (nests) that can be located peripherally or centrally (form polyp-like masses in bronchus)
It has a low grade malignancy & rarely causes carcinoid syndrome
Labs:
Chromogranin +ve
Describes which condition?
Carcinoid tumor
an accumulation of air into the pleural space which compresses the lung & prevents it from expanding. These are usually caused by ruptures of emphysematous blebs (younger people)
Note the trachea will shift to the SAME side as the collapse
Describes which condition?
Spontaneous pneumothorax
Describe a mesothelioma
A malignant neoplasm made of mesothelial cells that encases the lung
It’s associated with exposure to asbestos
Symptoms include:
1) recurrent pleural effusion
2) dyspnea
3) chest pain
Pneumonia acquired from hospital ventilators
Aspergillus
What is the most common causal agent of pneumonia in nursing homes, alcoholics, & homeless patients?
Klebsiella pneumoniae (causes cavitations)
Histology shows frothy cotton candy exudate in the alveoli with pink granulations, it may also look like a crushed pink pong ball
P. jirovecii
Pneumonia in someone with pigeons
C. neoformans
Pneumonia that causes hyponatremia (SIADH) causes which complications?
Caused by legionella
Comps:
Interstitial nephritis & CNS abnormalities
Ferruginous bodies are a hallmark of which pneumonia causing bacteria
Asbestos (surrounds it with iron & protein)
Curshmann spirals & charcot leyden crystals are findings of which condition?
Asthma
Non-caseating granulomas in many tissues but especially in the lungs, skin, face, salivary & glands
What is the condition?
what does it present with?
What are the labs?
Sarcoidosis
Presents with Uveitis & blurry vision
Histology:
Asteroid bodies & potato LN (Enlarged hilar LN)
Labs:
High ACE
High Hypercalcemia
Chest x-ray shows cannon ball nodules which is indicative of which condition?
Metastatic lung cancer that spreads from the breast or prostate to the bronchial epithelium
