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Basic Human Pathology > Ch 15: Lung > Flashcards

Ch 15: Lung Flashcards

1
Q

1.)

A

apical

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2
Q

2.)

A

posterior

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3
Q

3.)

A

anterior

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4
Q

4.)

A

medial

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5
Q

5.)

A

lateral

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6
Q

6.)

A

superior

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7
Q

7.)

A

posterior basal

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8
Q

8.)

A

lateral basal

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9
Q

9.)

A

anterior basal

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10
Q

10.)

A

right lung

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11
Q

11.)

A

left lung

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12
Q

12.)

A

anterior basal

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13
Q

13.)

A

posterior basal

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14
Q

14.)

A

lateral basal

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15
Q

15.)

A

superior

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16
Q

16.)

A

inferior lingual

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17
Q

17.)

A

superior lingual

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18
Q

18.)

A

anterior

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19
Q

19.)

A

apico-posterior

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20
Q

is this a left or right lung and how do you know

A

left
the artery is most superior

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21
Q

is this a left or right lung and how do you know

A

right
the artery is anterior

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22
Q

what do type 1 pneumocytes look like and what do they do

A

flattened
most common - cover 95% of aveolar surface

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23
Q

what do type 2 pneumocytes look like and what do they do

A

rounded
produce surfactant
help to repair aveolar epithelium if type 1 cell is destructed

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24
Q

what is the most common cause of pulmonary hypoplasia (incomplete development)

A

herniation of something like the bowl into that space which prevents the lung from growing to its full capability

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25
Q

what is the most common type of forgut cyst

A

bronchogenic

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26
Q

what is pulmonary sequestration

A

a congenital anomaly
non-functional mass of pulmonary tissue that is not connected to the main pulmonary branch

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27
Q

what is a resorption atelectasis

A

diminished lung volume because of some kind of obstruction
mediastinum shifts towards collapsed lung

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28
Q

what is compression atelectasis

A

compression of the lung due to fluid/air accumulation in the pleural cavity

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29
Q

what is contraction atelectasis

A

shriveling of lung
fibrosis prevents full lung expansion

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30
Q

what are the two main causes of pulmonary edema

A

hemodynamic disturbances (cardiac related)
microvascular injury (non-cardiac related)

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31
Q

what is the most common hemodynamic cause of pulmonary edema

A

left-sided congestive heart failure

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32
Q

how does microvascular injury lead to pulmonary edema
give two examples

A

damage produces inflammatory exudate that leaks into the interstital space
ex. COVID and acute respiratory distress syndrome (ARDS)

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33
Q

what are the four steps of noncardiogenic pulmonary edema (acute lung injury)

A

1.) endothelial activation - damaged endothelium stimulates an immune response
2.) adhesion of neutrophils - causes cycle of inflammation and damage
3.) accumulation of protein rich fluid - pulmonary capillaries are leaky
4.) resolution of injury - necrosis, fibrosis, and hyaline membranes

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34
Q

what is an obstrutive lung disease

A

cannot exhale properly due to increased resistance

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35
Q

what is a restrictive lung disease

A

cannot inhale poperly because of reduced expansion of lung parenchyma and reduced total lung capacity

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36
Q

what are the four types of chronic obstructive pulmonary disease (COPD)

A

emphysema
chronic bonchitis
asthma
bronchiectasis

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37
Q

what is emphysema

A

irreversible enlargement and destruction of the airspaces distal to the terminal bronchiole (acini)

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38
Q

what is centriacinar emphysema

A

most common type of emphysema
mostly seen in heavy smokers
starts in the center of the acinus and moves its way out
mostly affect upper (apical) lobes

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39
Q

what is panacinar emphysema

A

the second most common type of emphysema
affect all, but mostly lower, lobes
affects entire acinus equally

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40
Q

what is paraseptal emphysema

A

next to fibrosis
associated with spontaenous pneumothorax

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41
Q

what is the cause of panacinar emphysema

A

alpha1-antitrypsin deficiency

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42
Q

what is irregular emphysema

A

associated with scarring

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43
Q

what is an ephysematous bleb

A

distended areas of pleura
seen in any of the four types of emphysema

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44
Q

what must someone have to be diagnosed with chronic bronchitis

A

2 or more bouts of persistent cough with sputum production for at least three months

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45
Q

what causes 90% of chronic bronchitis cases

A

smoking

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46
Q

what are four factors of chronic bronchitis

A

mucus hypersecretion
CFTR dysfunction
inflammation
infection

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47
Q

what is bronchiolitis obliterans

A

obliteration of bronchiole lumen due fibrosis

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48
Q

what is cor pulmonale

A

a symptom of chronic bronchitis
heart tries to keep up, leading to pulmonary hypertension

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49
Q

what is asthma

A

chronic airway inflammation that causes overinflated lungs
symptoms such as weezing and shortness of breath

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50
Q

what causes atopic asthma

A

cause by IgE-mediated hypersensitivity reaction

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51
Q

what is non-atopic asthma and what is it casued by

A

respiratory infections caused by a virus being triggered

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52
Q

which medication causes drug-induced asthma

A

aspirin

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53
Q

what are three causes of occupational asthma

A

fumes
dusts
gases

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54
Q

what is the most striking gross finding in asthma

A

occlusion of bronchioles due to mucus plugs

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55
Q

what are the two characteristic features of asthma that helps it be diagnosed

A

curschmann spirals
charcot-ledyen crystals

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56
Q

what are curschmann spirals

A

seen in asthma patients
coiled, mucinous fibrils

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57
Q

what are charcot-leyden crystals

A

seen in asthma patients
bipyramidal hexagonal crystals

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58
Q

what is bronchiectasis

A

destruction of smooth muscle and elastic tissue due to severe infections
leads to permanent dilation of bronchioles and bronchi

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59
Q

what is idiopathtic pulmonary fibrosis

A

a type of restrictive pulmonary disease
dense fibrosis causes destruction of alveolar architecture
lungs appear cobblestoned due to scarring
occurs mostly in the subpleural regions and interlobular septa

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60
Q

honeycomb fibrosis is a characteristic of which disease

A

idiopathic pulmonary fibrosis

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61
Q

what is pneumoconiosis

A

lung reaction to inhalation of mineral dusts, chemical fumes, and vapors from the workplace

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62
Q

what is seen in the lungs of a coal worker

A

fibrosis
anthracosis (carbon deposits)

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63
Q

what is the most prevalent chronic occupational disease in the world

A

silicosis

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64
Q

what is the most common manifestation of asbestosis

A

pleural plaques

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65
Q

what causes mesothelioma

A

asbestos

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66
Q

what is simple coal workers’ pneumonconiosis (black lung disease)

A

earlier stage of coal workers’ pneumonconiosis
coal macules, 1-2 mm

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67
Q

what disease has eggshell calcification (thin sheets of calcification) within the lymph nodes

A

silicosis

68
Q

this whorled aggregate of collagen fibers is seen in which disease

A

silicosis

69
Q

what are the two geometric forms of asbestos

A

serpentine
amphibole

70
Q

what is the most common geometric form of asbestos

A

serpentine

71
Q

what are asbestos bodies

A

golden brown rods that have asbestos fibers coated with iron
form when a macrophage engulfs asbestos fibers

72
Q

what are pleural plaques

A

well-circumscribed plaques of dense collagen that are often calcifed
seen in asbestos cases

73
Q

what are the two most important findings of sarcoidosis

A

non-necrotizing granulomas
prominent hilar lymphadenopathy

74
Q

what are three histologic patterns of sarcoidosis

A

langerhans giant cells
schaumann bodies
asteroid bodies

75
Q

what are langhans giant cells

A

fusion of histiocytes forms a granuloma
characteristic of sarcoidosis

76
Q

what are schaumann bodies

A

calcified inclusions
sometimes found in sarcoidosis

77
Q

what are asteroid bodies

A

spider-like inclusions seen in cytoplasm of giant cells
sometimes seen in sarcoidosis

78
Q

what is sarcoidosis

A

a restrictive disease
systemic granulomatous disease with unknown etiology
has non-necrotizing granulomas

79
Q

what is desquamative interstitial pneumonia

A

type of restrictive lung disease caused by smoking
large collection of smoker’s macrophages

80
Q

what is pulmonary langerhans cell histiocytosis

A

type of restrictive disease
collection of langerhans cells which cause scarring

81
Q

what is the most common distant source of pulmonary emobli

A

DVTs

82
Q

what is considered pulmonary hypertension

A

pulmonary artery pressure greater than 25 mm Hg at rest

83
Q

all forms of pulmonary hypertension are associated with what

A

media hypertrophy of the pulmonary muscular and elastic arteries
right ventricular hypertrophy

84
Q

Goodpasture is which type of hypersensitivity

A

antibody-mediated (type 2)

85
Q

what is pneumonia

A

any infection of the lung parenchyma

86
Q

what is the most common cause of community-aquired acute pneumonia

A

streptococcus pneumoniae

87
Q

which bacteria causes pediatric H. influenzae pneumonia (a type of community acquired bacterial pneumonia)

A

haemophilus influenzae

88
Q

which bacteria are intravenous drug users most at risk of aquiring

A

staphylococcus aureus

89
Q

which bacteria is associated with lung abcesses

A

staphylococcus aureus

90
Q

which bacteria causes pneumonia and commonly affects chronic alcoholics and those with nutrional deficiencies

A

klebsiella pneumoniae

91
Q

which bacteria is most commonly acquired in a hospital and in patients with cystic fibrosis

A

pseudomonas aeruginosa

92
Q

which type of bacteria flourishes in artificial aquatic environments like water-cooling towers

A

legionella pneumonphilia

93
Q

which type of bacteria commonly affects adults and children and is acquired in places like schools and prisons

A

mycoplasma pneumoniae

94
Q

which type of viruses infect farm animals and are the major cause of pandemic influenza infections

A

influenza viruses of type A

95
Q

which virus is associated with upper and lower respiratory tract infections

A

human metapneumonovirus

96
Q

what are 2 common morphologic changes in viral infections

A

laryngotracheobronchitis
bronchiolitis

97
Q

what are the two most common community acquired viral pneumonias

A

S. aureus
P. aeruginosa

98
Q

what are the two patterns of anatomic distribution of pneumonia

A

bronchopneumonia (most common)
lobar pneumonia

99
Q

what does bronchopneumonia look like

A

patchy

100
Q

what does lobar pneumonia look like

A

only includes one lobe

101
Q

what are the four steps of lobar pneumonia

A

congestion
red hepatization
gray hepatization
resolution

102
Q

explain the congestion phase of lobar pneumonia

A

occurs in first 1-2 days
lung is heavy, boggy, and red
lots of bacteria

103
Q

explain the red hepatization step of lobar pneumonia

A

occurs in days 3-4
lots of neutrophils, red cells, and fibrin
lobe is firm and red

104
Q

explain the grey hepatization step of lobar pneumonia

A

occurs days 4-8
red cells die leaving the lobe brown/grey
perstistanceof fibrinosuppurative exudate

105
Q

explain the resolution step of lobar pneumonia

A

occurs between 1-3 weeks
fluid is broken down and debris is engulfed by macrophages

106
Q

what are the three complications of lobar pneumonia

A

necrosis
empyema
bacteremic spreading to other areas

107
Q

what is a soil-inhabiting dimorphic fungus that cause chronic pneumonia

A

blastomycosis

108
Q

which fungi causes a delayed-type hypersensitivity leading to chronic pneumonia

A

coccidiodomycosis

109
Q

which type of fungi is acquired by inhalation of dust particles from soil contamination with bird or bat droppings - leads to granulomas

A

histoplasmosis capsulatum

110
Q

what is bronchiolitis obliterans characteristic of

A

a sign of lung transplant rejection
obliteration of bronchiole lumen due to inflammatory response

111
Q

what is the most common type of lung tumor

A

carcinomas

112
Q

what is the most common type of non-small cell lung cancer that is mostly associated with non-smokers

A

adenocarcinoma

113
Q

what are the four subtypes of non-small cell lung cancer

A

adenocarcinoma
squamous cell carcinoma
large cell carcinoma
others

114
Q

what is the main subtype of small cell lung cancers

A

small cell carcinoma

115
Q

what percentage of lung cancers occur in smokers

A

80%

116
Q

how is cytochrome P450 related to lung cancer

A

cytochrome P450 enzyme converts cigarrette chemicals into carcinogens

117
Q

what are the four main gene mutations of squamous cell carcinoma

A

TP53
p53
CDKN2A
FGFR1

118
Q

which three gene mutations are common in small cell carcinomas

A

TP53
RB
MYC

119
Q

which gene mutation of adenocarcinoma has the worst prognosis

A

KRAS

120
Q

what are the four classifications of adenocarcinoma

A

atypical adenomatous hyperplasia (AAH)
adenocarcinoma in sit (AIS)
minimally invasive adenocarcinoma (MIA)
invasive adenocarcinoma (IAC)

121
Q

what is atypical adenomatous hyperplasia

A

small precursor lesion with dysplastic pneumocytes

122
Q

what is adenocarcinoma in situ

A

<3 cm lesion made of cells growing along alveolar septa

123
Q

what does in situ mean

A

lesion has not pentrated the basement membrane

124
Q

where is adenocarcinoma most commonly seen in the lung

A

periphery, in the lung parenchyma

125
Q

where is squamous cell carcinoma most commonly seen in the lung

A

around the bronchial tree

126
Q

which type of lung tumor can produce a puckered/umbilicated area of the pleura

A

adenocarcinoma

127
Q

what are the five growth patterns of adenocarcinoma

A

acinar
lepidic
papillary
micropapillary
solid with mucin formation

128
Q

what is seen in the lepidic adenocarcinoma growth pattern

A

cells appear to be crawling

129
Q

what is seen in the acinar adenocarcinoma growth pattern

A

glandular formation

130
Q

what is seen in the papillary adenocarcinoma growth pattern

A

fibroelastic cores with lines coming off them

131
Q

what is seen in the micropapillary adenocarcinoma growth pattern

A

similar to papillary but minus the fibroelastic cores

132
Q

which stain is used to test for adenocarcinoma

A

TTF-1 (thyroid transcription factor 1)

133
Q

who, men or women, are most susceptible to squamous cell carcinoma

A

men

134
Q

what are the two types of squamous cell carcinoma

A

keratinizing
non-keratinizing

135
Q

what are the three morphological features of keratinized SCC

A

abundant eosinophilic cytoplasm
keratin pearls
intercellular bridges

136
Q

how is large cell carcinoma diagnosed

A

through exclusion since it really doesn’t match anything else

137
Q

what are the four most common sites of lung tumor metastasis

A

adrenal glands
liver
brain
bone

138
Q

what is the most common site of metastasis of lung cancer

A

adrenal glands

139
Q

what are the four major complications of lung cancer

A

cough
weight loss
chest pain
dyspnea

140
Q

what are the two most common routes of spread of a lung carcinoma

A

lymphatic and hematogenous

141
Q

what is a pancoast tumor

A

tumor of pulmonary apex that causes horner syndrome

142
Q

what is Horner syndrome

A

invasion of pancoast tumor to areas like the ribs and vertebrae

143
Q

what is lung scar carcinoma (SC)

A

lung cancer that originates around peripheral scars in the lung
scar can oringinally be from infection or trauma
often found as subpleural adenocarcinoma that causes puckering

144
Q

what are the two types of small cell carcinoma

A

neuroendocrine
carcinoids

145
Q

what are the two types of carcinoid tumors

A

atypical
typical

146
Q

what are kulchitsky cells

A

neuroendocrine cells of the lung that can turn into neuroendocrine tumors

147
Q

what are the four types of neuroendocrine tumors

A

typical carcinoid
atypical carcinoid
small cell lung carcinoma
large cell neuroendocrine carcinoma

148
Q

what are carcinoid tumors

A

type of small cell lung cancer
make up 1-5% of all lung tumors
found mostly in younger men and women
found within the bronchial tree

149
Q

what are some features of a typical carcinoid tumor

A

type of neuroendocrine tumor
small, 3-4 cm
well circumscribed
mainstem bronchi
collar-button lesions

150
Q

what are collar button lesions

A

typical carcinoid tumors

151
Q

what do atypical carcinoid tumors look like

A

tan-yellow areas with focal necrosis

152
Q

which type of lung cancer has a strong relationship to ciagarette smoking and is the most aggresive type

A

small cell carcinoma

153
Q

what are two stains commonly used to identify carcinoid tumors

A

synaptophysin
chromogranins

154
Q

what is a hamartoma

A

benign coin lesion made of connective tissue like cartilage

155
Q

what is the most common site of metastatic neoplasms

A

lung

156
Q

what condition shows up as bread and butter

A

fibrinous pleuritis of the lung

157
Q

what is an empyema

A

intrapleural fibrinosuppurative reaction that usually develops from the spread of bacteria or fungal infections of the lung parenchyma

158
Q

what does serosanguineous mean

A

thin and watery fluid from pleura with light red or pink hue

159
Q

what does sanguineous mean

A

bright red fluid from the lungs that likely has fresh blood in it

160
Q

what is a chylothorax

A

milky fluid in plerual cavity, usually of lymphatic origin

161
Q

what happens in a tension pneumothorax

A

air can get in but can’t get out

162
Q

what are the two types of primary pleural tumors

A

solitary fibrous tumors
mesothelioma

163
Q

what is a solitary fibrous tumor

A

soft-tissue pleura tumor that is attached by a pedicle

164
Q

what causes malignant mesothelioma

A

asbestos exposure

165
Q

what are the three microscopic variants of malignant mesothelioma

A

epitheliod type
mesenchymal type
biphasic type

Basic Human Pathology (18 decks)

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