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finalz > DEVINE > Flashcards

DEVINE Flashcards

1
Q

ATELECTASIS

A

collapse of lung w/absorption of air from alveoli

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2
Q

resorptive type

A

obstruction/block of bronchus by foreign body/mucous/tumor

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3
Q

most common cause of dyspnea

A

resorptive type - 1st 24hrs postop

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4
Q

compression type

A

mechanical collapse: pneumothorax, pleural effusion

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5
Q

ARDS

A

capillaritis = increased permeability»inflammation>widened gap jxn>exudation>neutrophils mediate injury

SARS/influenza
micro=diffuse alveolar damage
permits exudation fr injured vessles into alveoli w/formation of HYALINE MEMBRANES

INCREASED CAP PERMEABILITY

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6
Q

ARDS clinical

A

rapidly progressive dyspnea w/hypoxemia. poor response to O2 therapy

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7
Q

ARDS causes

A

local: inhalation smoke/chemicals; near drowning; aspiration of gastric contents, pulm infections, radiation

**SYSTEMIC: systemic inflamm response. septic shock, trauma, narcotics, surgery

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8
Q

spirometry: obstructive

A

decreased FEV1

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9
Q

spirometry: restrictive

A

decreased FVC

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10
Q

obstructive disease

A

block air, destruction of elastic fibers
most common
low O2, normal pH

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11
Q

obstructive disease CAUSES

A 
parenchymal disease of lung (decreased FEV1)
asthma
emphysema
chronic bronchitis/bronchiolitis
bronchiectasis
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12
Q

bronchiectasis

A 
bad smelling sputum
PERM. dilation and scarring
persistent &/or sever infection 
immotile cilia
cystic fibrosis
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13
Q

asthma

A

smooth muscle hypertrophy
type I: IgE
wheezing

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14
Q

emphysema

A

acinus (sac)
airspace enlargement - alveolar wall destruction
tobacco smoke (elastase fr neutrophils…LOSS OF ELASTIC RECOIL)
dyspnea

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15
Q

bronchiectasis

A

bronchiole

inflamm scarring

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16
Q

pulmonary emphysema

A

dyspnea. barrel chest
“pink puffer” - malnourished, SOB w/o serious hypoxia. pursed lips, hunched over
may die fr resp failure, pneumothorax fr rupture bullae
secondary pulmonary hypertension w/cor pulmonale

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17
Q

bullae

A

subpleural balloon-like spaces (blebs)
associations w/all forms of pulm emphysema
lung apex
may rupture to produce spontaneous pneumothorax

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18
Q

intersitial emphysema

A

air w/in connective tissue of the lung

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19
Q

CHRONIC BRONCHITIS

A

prolonged cough productive of sputum (3mo-2yr)
tobacco smoke
submucosal mucous glands/gob cells increased: hyperplasia/trophy
infiltrates of lymphocytes//mucus plugs, incur mucus glands

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20
Q

ASTHMA

A

type 1
pollen, allergy
eosinophils, mast cells, IgE

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21
Q

asthma detail

A

IgE formed in response to exposure to allergen.
IgE antibody attaches to mast cells; mast cells release histamines, proteases; vagal receptors stimulated to produce edema and bronchial constriction.
Eosinophils and neutrophils recruited that damage mucosa; leukotrienes elaborated from arachadonic acid that intensify (2nd phase) bronchoconstriction.
Nonatopic type due to exercise, viral infection or aspirin
Morphology of asthma: Bronchi demonstrate edema, infiltrate of eosinophils, increase in mucous glands and smooth muscle hypertrophy

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22
Q

asthma clin course

A

first attack = childhood
recurrent eps of sever dyspnea w/wheezing, chron cough last >hours
may progress to COPD

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23
Q

bronchiectasis (ectasis=dilation)

A

PERMANENT ABNORMAL DILATION OF BRONCHI/BRONCHIOLES due to NECROSIS by INFECTION of WALL

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24
Q

bronchiectasis causes

A

CF

persistent cough, smells horrible

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25
Q

restrictive lung diseases

A 
decreased FVC (lung vol)
ground glass/reticulo (net) nodular appearance on radiographs 
honeycomb lung of increased interstitial fibrosis on biopsy
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26
Q

restrictive lung disease causes

A

lung disease in lupus
scleraderma, RA, other type III systemic immune complex diseases
immune complexes
no cough = no FEV1 = no obstructive

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27
Q

RLD pathology

A

type I pneumocyte injury /activation of macrophages w/producion of fibrogenic cytokines resulting in fibrosis of lung w/decreased compliance

28
Q

interstitial fibrosis

A

injury, repair, injury, repair

dry/velcro like rub

29
Q

pneumonoconisis

A

chronic fibrosing diseases of the lung due to occupational exposure to inhaled dusts

30
Q

silica

A

increased risk of TB

31
Q

ASBESTOS

A 
insulation
pleural plaques- CARCINOGENIC
asbestos/ferruginous bodies (looks like a screw)
progressive, involves lower lobes
years after exposure
32
Q

radiation & lung

A

1-6 mo after radiation
hyaline membranes, responds to corticosteroids

chronic radiation pneumotitis: interstitial fibrosis (permanent)

33
Q

SARCOIDOSIS

A 
multisystem disease characterized by NONCASEATING GRANULOMAS in many tissues & organs
TYPE IV (cell mediated)
GRANULOMAS = ALWAYS TYPE IV
NON TB RELATED
34
Q

laryngeal carcinoma

A

squamous cell carcinoma
arises from dysplasia>carcinoma in situe
Most associated with tobacco smoking and alcohol abuse May be due to asbestos; radiation

Tumors of the true vocal cords (glottis tumors) cause hoarseness Local growth into tissues of the neck; cure rate 65%
//suffocates one locally; doesn’t metastasis

35
Q

laryngeal papillomas

A

Benign HPV-related neoplasm(s) of vocal cords, larynx

May be multiple and may recur, esp. in children

36
Q

laryngeal nodules

A

nonneoplastic reactive proliferation of vocal cord due to voice oversuse, eg “singers nodes”
HOARSENESS

37
Q

mesothelioma

A

(uncommon, distractor)
most assoc w/ asbestos. no tobacco assoc.
pleural cav: encases lungs, leads to pulm effusion; resp failture
pericardial: encases heart: heart failure
peritoneum: obstructs intestines
not curable
morphology: asbestos body

38
Q

pneumothorax

A

air in pleural cav due to puncture
secondary to rupture emphysematous bleb in a pt w/emphysema or ruptured cavity

spontaneous pneumothorax: occurs in young adults (tall) due to paraseptal emphysematous bulla/bleb

39
Q

HORNER SYNDROME

A

pancoast tumor - apex of lung
unilateral enophthalmos (shrunken in eyeball)
ROUND THE HORN, ROUND THE COAST

40
Q

SUPERIOR VENA CAVA SYNDROME

A

tumour grows around VC blocking venous return fr head/arms
head & neck congested
cyanotic
inoperable

41
Q

local effects of lung cancer

A

obstruction of bronchus: pneumonia
growth into adjacent organ/tissue - esophagous: diff swalling; rib: pain/fracturel recurrent laryngeal nerve (hoarseness) & othrs including SVC and symp ganglia

42
Q

hyperplastic pulm osteoarthopathy

A

clubbing of distal fingers/arthritis

causes: lung cancer - paraneoplastic,CBD, RL shunt

43
Q

paraneoplastic syndrome

A

effects related to a neoplasm distal from the tumor

not due to local extension

44
Q

chronic pneumonia

A

lasts weeks-months

caseating (cheesy) granuloma

45
Q

lung abscess

A

pus-filled cavity
contains neutrophils, living pyogenic BACTERIA
xray demonstrates air-fluid level

46
Q

atypical pneumonia

A

viral infection
interstitial pneumonia w/lymphocytic response
no alveolar exudates, no consolidation
no sputum

47
Q

aspiration pneumonia

A

due to anesthesia, no gag reflex
mixture of microbes + gastric acid
high death rate

48
Q

morphology of lobar pneumonia

A

Congestion>red hepatization>gray hepatization>resolution (good) or organization (scar)

49
Q

goodpasture syndrome

A

TYPE2 hypersensitivity
develops following injury exposing basement membrane: resp infection in someone exposed to solvents

pt produces anti-glomerular basement membrane antiB that cross reacts w/basement membranes in the lung

50
Q

destruction of centriacinar septae

A

tobacco smoke

51
Q

destruction of panacinar

A

alpha 1 antitrypsin deficiency

52
Q

destruction of irregular septae

A

aging

53
Q

destruction of paraseptal

A

spontanoues pneumothorax due to bleb rupture

54
Q

ectasis

A

dilation

55
Q

sarcoidosis assoc

A

gland enlargement/dry eyes & mouth: MICKULICZ DISEASE

56
Q

hemoptysis causes

A

pulmonary emboli, lung cancer, TB, goodpasture, wegener’s granulomatosis

57
Q

wegener’s granulomatosis

A

vasculitis w/cANCA antibodies
causes nasopharyngeal necrosis
eye/oribtal lesions
renal glomerular disease

58
Q

pulmonary hypertension primary

A

defect in endothelium/SM

young women

59
Q

pulmonary hypertension secondary

A

all chronic lung disease
recurrent pulmonary emboli
l-r shunts of CHD

60
Q

common cause of lobar pneumonia

A

strep pneumonia

61
Q

common cause of bronchopneumonia in COPD

A

h. influenza

62
Q

lobar

A

confluent via alveolar pores
large dose virulent organisms
more common in alcoholics, smokers

63
Q

bronchial

A

patchy, spread from bronchioles
elderly & very young
follows resp. infection/aspiration

64
Q

LOBAR

A

CRGR

65
Q

aenocarcinoma “non small”

A

more common in women
may arise in scar: stab= cancer later
trousseau syndrome

66
Q

small cell carcinoma - neuroendocrine

A

aggressive local growth

adh production

finalz (5 decks)

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