Diseases Of Organ Systems RESPIRATORY - 34% Flashcards
Asthma? Sx?
Reversible bronchospasm due to hypersensitivity of the bronchi. Bronchial mucosa inflammation and constriction of bronchial smooth muscle
Sx- paroxysms of shortness of breath and wheezing worse at night
Extrinsic and intrinsic causes of asthma
E - allergens, eczema and hay fever
I - exercise
What can be found in the sputum of someone with asthma
Curschmann spiral and charcot-Leyden crystals
Bronchiectasis? Associated with? Sx?
Chronic dilation of bronchi due to bronchial obstruction by mucous plugs
May be associated with cystic fibrosis
Copious fouls smelling mucopurulant sputum early in the morning
Kartangener’s syndrome
Immotile cilia which present with a clinical triad consisting of
- chronic sinusitis, bronchiectasis, situs inverses
Atelectasis? Types?
Collapse or incomplete expansion of alveoli
3 types: compression atelectasis, resorption atelectasis, contraction atelectasis
Compression atelectasis
Collapse due to external pressure like pleural effusion and pneumothorax
Resorption atelectasis
Collapse distal to an obstructed bronchi by foreign body or tumor
Contraction atelectasis
Collapse due to interstitial fibrosis and loss of elastic recoil. Commonly seen in pulmonary TB
COPD? Types?
Chronic obstructive pulmonary disease
Emphysema or chronic bronchitis
Emphysema? Types?
A type of COPD
Pink puffers who tend to thin
Alveolar wall destroyed, loss of elastic recoil, good oxygenation
2 types: centriacinar, panacinar
Centriacinar emphysema
Smoking related, affects respiratory bronchioles, barrel-chest
Panacinar emphysema
Alpha1-antitrypsin deficiency
Affects all pulmonary acini
Destruction of elastic tissue in alveolar wall, younger patients
Chronic bronchitis
Blue (cyanosis) bloaters (right-sided heart failure) who tend to be overweight
- chronic cough >3 months for at least 2 consecutive years
- bronchial gland hyperplasia due to infection
Pneumonia? Types?
Inflammation of lung tissue
4 types: lobar, bronchopneumonia, interstitial, pneumocystis jiroveci pneumonia (PJP)
Lobar pneumonia
Inflammation of a lobe with red then grey hepatization. Streptococcus pneumonia
Bronchopneumonia
Patchy inflammation of both lungs usually in the bases
Interstitial pneumonia
Involved both lungs
Caused by mycoplasma or chlamydia pneumoniae
Pneumocystis jirovci pneumonia (PJP)
Opportunistic infection by pneumocystis jiroveci - AIDS
Causes ground glass appearance on chest x-ray
Lung abscess? causes? who?
Pus filled cavity in the lung
- staph aureus and Klebsiella pneumoniae
Seen more in alcoholics and epileptics
Pneumoconiosis
Occupational lung disease
- caused by inhalation of inorganic industrial particles: anthracosis, silicosis, asbestosis, siderosis, Caplan’s lung
Anthracosis
Lung disease caused by coal dust in coal miners
One of the pneumoconiosis
Silicosis
Lung disease caused by silica dust in quarry workers: quartz and sand
One of the pneumoconiosis
Asbestosis
Lung disease caused by asbestos fibers in miners. Increased risk of mesothelioma
One of the pneumoconiosis
Siderosis
Lung disease caused by iron dust in iron minors
One of the pneumoconiosis
Caplan’s lung
Pneumoconiosis with progressive pulmonary fibrosis in RA
Hypersensitivity pneumonitis
Allergic lung reactions caused by organic dust: byssinosis, bagassosis, farmer’s lung, silo-filler’s lung
Byssinosis
Allergic lung reactions caused by cotton dust from mill workers
One of hypersensitivity pneumonitis
Bagassosis
Moldy fibrous waste (bagasse) in sugar cane workers
One of hypersensitivity pneumonitis
Farmer’s lung
Allergic lung reactions caused by moldy hay in farmers
One of hypersensitivity pneumonitis
Silo-filler’s lung
Caused by nitrogen dioxide found in corn-filled silos
One of hypersensitivity pneumonitis
What type of sensitivity is Sarcoidosis
Type Iv hypersensitivity reaction
bilateral hilar lymphadenopathy and pulmonary fibrosis - dyspnea and dry cough
Sarcoidosis
non-caseous granulomas with epithelioid macrophages
Sarcoidosis
What does sarcoidosis affect
Splenomegal, uveitis, Bell’s palsy, erythema nodusum (red painful bumps over the shins)
Sarcoidosis has elevated
Serum calcium due to increased conversion of Vit D in the epithelioid macrophages
- associated with raised levels of angiotensin converting enzyme in 40-80% of patients
- ACE is also produced in epithelioid cells in granulomas
Ghon focus
Caseous granulomas in lung (with TB)
- epithelioid cells and Langhan’s giant cells
- epithelioid cells are activated macrophages
- lower part of the upper lobe or the upper part of the lower lobe
Ghon complex
Peripheral Ghon focus with involvement of regional lymph nodes
- seen in primary TB
Langhan’s giant cells
Fused epithelioid cells with the nuclei arranged in a horse-shoe pattern
What is the most common lung cancer
Bronchogenic carcinoma
- squamous cell type is the most common
Bronchogenic carcinoma
M/C lung cancer
M/C in males
- smoking, mining, industrial cities
- chronic cough, hemoptysis, weight loss, and SPHERE
Superior vena cava syndrome (distended neck and upper limb veins)
Pancoast tumor
Horner’s syndrome
Endocrine (paraneoplastic ectopic hormone secretions)
Recurrent laryngeal damage (hoarseness)
Effusions (pleural or pericardial)
What causes 25% of lung cancers
Small cell lung carcinoma, previously called oat cell carcinoma - uncommon cause of lung cancer
What does small cell carcinoma produce
Ectopic hormone production such as: parathormone, ACTH, ADH
SIADH
Syndrome of Inappropriate ADH secretion by small cell lung cancers
Pancoast tumor
Bronchogenic carcinoma in one of the lung apices
- may invade roots of the brachial plexus, first rib, sympathetic trunk (causing Horner’s syndrome), subclavian vein or artery
Pneumothorax
Air within the pleural cavity
- spontaneous - no previous underlying lung disease
- secondary - traumatic, underlying asthma or emphysema
- tension - trapped air in the pleural space cannot escape and builds up in the space causing mediastinal shift away from the affected side
Emphysema
Pus-filled pleural cavity
- secondary to bacterial infection in the lungs
Pleural effusion? Types? How to tell the difference between the types?
Fluid-filled pleural cavity
- may be an exudate as a result of local inflammation, or transudate related to systemic diseases.
Exudates has more protein (>2g/dl)
Exudates
Pleural effusion seen in pneumonia, TB, lung cancer, pulmonary embolism
Transudates
Pleural effusion seen in congestive heart failure, renal failure, liver failure, nephrotic syndrome
Mesothelioma
Malignant tumor the pleura
- associated with prolonged exposure to asbestos
