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Undeleted > Exam 1 path > Flashcards

Exam 1 path Flashcards

1
Q

Premortum exam of pulmonary embolism

A

lines of Zahn

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2
Q

Pulmonary embolism on gross exam

A

lower lobe

triangle shaped pointing toward hilum

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3
Q

Microscopic exam of pulmonary embolism

A 
plexiform lesions (adjacent to vessel)
concentric laminar intimal fibrosis
(above both are irreversible)
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4
Q

Goodpasture syndrome

A 
type II cytotoxic hypersensitivity
triad of sx
1. diffuse pulmonary hemorrhage
2. glomerulonephritis
3. anti-GBM Abs
men b/t 15-30 y/o
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5
Q

Goodpastures dx tool

A

IgG Abs against alveoli and glomeruli in serum

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6
Q

Goodpastures microscopic exam

A

lungs: linear deposits of IgG, thickening of alveolar septa
kidney: focal proliferative to crescentic glomerulonephritis, linear deposits of IgG

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7
Q

Idiopathic pulmonary hemosiderosis

A

intermittant hemoptysis
refractory anemia
in children/teens
no serum Abs

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8
Q

Microscopic exam of idiopathic pulmonary hemosiderosis

A

hemosiderin laden macrophages
alveolar capillary congestion
no necrosis/vasculitis/granulomas
interstitial fibrosis

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9
Q

Wegener granulomatosis

A

necrotizing granuolmatous inflammation (kidney and lungs)
necrotizing vasculitis (sm/med vessels)
c-ANCA against neutrophil proteinase 3 (PR3)
neutrophils activated and damage endothelium

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10
Q

Pulmonary HTN presentation

A

exertional dyspnea

in women 20-40 y/o

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11
Q

Familial pulmonary HTN gene

A

BMPR2 mutation (when inactivated)

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12
Q

Most common cause of secondary pulmonary HTN

A

recurrent pulmonary embolism

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13
Q

Acute Respiratory Distress syndrome

A

hyaline membrane at capillary/alveolar interface,
neutrophil damage to type I and II pneumocytes,
inhibited recovery due to damage to type II pneumocytes

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14
Q

Causes of pulmonary hypoplasia

A

oligohydramnios

decreased intrathoracic space

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15
Q

Most common tracheoesophageal fistula type

A

blind esophagus with lower esophagus connected to trachea

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16
Q

Extralobar sequestration

A

mostly on L side
polyhydramnios and edema can cause
external to lung w/ separate pleural lining

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17
Q

Intralobar sequestration

A

assc with fibrosis/infections/bronchiectasis
usually lower lobe
aortic branch supplied
not in pleura

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18
Q

Atelectasis

A

incomplete expansion of the lungs

collapse of previously inflated lung

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19
Q

Resorption atelectasis

A 
complete airway obstruction
mediastinal shift toward obstruction
excess secretions/asthma/foreign body
retraction of lung in airless state (cells filled with secretions)
most common type
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20
Q

Compression atelectasis

A

mediastinal shift away from affected lung

pleural cavity filled (with fluid/air)

21
Q

Contraction atelectasis

A

fibrotic changes in lung/pleura
prevents full expansion
irreversible

22
Q

Pulmonary edema histology

A

engorged capillaries
hemosiderin laden macrophages
granular pink precipitate

23
Q

Acute respiratory distress syndrome (acute lung injury)

A

diffuse alveolar damage with hyaline deposition lining capillary/alveoli interface

24
Q

Acute interstitial pneumonia

A

Hamman-Rich syndrome
rapidly progressive in young aduts
flu like illness w/ SOB
brisk interstitial fibroblastic proliferation

25
Q

Impact of obstructive lung disease on airflow rate

A

decreases (FEV1/FEV)

26
Q

Impact of restrictive lung disease on airflow rate

A

normal or increased (FEV1/FEV)

27
Q

Cause of emphysema

A

imbalance of protease/antiproteases

28
Q

Centriacinar emphysema

A

upper half of lungs
respiratory bronchioles
from long standing smoking

29
Q

Panacinar emphysema

A

uniform destruction of entire alveolus
lower half of lungs
A1AT deficiency
assc with liver cirrhosis (PAS + stain)

30
Q

Paraseptal emphysema

A

distal airway structures
apical/giant bullae with spontaneous pneumothorax
around septa or pleura

31
Q

Symptoms/findings of emphysema

A

pursed lips/pink skin/Tx barrel chest
functional capacity loss
decreased FEV1/FEV

32
Q

Dx for chronic bronchitis

A

persistent cough/copious sputum production for 3 months (2x) within 2 years

33
Q

Symptoms/findings of chronic bronchitis

A

hypercapnea (cyanotic)
wt gain
aka blue bloaters
elevated Reid index (over 0.4) due to thickened mucus layer

34
Q

Atopic asthma

A

in children

type 1 hypersensitivity (IgE mediated)

35
Q

Occupational asthma

A

from repeated exposure to chemicals/irritants

36
Q

Drug induced asthma

A

commonly aspirin (assc with nasal polyps)

37
Q

Non-atopic asthma

A

respiratory infections with normal serum IgE

38
Q

Status asthmaticus

A

unrelenting asthma attack

refractory to bronchodilators

39
Q

Findings with asthmatic lungs

A

Curschmann spirals
Charcot-Leyden crystals (from eosinophils)
over distended lungs
goblet cell hyperplasia

40
Q

What is bronchiectasis?

A

permanent dilation of the airways

41
Q

Sx of bronchiectasis

A

SOB
cough
hemoptysis

42
Q

Cause of congenital bronchiectasis

A

developmental arrest of bronchial tree

43
Q

Acquired bronchiectasis

A

in adults

infectious insult/obstruction/drainage impairment can cause

44
Q

Causes of bronchiectasis

A

bronchial obstruction
cystic fibrosis
Kartagener syndrome (immotile cilia/sinusitis/situs inversus)
allergic bronchopulmonary aspergillosis

45
Q

Pts with allergic bronchopulmonary aspergillosis

A

asthmatics

cystic fibrosis

46
Q

Who are pink puffers?

A

pts with emphysema

thin/barrel chest/pursed lips

47
Q

Who are blue bloaters?

A

pts with chronic bronchitis

heavy/cyanotic

48
Q

Kartagener’s syndrome

A

dynein arms mutation (immotile cilia)
situs inversus
bronchiectasis
sinusitis

Undeleted (71 decks)

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