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SP15 Pathology > Exam 1; Pulmonary Pathology > Flashcards

Exam 1; Pulmonary Pathology Flashcards

1
Q

What is the pulmonary defense of the upper respiratory tract

A

filtering

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2
Q

What is the pulmonary defense of the lower respiratory tract

A

mucociliary units

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3
Q

What types of cells/tissues are found in the respiratory tract

A

lymphoid tissues - cellular and humoral immunity

alveolar macrophages

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4
Q

What are the two cell types found in the alveoli

A

type 1 - flat pneumocytes (95%)

type 2 - cubodial pneumocytes which produce surfactant

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5
Q

What is hemoptysis

A

coughing up blood

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6
Q

What is dyspnea

A

difficulty breathing, perception of needing to breathe deeper and faster (shortness of breath)

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7
Q

What is atelectasis

A

collapse of lung volume

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8
Q

What is pneumothorax

A

air in the pleural space or cavity, leading to collapse of the lung

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9
Q

This is fluid in the pleural space

A

pleural effusion

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10
Q

This type of pleural effusion is a low protein fluid caused by increased venous pressure (CHF)

A

transudate

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11
Q

This type of pleural effusion is a high protein fluid with out without inflammatory cells, caused by increased vascular permeability (damage), pneumonia is an example

A

exudate

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12
Q

This is the accumulation of fluid in the lungs, first in the interstitial tissues, then ultimately filling up the distal air spaces

A

pulmonary edema

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13
Q

What are three causes of pulmonary edema

A

increased intravascular pressure (CHF)
hypoproteinemia
vascular damage

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14
Q

What are two main issues with pulmonary edema

A

inhibits normal oxygen exchange

predisposes to infection

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15
Q

This usually arises from the DEEP veins of the legs or pelvic veins

A

pulmonary thromboemboli

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16
Q

large pulmonary thromboemboli may cause what

A

hemorrhage or infarction

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17
Q

Very large pulmonary thromboemboli may do what

A

lodge at the bifurcation of the pulmonary arteries (saddle) and can cause sudden death

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18
Q

What are four predisposing factors of pulmonary thromboemboli

A

chronic illness
prolongs bed rest
hyper coagulable state
deep vein thromboses

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19
Q

What are the four classic disorders that can cause chronic airflow obstruction

A

emphysema
chronic bronchitis
bronchiectasis
asthma

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20
Q

This is the permanent enlargement of the distal small airspaces due to destruction of the alveolar septae

A

emphysema

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21
Q

What are the clinical manifestations of emphysema

A

dyspnea
cough
prolonged exhalation

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22
Q

What is the pathogenesis of emphysema

A

imbalance between protease and anti-protease enzymes

upregulation of the inflammatory pathway

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23
Q

What is a major cause of the pathogenesis of emphysema

A

smoking

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24
Q

This involves the central portion of the lobule, may progress to bull, usually affecting the upper lobes, typically associated with smoking

A

centriacinar emphysema

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25
This involves the entire respiratory lobule and usually involves the lover lobes; associated with a ɑ-1 AT deficiency
panacinar emphysema
26
This is when there is cough with sputum production at least 3 consecutive months for 2 consecutive years, and often occurs with emphysema
chronic bronchitis
27
What is the pathogenesis of chronic bronchitis
chronic irritation and infections hypoxemia cyanosis
28
What is the pathology of chronic bronchitis
increased mucous glands chronic inflammation fibrosis narrowing of the airways due to edema, seromucous gland hypertrophy and excessive secretions
29
What are some pre-disposing factors for chronic bronchitis
smoking atmospheric pollutants infection(s) genetic factors
30
Emphysema and chronic bronchitis are also known as what
COPD
31
This is a chronic infection with permanent large airway dilation; its secondary to obstruction, infection, or both
bronchiectasis
32
What are the clinical features of bronchiectasis
severe cough bloody mucoid expectoration dyspena
33
What are some some complications of bronchiectasis
abscess pneumonia bronchopleural fistula empyema (pus)
34
What are some pre-disposing factors of bronchiectasis
``` obstructive tumors foreign bodies cystic fibrosis other COPS suppurative or necrotizing pneumonia ```
35
What is the pathology of bronchiectasis
dilated distal bronchi and bronchioles | chronic infection with inflammation and variable purulence
36
This is the increased irritability of smooth muscle in the bronchi and bronchioles leading to marked, reversible episodes of contraction and airway constriction
asthma
37
What are some initiating factors of asthma
``` allergies infections exercise drugs emotions ```
38
What are the clinical symptoms of asthma
wheezing long exhalation hyperinflation of the lungs
39
What is atopic asthma
allergic, extrinsic type I hypersensitivtiy (IgE mediated) environmental antigen
40
What is non atopic asthma
intrinsic | may be initiated by viruses and air pollutants
41
What is the pathology of asthma
increased mucus glands smooth muscle hypertrophy (narrowing airways) inflammation with eosinophils and TH2 cells - narrow airway filled with mucous
42
What is the pathogenesis of asthma
antigens binds to surface IgE on mast cells, releasing a large number of mediators, including histamine and leukotrienes
43
What are treatment options for asthma
attacks may subside spontaneously inhalation broncho-dilators (albuterol) controller meds (corticosteriods)
44
True or False | Any organism can cause pneumonia including, bacteria, viral, fungal, parasites
True
45
What are 5 pre-disposing factors for bacterial pneumonia
``` loss of cough reflex injury to cillia decreased phagocytosis pulmonary edema immunocompromised ```
46
What are the clinical features of bacteria pneumonia
``` cough dyspnea fever chills sputum production ```
47
This pathology of pneumonia is common in the very young and old it is a patch process, beginning around the small bronchi
bronchopneumonia
48
This pathology of involves the entire lung and is typically found in healthy adults
lobar pneumonia
49
What is the cause of lobar pneumonia is 90% of cases
strep. pneumoniae
50
What is the early stage of pneumonia
"red hepatization" | purulent exudate with many RBCs
51
What is the later stage of pneumonia
"grey hepatization" | exudate with fibrin and macrophages
52
What are the two possible outcomes of pneumonia
complete resolution or scarring (fibrosis)
53
What are five complications of pneumonia
``` abscess pleuritits empyema (pus in the cavity) pericarditis bacteremia ```
54
What is seen with atypical (interstitial) pneumonia
viruses and mycoplasma pneumoniae
55
What are the clinical features of atypical (interstitial) pneumonia
highly variable | from mild fever, H/A, dry cough, myalgia to life threatening
56
What is the pathology of interstitial pneumonia
interstitial inflammation mononuclear cells congestion and hyaline membranes (diffuse alveolar damage)
57
This is a rapidly developing serious condition with the same histological features of intentional pneumonia
acute respiratory distress syndrome (ARDS)
58
What are some causes of ARDS
``` shock infections trauma drug overdose irritants, etc. ```
59
What is injured in ARDS
injury to the endothelium and alveolar epithelium
60
ARDS increase what
endothelial permeability (leaky)
61
What are the clinical features of a pulmonary abscess
cough fever purulent sputum
62
What are the pre-disposing factors of a pulmonary abscess
``` bronchiectasis aspiration** septic emboli airway obstruction dental sepsis ```
63
What is the course of a pulmonary abscess
scarring | may progressively enlarge or cavitate
64
This bacterium causes the most common infectious cause of death in the world
mycobacterium tuberculosis (tuberculosis)
65
Mycobacterium tuberculosis is what kind of bacteria
acid fast bacillus
66
What is the pathology of tuberculosis
caseating granuloma
67
How is tuberculosis acquired
via inhalation
68
This is the site of early infection of tuberculosis
Ghon lesion
69
This is a parenchymal lesion + hilar lymph nodes involved with tuberculosis
Ghon complex
70
What is cavitary tuberculosis
found at the apex significant scarring may seed the large airways, lymph nodes or blood direct extension of the pleura; effusion
71
What percentage of primary TB resolves and what are the courses TB can take
90-95% infection may become inactive or progress inactive infection may reactivate years later; reactivation induces type IV hypersensitivity and tissue necrosis may widely disseminate (military TB) and involve other organs
72
This results from spread of TB via lymphatics or blood (lymphohematogenous)
miliary TB
73
TB is a classic form of this, but it is also associated with fungal infections, histoplasmosis is the most common; sarcoidosis also
granulomatous inflammation
74
What are the leading causes of lung cancer
cigarette smoking** asbestos radon gas nickel, chromates, pollutants, lung scarring
75
What are the clinical symptoms of lung cancer
``` cough weight loss chest pain hemoptysis (coughing up blood) dyspnea (labored breathing) ```
76
Tumors of the lungs may produce what
hormones such as ADH, ACTH, PTH - paraneoplastic syndrome
77
What are the four main types of lung cancer pathology
``` SCC ( 25-30%)** adenocarcinoma (35-35%) small cell; oat (20-25%)** large cell (10-15%) ***strongly associated with smoking ```
78
What is the prognosis for lung cancer
5 year survival rate - 16% | if localized when found - 45%
79
This is a group of lung disorders caused by inhalation of dusts/particles; size/shape/concentration of the particles are important factors
pneumoconioses
80
What size particles is the most dangerous in regards o pneumoconioses
1-5µm; will remain in terminal airways
81
Inhaled particles of pneumoconioses induce what
fibrosis (scarring)
82
What can cause pneumoconioses
occupational and environmental causes; coal workers silicosis (silicon) - most common asbestosis

SP15 Pathology (17 decks)

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