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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
Q

This involves the entire respiratory lobule and usually involves the lover lobes; associated with a ɑ-1 AT deficiency

A

panacinar emphysema

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26
Q

This is when there is cough with sputum production at least 3 consecutive months for 2 consecutive years, and often occurs with emphysema

A

chronic bronchitis

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27
Q

What is the pathogenesis of chronic bronchitis

A

chronic irritation and infections
hypoxemia
cyanosis

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28
Q

What is the pathology of chronic bronchitis

A

increased mucous glands
chronic inflammation
fibrosis
narrowing of the airways due to edema, seromucous gland hypertrophy and excessive secretions

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29
Q

What are some pre-disposing factors for chronic bronchitis

A

smoking
atmospheric pollutants
infection(s)
genetic factors

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30
Q

Emphysema and chronic bronchitis are also known as what

A

COPD

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31
Q

This is a chronic infection with permanent large airway dilation; its secondary to obstruction, infection, or both

A

bronchiectasis

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32
Q

What are the clinical features of bronchiectasis

A

severe cough
bloody mucoid expectoration
dyspena

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33
Q

What are some some complications of bronchiectasis

A

abscess
pneumonia
bronchopleural fistula
empyema (pus)

34
Q

What are some pre-disposing factors of bronchiectasis

A 
obstructive tumors
foreign bodies
cystic fibrosis
other COPS
suppurative or necrotizing pneumonia
35
Q

What is the pathology of bronchiectasis

A

dilated distal bronchi and bronchioles

chronic infection with inflammation and variable purulence

36
Q

This is the increased irritability of smooth muscle in the bronchi and bronchioles leading to marked, reversible episodes of contraction and airway constriction

A

asthma

37
Q

What are some initiating factors of asthma

A 
allergies
infections
exercise
drugs
emotions
38
Q

What are the clinical symptoms of asthma

A

wheezing
long exhalation
hyperinflation of the lungs

39
Q

What is atopic asthma

A

allergic, extrinsic
type I hypersensitivtiy (IgE mediated)
environmental antigen

40
Q

What is non atopic asthma

A

intrinsic

may be initiated by viruses and air pollutants

41
Q

What is the pathology of asthma

A

increased mucus glands
smooth muscle hypertrophy (narrowing airways)
inflammation with eosinophils and TH2 cells
- narrow airway filled with mucous

42
Q

What is the pathogenesis of asthma

A

antigens binds to surface IgE on mast cells, releasing a large number of mediators, including histamine and leukotrienes

43
Q

What are treatment options for asthma

A

attacks may subside spontaneously
inhalation broncho-dilators (albuterol)
controller meds (corticosteriods)

44
Q

True or False

Any organism can cause pneumonia including, bacteria, viral, fungal, parasites

A

True

45
Q

What are 5 pre-disposing factors for bacterial pneumonia

A 
loss of cough reflex
injury to cillia
decreased phagocytosis
pulmonary edema
immunocompromised
46
Q

What are the clinical features of bacteria pneumonia

A 
cough
dyspnea
fever
chills
sputum production
47
Q

This pathology of pneumonia is common in the very young and old it is a patch process, beginning around the small bronchi

A

bronchopneumonia

48
Q

This pathology of involves the entire lung and is typically found in healthy adults

A

lobar pneumonia

49
Q

What is the cause of lobar pneumonia is 90% of cases

A

strep. pneumoniae

50
Q

What is the early stage of pneumonia

A

“red hepatization”

purulent exudate with many RBCs

51
Q

What is the later stage of pneumonia

A

“grey hepatization”

exudate with fibrin and macrophages

52
Q

What are the two possible outcomes of pneumonia

A

complete resolution or scarring (fibrosis)

53
Q

What are five complications of pneumonia

A 
abscess
pleuritits
empyema (pus in the cavity)
pericarditis
bacteremia
54
Q

What is seen with atypical (interstitial) pneumonia

A

viruses and mycoplasma pneumoniae

55
Q

What are the clinical features of atypical (interstitial) pneumonia

A

highly variable

from mild fever, H/A, dry cough, myalgia to life threatening

56
Q

What is the pathology of interstitial pneumonia

A

interstitial inflammation
mononuclear cells
congestion and hyaline membranes (diffuse alveolar damage)

57
Q

This is a rapidly developing serious condition with the same histological features of intentional pneumonia

A

acute respiratory distress syndrome (ARDS)

58
Q

What are some causes of ARDS

A 
shock
infections
trauma
drug overdose
irritants, etc.
59
Q

What is injured in ARDS

A

injury to the endothelium and alveolar epithelium

60
Q

ARDS increase what

A

endothelial permeability (leaky)

61
Q

What are the clinical features of a pulmonary abscess

A

cough
fever
purulent sputum

62
Q

What are the pre-disposing factors of a pulmonary abscess

A 
bronchiectasis
aspiration**
septic emboli
airway obstruction
dental sepsis
63
Q

What is the course of a pulmonary abscess

A

scarring

may progressively enlarge or cavitate

64
Q

This bacterium causes the most common infectious cause of death in the world

A

mycobacterium tuberculosis (tuberculosis)

65
Q

Mycobacterium tuberculosis is what kind of bacteria

A

acid fast bacillus

66
Q

What is the pathology of tuberculosis

A

caseating granuloma

67
Q

How is tuberculosis acquired

A

via inhalation

68
Q

This is the site of early infection of tuberculosis

A

Ghon lesion

69
Q

This is a parenchymal lesion + hilar lymph nodes involved with tuberculosis

A

Ghon complex

70
Q

What is cavitary tuberculosis

A

found at the apex
significant scarring
may seed the large airways, lymph nodes or blood
direct extension of the pleura; effusion

71
Q

What percentage of primary TB resolves and what are the courses TB can take

A

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
Q

This results from spread of TB via lymphatics or blood (lymphohematogenous)

A

miliary TB

73
Q

TB is a classic form of this, but it is also associated with fungal infections, histoplasmosis is the most common; sarcoidosis also

A

granulomatous inflammation

74
Q

What are the leading causes of lung cancer

A

cigarette smoking**
asbestos
radon gas
nickel, chromates, pollutants, lung scarring

75
Q

What are the clinical symptoms of lung cancer

A 
cough
weight loss
chest pain
hemoptysis (coughing up blood)
dyspnea (labored breathing)
76
Q

Tumors of the lungs may produce what

A

hormones such as ADH, ACTH, PTH - paraneoplastic syndrome

77
Q

What are the four main types of lung cancer pathology

A 
SCC ( 25-30%)**
adenocarcinoma (35-35%)
small cell; oat (20-25%)**
large cell (10-15%)
***strongly associated with smoking
78
Q

What is the prognosis for lung cancer

A

5 year survival rate - 16%

if localized when found - 45%

79
Q

This is a group of lung disorders caused by inhalation of dusts/particles; size/shape/concentration of the particles are important factors

A

pneumoconioses

80
Q

What size particles is the most dangerous in regards o pneumoconioses

A

1-5µm; will remain in terminal airways

81
Q

Inhaled particles of pneumoconioses induce what

A

fibrosis (scarring)

82
Q

What can cause pneumoconioses

A

occupational and environmental causes;
coal workers
silicosis (silicon) - most common
asbestosis

SP15 Pathology (17 decks)

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