Final Exam Lungs Cont. Flashcards
1
Q
Chronic interstitial lung diseases appearance on x-ray
A
Ground glass shadows
Honeycomb lung
2
Q
Chronic intestinal Lung disease MC to produce
A
Reduced FVC
3
Q
Occupation related lung disease least likely to be associated with lung cancer
A
Coal worker’s pneumoconiosis
4
Q
Widespread interstate fibrosis and Velcro-like crackles observed in
A
Idiopathic pulmonary fibrosis
5
Q
Idiopathic pulmonary fibrosis MC in
A
Males
Age >55 years
6
Q
Prognosis for idiopathic pulmonary fibrosis
A
Poor
<5 years
7
Q
Non-neoplastic lung reactions
A
Pneumoconioses
8
Q
Traditional pneumoconioses
A
Coal
Silica
Asbestos
9
Q
MC worldwide pneumoconiosis
A
Silicosis
10
Q
Asbestos is risk for
A
Mesothelioma
11
Q
Simple coal workers pneumoconsiosis
A
Macrophages
Little to no dysfunction
12
Q
Progressive massive fibrosis (PMF)
A
Massive black Scars
Pulmonary HTN
13
Q
Anthracosis
A
Pigment accumulates in lungs
Asymptomatic
City dwellers and smokers
14
Q
Coal worker’s pneumoconiosis MC affects what part of lung
A
Upper lobes
15
Q
Inhalation of silica crystals, often from quartz results in
A
Silicosis
16
Q
MC pneumoconiosis
A
Silicosis
17
Q
Silicosis destroys
A
Alveoli
18
Q
“Whirled” appearance in middle and upper lobes indicates
A
Silicosis
19
Q
Egg-shell calcifications observed in
A
Silicosis
20
Q
Asbestos MC affects what part of lung
A
Lower lungs/ pleura
21
Q
Histological appearance indicative of asbestos
A
Ferruginous bodies
22
Q
Erythema nodosum observed in
A
Sarcoidosis
23
Q
Sarcoidosis
A
Multisystem inflammatory disorder
24
Q
Noncaseating granulomas and bilateral hilar lymphadenopathy indicates
A
Sarcoidosis
25
MC population for sarcoidosis
African Americans
Age 20-40
MC non smokers and females
26
MC sarcoidosis symptom
Asymptomatic
27
Most PE originate as
DVTs
28
Prognosis of sarcoidosis
70% recover
20% moderate dysfunction
10% PMF
29
Percent of PEs causing infarction
10%
| Rare
30
Saddle embolism
Clots at Pulmonary artery bifurcation
>60% occlusion
31
Up to 80% of PEs are
Clinically silent
32
Pulmonary HTN
> 30/20
33
Normal pulmonary BP
15/20
34
Pulmonary HTN can be due to
Decrease in cross-sectional area of pulmonary arteries
Increase in blood volume
35
Vascular changes from pulmonary HTN affect
Entire arterial tree
36
Primary pulmonary HTN
Idiopathic
| 10% Familial
37
Primary pulmonary HTN MC in
Young adult females
38
Prognosis of primary pulmonary HTN
Poor
Cor pulmonale 2-5 years
39
Hypothesis for primary pulmonary HTN
Endothelial dysfunction, vascular fibrosis, smooth muscle hyperplasia
40
Goodpasture Syndrome
Antibodies against lung and kidney collagen
HS type 2
Hemoptysis
Hematuria
41
Diffuse alveolar hemorrhage syndromes
Group of diseases that cause pulmonary hemorrhage
42
3 things that all DAHS have
Hemoptysis
Anemia
Diffuse pulmonary edema
43
Goodpasture MC affects
20-30 yo males
| 60-70 yo females
44
7th MC cause of death in US
Pneumonia
45
Smoking effect on preventing pulmonary infections
Lower mucociliary clearance
| Lower immune chemotaxis
46
Alcohol effect on pulmonary infections
Lower cough and epiglottic reflexes
47
Intrinsic factors for pulmonary infection
Defects in cell-mediated immunity
Defects in adaptive immunity
48
Alveolar inflammation from infection
Pneumonia
49
Alcoholics MC to get what pneumonia
Klebsiella pneumoniae
50
Acute bacterial pneumonia includes
Bronchopneumonia
Lobar pneumonia
51
Bronchopneumonia
Multiple lobes
| Patchy, well developed lesions
52
Lobar pneumonia
Single lobe, homogenous consolidation
Abrupt radiopacity
53
___ in upper airway and ___ in lower airway
IgA
IgG
54
90% of lobar pneumonia cases are from infection with
Strep pneumoniae
55
Community acquired acute pneumonia MC from
Strep pneumoniae
56
Mucopurulent sputum appearance in community acquired acute pneumonia
Yellow/ greenish
57
Risk factors for community acquired acute pneumonia
```
Diabetes
CHF
COPD
Immunosuppressive
Reduced splenic function
```
58
Pattern of community acquired acute pneumonia MC
Lobar, possible bronchopneumonia
59
Staph Aureus infects
Kids, after viral URTI
60
Klebsiella pneumoniae infects
Alcoholics or debilitated
61
Pseudomonas aeruginosa infects
Burn patients
Chemo therapy
CF
62
Best to classify pneumonia by ___ or ___
Microbes
Clinical setting
63
Legionella pneumophila
Aquatic
| Spread via inhalation/ aspiration
64
Legionnaire disease
Pneumonia due to legionella
65
Symptoms of Legionnaries
Dyspnea
Fever
Aches
66
Legionnaries Disease MC in
Transplant recipients
67
Legionella can cause 2 diseases
Legionnaire
Pontiac Fever
68
Pontiac Fever
Mild URTI
Spontaneously resolves
69
During sleeping, aspiration of ___ occurs with community acquired acute pneumonia
Strep pneumoniae
70
Features of “atypical” pneumonia
Moderate sputum
Modestly high WBCs
No physical exam bindings to support lung consolidation
Minimal pulmonary infiltrates
71
Community acquired atypical pneumonia: edema confined to
Alveolar septa
Absence of consolidation on x-ray
72
Legionnaries disease _____ lethal
30-50%
73
Community acquired atypical pneumonia caused by same microbes as
Common cold
Mycoplasma pneumonia (MC)
Influenza A, B, RSV, rhinovirus
74
Community acquired atypical pneumonia may be lethal if advanced due to
Low mucociliary clearance
Alveolar necrosis
75
Variable features of community acquired atypical pneumonia
Malaise
HA
Non-productive cough
Chest cold
76
Community acquired atypical pneumonia aka
Walking pneumonia
77
Subjective distress not matching objective findings is indicative of
Walking pneumonia
78
Hospital acquired pneumonia MC caused by
Bacteria
Staph aureus
E. coli
79
Nosocomial
Hospital acquired
80
Aspiration pneumonia
Inhalation of foreign material (vomitus)
81
Hospital acquired pneumonia develops
48 hours after hospitalization
82
Hospital acquired pneumonia occurs in patients with
Severe co-morbidities
83
Aspiration pneumonia occurs after
Debilitation
Stroke, stupid, physical disabilities, dysfunctional gag reflex)
84
Dysfunction gag reflex MC due to
Alcohol
85
Aspiration pneumonia MC due to
Strep pneumoniae
Staph aureus
H. Influenzae
86
Aspiration pneumonia is ___ ___ and ____
Acute
Severe
Necrotizing
87
If aspiration pneumonia is not lethal, __ forms in lungs
Abscess
88
Lung abscess cavitation MC on which side
Ride side of lung
89
Lung abscess can be due to 3 things
Aspiration
Bronchial obstruction
Hematogenous spread
90
Chronic granulomatous diseases (bacterial)
Mycobacterium tB
91
Chronic granulomatous diseases (fungal)
Histoplasma capsulatum
92
MC cause of infectious death worldwide (6%)
TB
93
Cases of TB in US
10,000 per year
94
TB transmitted via
Respiratory droplets
95
TB tubercles are filled with
Caseous necrosis
96
TB infection is what type of HS
Type 4
97
TB infection is ___, post infection
Delayed, 2-4 weeks
98
+ TB test occurrence
10% US
| 80% Asian/African
99
TB disease
Re-infection
Tissue destruction
100
Tuberculin Test aka
PPD
Mantoux
101
Disease of TB MC from deactivation of
Dormant lesions
102
Ghon Focus
Subpleural caseous granulomas (1-2 cm)
103
Ghon Complex
Subpleural and lymph node regions have granulomas (tuberculoma)
104
Ranke complex
Calcification and fibrosis of hilar nodes
Visible on radiographs
105
Ghon focus and complex and ranke complex indicative of
TB
106
In US, ___ of infected individuals with TB develop disease
3-15%
107
Most TB infections are
Controlled
108
TB DISEASE must result from
Re-infection
109
Infected people with TB are not
Contagious
110
Miliary TB
Pulmonary lymphatic and hematogenous spread
Accelerated with HIV
111
Miliary TB can spread to
Nearly every organ
*vertebrae = Pott’s Disease
112
Lymphadenitis from miliary TB MC found
Cervical nodes
113
Cervical node lymphadenitis in miliary TB MC form of
Extrapulmonary TB
114
Symptoms of Pott’s disease
Back pain
Paraesthesia
LE weakness
115
Low-grade afternoon fever, nigh sweats, hemoptysis are symptoms of
TB (disease)
116
MC opportunistic viral pathogen in AIDS patients
CMV
117
Owl’s eye appearance (cellular gigantism) on histological slides
CMV
118
Hamartoma
Coin lesion
Solitary pulmonary nodule
119
MC lung tumor, benign
Hamartoma
120
___ common site of metastasis
Lungs
121
Most bronchogenic carcinomas arise from
Bronchial epithelia
122
Bronchogenic carcinoma is ___ and ___
Common and lethal
123
Occurrence of lung cancer
1 in 15 males
| 1 in 17 females
124
Pulmonary cancer-related death
Males 29%
| Females 26%
125
MC ages for pulmonary carcinomas
50-70
126
Risk factors for bronchogenic carcinoma
Age
Smoking
Asbestos
Radon
127
If pulmonary carcinomas localized....
45% 5 year survival
128
If pulmonary carcinomas Mets...
15% 5 year survival
Early Mets in 50% of all cases
129
MC type of lung Ca
Adenocarcinoma
130
4 types of lung cancer
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
Small cell carcinoma
131
2 types of lung cancer linked with smoking
Squamous cell carcinoma
Small cell lung cancer
132
Common sites of Mets from primary pulmonary Ca
Brain
Liver
Bones
Adrenals
133
Non-small cell lung Ca includes
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
134
Lung Ca of pulmonary apex
Pancoast tumor
135
MC non-small Cell Lung Ca
| 5% of all lung ca
Pancoast tumor
136
Pancoast tumor can cause possible osseous destruction in
Upper ribs
| Thoracic vertebrae
137
Pancoast Syndrome
Neurologic destruction
Stellate ganglion
Brachial plexus
138
Adenocarcinoma MC in
Non-smokers
| Women
139
Hallmarks of pancoast tumor
Shoulder pain
C8-T2 radicular pain
Horner syndrome
140
Horner syndrome
Ptosis
Miosis
Anhidrosis
141
Pancoast tumor aka
Superior sulcus tumor
142
General symptoms of all pulmonary carcinomas
```
Chronic cough
Hemoptysis
Chest pain
SVC syndrome
Pleural effusion
```
143
Primary pleural lesions are
Rare
144
2 types of primary pleural lesions
Bacterial infections
| Mesothelioma
145
Secondary pleural lesions
Pleuritis
Emphysema
Lung ca
TB
146
Space between visceral pleura and parietal pleura
Pleural cavity
147
Transudate
Protein poor
148
MC cause of pleural effusion
Heart failure
149
Exudate
Protein rich
150
Exudate occurs due to
Inflammatory conditions
151
Transudate occurs MC due to
Heart failure
152
Transudate =
Hydrothorax
153
Exudate =
Pleuritis
154
Pleural effusion
Fluid in pleural cavity
155
Types of pleural effusion
Transudate
Exudate
156
Pus in pleural space
Empyema
157
Causes of pleural exudate
```
Bacterial infections
Viral infections
Tumor invasion
Pulmonary infarction
SLE, RA, thoracic surgery
```
158
Air within pleural cavity
Pneumothorax
159
Spontaneous pneumothorax
Idiopathic
Slender habitus
Males
160
Tension pneumothorax
Air accumulates and shifts mediastinum
Vascular compression
Medical emergency
161
Secondary pneumothorax
Due to trauma or pathology
- rib fracture
- emphysema
162
Tension pneumothorax can lead to
Cardiogenic shock
163
Hemothorax
Blood in pleural cavity
Coagulates
Can be lethal
164
Chylothorax
Lymphatic fluid (chyle) in pleural cavity
Milky-white
Major lymphatic obstruction
165
Firm mass
Yellow white
Both describe
Mesothelioma
166
Locally invasive but rarely Mets describes what lung pathology
Mesothelioma
167
Mesothelioma has a very long ___
Latency
25-40 years
168
Cancer of mesothelial cells from asbestos exposure
Mesothelioma
169
Prognosis for mesothelioma
4-18 months post diagnosis
Very poor
170
Vocal cord polyp
Small round nodules on vocal cords
171
Vocal cord polyps is due to chronic irritation, observed commonly in
Smokers
| Singers
172
Laryngeal papilloma
Raspberry-like growth on vocal cords
173
MC recur after excisions
Laryngeal papilloma
174
Characteristics of laryngeal carcinoma
Pearly gray
Wrinkled
Ulceration
Necrosis
175
2% of all Ca
Carcinoma of larynx
176
Laryngeal papilloma can be due to
HPV 6
| HPV 11
177
Carcinoma of larynx type
Squamous cell carcinoma
178
1/3 of larynx ca is
Fatal
179
Death from Larynx ca MC from
LRTI
Widespread Mets
180
Risks for larynx ca
```
>40 yo
Smoking
Alcohol
Males
Asbestos
Irradiation
```
181
Supraglottic laryngeal ca
20-40% cases
| 30% Mets by diagnosis
182
Glottis laryngeal ca
60-70% cases
| 10% Mets by diagnosis
183
Subglottic laryngeal ca
Very rare
184
Types of laryngeal ca
Supraglottic
Glottic
Subglottic
