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Flashcards - Pulm

1
Q

plexiform lesions

A

pulmonary hypertension

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2
Q

Birbeck’s granules (tennis rackets)

A

Langerhans histiocytosis - S100 and CD-1a positive

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3
Q

1gm of Hb binds to mL of O2

A

1gb Hb = 1.34mL of O2

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4
Q

Taut hemoglobin

A

low affinity for O2

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5
Q

relaxed hemoglobin

A

high affinity for O2

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6
Q

methemoglobiemia

A

treat with methylene blue - caused by nitrites, benzocaine - can be induced to treat cyanide

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7
Q

Kiesselbach plexus

A

anterior segment of nostril - most common site of nose bleed

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8
Q

Sphenopalatine artery

A

posterior - branch of maxillary - life threatening nose bleed

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9
Q

lines of Zahn

A

platelet+fibrin/RBC layers in PE, premortem

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10
Q

Pulmonary artery hypertension

A

bone morphogenic protein receptor 2 (BMPR2) - smooth muscle proliferation

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11
Q

Rifampin

A

inhibits DNA-dependent RNA polymerase - inhibits CYP450

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12
Q

Ethambutol

A

inhibits mycolic wall synthesis - optic neuropathy

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13
Q

Isoniazid

A

inhibits mycolic acid synthesis - can cause B6 deficiency, neuropathy

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14
Q

neuroendocrine (Kulchitsky cells) - dark blue cells, chromogranin+

A

central - small cell carcinoma - smokers - ADH, ACTH, Eaton-Lambert

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15
Q

squamous cell carcinoma

A

central - smokers - keratin pearls/intercellular bridges(desmosomes) - PTHrP

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16
Q

adenocarcinoma

A

peripheral - non-smokers - glands/mucin - KRAS, EGFR, ALK

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17
Q

large cell carcinoma

A

central/peripheral - smokers - poorly differentiated large cells

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18
Q

bronchoalveolar carcinoma

A

peripheral - non-smokers - columnar cells arising from clara cells, grows along bronchioles/alveoli - pneumonia-like

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19
Q

carcinoid tumor

A

central/peripheral - non-smokers - chromogranin +, polypoid, nests of neuroendocrine cells

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20
Q

aspiration bacteria

A

bacteroides, fusobacterium, peptococcus - treat with clindamycin

21
Q

aortic/carotid bodies chemoreceptor

A

PaO2 + PaCO2 driven

22
Q

central chemoreceptors

A

PaCO2 driven only

23
Q

sarcoidosis

A

non-caseating granulomas - CD4+ T-cell mediated - causes increased ACE, Ca2+

24
Q

IPF

A

TGF-b induced - bleomycin/amiodarone

25
Q

stellate inclusions/asteroid bodies

A

sarcoidosis

26
Q

coal workers/black lung

A

associated with RA, Caplan syndrome - carbon laden macrophages - upper lobes

27
Q

upper lobe fibrotic nodules, eggshell calcifications, birefringent particles

A

silicosis - increases risk of TB (decreased phagolysosomes in macrosomes) - upper lobes

28
Q

berylliosis

A

non-caseating granulomas - upper lobes - increased risk of lung Ca

29
Q

fusiform rods resembling dumbbells, fibrosis of lung/pleura, long gold-brown fibers w/ iron, “ivory white”

A

asbestosis - lower lobes

30
Q

Allergen immuno

A

induces TH2 in CD4+ cells, secretes IL-4,5,10 –> rexposure = IgE activation of mast cells

31
Q

ARDS

A

hyaline membrane deposits - activation of neutrophils –> protease/free radical damage –> fibrosis

32
Q

asplenic susceptibility

A

S. pneumo, H. flu, N. meningitidis

33
Q

ABPA

A

high IgE, eosinophilia, IgG to Aspergillus

34
Q

legionella growth medium

A

buffered charcoal yeast extract with L-cysteine and iron

35
Q

mycobacteria pneumoniae growth medium

A

acellular medium with cholesterol

36
Q

congestion

A

first 24 hours - red, heavy, boggy - vascular dilation, alveolar exudate with bacteria

37
Q

red hepatization

A

days 2-3 - red, firm lobe - alveolar exudate with erythrocytes, neutrophils and fibrin

38
Q

gray hepatization

A

days 4-6 - gray brown firm lobe - RBCs disintegrate - exudate contians neutrophils and fibrin

39
Q

resolution of bronchopneumonia

A

restoration of architecture - enzymatic digestion of exudate

40
Q

club cells

A

degrades toxins - produces component of surfactant

41
Q

lobar pneumonia causes

A

S. pneumo, Legionella, Klebsiella

42
Q

bronchopneumonia causes

A

S. pneumo, S. aureus, H. flu, Klebsiella, pseudomonas (CF), moraxella, legionella

43
Q

Interstitial pneunomia causes

A

Viruses (influenza, CMV, RSV, adenovirus), mycoplasma, legionella, chlamydia, coxiella burnetti (Q fever)

44
Q

pleomorphic keratin-positive epithelial cells in background of lymphocytes

A

nasopharyngeal carcinoma - EBV - involves cervical lymph nodes

45
Q

croup

A

laryngotracheobronchitis - parainfluenza

46
Q

acute epiglottitis

A

H. flu b - muffled voice, stridor, obstruction

47
Q

hypersensitivity pneumonotis

A

granulomatous reaction to organic antigens - eosinophils - pigeon breeders lung

48
Q

Curshmann spirals

A

shed-epithelium forms whorled mucus plugs - asthma

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