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D2 Fall > Gen Path Exam 2 - Respiratory Pathology > Flashcards

Gen Path Exam 2 - Respiratory Pathology Flashcards

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1
Q

What disease category?

Pneumonia

A

Infectious

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2
Q

What disease category?

TB

A

Infectious

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3
Q

What disease category?

COPD

A

Injury

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4
Q

What disease category?

Chronic bronchitis

A

Injury

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5
Q

What disease category?

Emphysema

A

Injury

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6
Q

What disease category?

Sarcoidosis

A

Immune-mediated

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7
Q

What disease category?

Asthma

A

Immune-mediated

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8
Q

What disease category?

Lung cancer

A

Neoplastic

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9
Q

What is the primary function of the lungs?

A

Gas exchange

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10
Q

What is the site of gas exchange in the lungs?

A

Alveoli

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11
Q

What disease?

Caused by infection of the lung

A

Pneumonia

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12
Q

In pneumonia, what does an infection of the lung cause?

A

Inflammation
Neutrophilic exudate

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13
Q

What disease?

Often follows a viral upper-respiratory tract infection

A

Pneumonia

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14
Q

What disease?

Most often bacterial, but can be viral or fungal

A

Pneumonia

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15
Q

What is the most common cause of community-acquired acute pneumonia?

A

Strep pneumoniae

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16
Q

What is the most common cause of pneumonia in children and young adults?

A

Mycoplasma pneumoniae

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17
Q

What are the 4 common bacteria that cause pneumonia?

A

Strep pneumoniae
Mycoplasma pneumoniae
Haemophilus influenzae
Klebsiella pneumoniae

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18
Q

What disease?

Can be community-acquired, health care-associated, or hospital-acquired

A

Pneumonia

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19
Q

Why do the lungs get infected?

A

Airborne microbes are inhaled
Nasopharyngeal flora aspirated during sleep
Other lung diseases lower local immune defenses

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20
Q

What disease?

Demographics include children, elderly, smokers, immunocompromised, COPD

A

Pneumonia

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21
Q

What disease?

Clinical presentation includes fever, chills, productive cough, possible hemoptysis

A

Pneumonia

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22
Q

Coughing up blood

A

Hemoptysis

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23
Q

What disease?

Diagnosis includes sputum culture and CBC

A

Pneumonia

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24
Q

In pneumonia, what will you see in the CBC?

A

Leukocytosis
Left shift

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25
Q

Elevated WBC count

A

Leukocytosis

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26
Q

Increase in immature neutrophils

A

Left shift

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27
Q

Increase in mature white blood cells

A

Right shift

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28
Q

Immature white blood cells in the _______ convert to mature white blood cells in the ________

A

left; right

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29
Q

In pneumonia, what is the treatment for bacterial origin?

A

Antibiotics

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30
Q

In pneumonia, what is the treatment for viral origin?

A

Supportive care

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31
Q

In pneumonia, what is the treatment for fungal origin?

A

Antifungal

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32
Q

What are the complications of pneumonia?

A

Tissue destruction and necrosis
Spread of infection to pleural cavity
Bacterial dissemination to critical structures

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33
Q

In pneumonia, what can tissue destruction and necrosis lead to?

A

Abscess formation

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34
Q

In pneumonia, what can spread of infection to pleural cavity lead to?

A

Empyema

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35
Q

In pneumonia, what can bacterial dissemination to critical structures lead to?

A

Metastatic abscesses, endocarditis, meningitis, suppurative arthritis

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36
Q

What bacteria causes TB?

A

Mycobacterium tuberculosis

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37
Q

Primary or secondary TB?

Spread via airborne droplets

A

Primary TB

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38
Q

Primary or secondary TB?

Alveolar macrophages engulf bacteria

A

Primary TB

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39
Q

Primary or secondary TB?

Cell-mediated immunity results in hypersensitivity to tubercular antigens

A

Primary TB

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40
Q

Primary or secondary TB?

TH1 cells cause formation of caseating granulomas

A

Primary TB

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41
Q

What 2 things can happen if primary TB is not controlled?

A

Cavitation
Dissemination

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42
Q

Pathologic cavity in lung

A

Cavitation

(can happen if primary TB is not controlled)

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43
Q

Can occur locally within lung or hematogenous spread

A

Dissemination

(can happen if primary TB is not controlled)

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44
Q

Widespread infection with multiple organ involvement

A

Hematogenous spread in TB

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45
Q

Called “miliary” TB

A

Hematogenous spread in TB

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46
Q

1-2 mm foci of disease, looks like millet seeds

A

Hematogenous spread in TB

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47
Q

Primary or secondary TB?

Occurs in previously infected host

A

Secondary TB

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48
Q

Primary or secondary TB?

Reactivation of dormant primary lesions or reinfection

A

Secondary TB

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49
Q

Primary or secondary TB?

Tissue response can cause cavitation

A

Secondary TB

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50
Q

Primary or secondary TB?

May disseminate

A

Secondary TB

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51
Q

What disease?

Demographics include immunocompromised and regions with poverty/crowding

A

TB

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52
Q

What disease?

Organisms present, may or may not cause symptoms. Not contagious

A

TB infection

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53
Q

What disease?

Infection causing clinically significant tissue damage and accompanying symptoms. Contagious

A

TB disease

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54
Q

What disease?

Clinical presentation includes persistent cough, hemoptysis, night sweats, weight loss, fatigue, varying symptoms depending on organs involved

A

TB

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55
Q

What disease?

Oral manifestation is rare, but possible

A

TB

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56
Q

What are the possible oral manifestations of TB? What is the most common site?

A

Chronic ulceration/swelling
Most common site = tongue

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57
Q

What disease?

Calcification of cervical lymph nodes is possible

A

TB

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58
Q

What disease?

Can be diagnosed by detecting bacteria via culture or PCR amplification

A

TB

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59
Q

What disease?

Can be diagnosed by skin test

A

TB

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60
Q

What disease?

Can be diagnosed by chest X-Ray, biopsy, or Bacillus Calmette-Guerin vaccine

A

TB

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61
Q

What are the 5 ways to diagnose TB?

A

Detection of mycobacterium tuberculosis (culture, PCR)
Skin test
Chest X-Ray
BCG vaccine
Biopsy

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62
Q

What does a positive TB skin test show?

A

Cell-mediated hypersensitivity to tubercular antigens

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63
Q

What does a TB skin test NOT differentiate between?

A

TB infection vs TB disease

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64
Q

T/F: There can be false positive and false negative TB skin test results

A

True

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65
Q

What can result in a false positive TB skin test?

A

BCG vaccine

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66
Q

What would you see in a TB biopsy?

A

Caseating granulomas
+ for AFB (acid-fast bacilli) stain

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67
Q

What disease?

Tx is long term antibiotic regimen

A

TB

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68
Q

What specific antibiotics are used to treat TB?

A

Isoniazid
Rifampin
Pyrazinamide
Ethambutol

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69
Q

What are the 5 dental implications of TB?

A

Need to identify presence/absence of active TB
Recent + TB skin test
Symptoms of undiagnosed, active TB
Recently diagnosed, active TB
History of TB

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70
Q

In the dental office, how should you identify the presence or absence of active TB?

A

Ask about presence of symptoms
Dates/results of prior TB skin tests

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71
Q

In the dental office, what should you do if your pt has had a recent + TB skin test?

A

Treat as having TB until proven otherwise
Need to see PCP for exam and chest X-Ray

If pt is under medical tx and confirmed to be absent of active TB, they can be treated w/o special precautions

72
Q

In the dental office, what should you do if your pt has symptoms of undiagnosed, active TB?

A

Refer ASAP for medical exam
Defer elective dental tx until confirmed pt doesn’t have TB
Urgent dental tx should be provided in facility w/ airborne infection isolation (hospital)

73
Q

In the dental office, what should you do if your pt has been recently diagnosed for active TB?

A

May be treated after receiving antibiotics for 3+ weeks (if physician confirms they are non-infectious)

74
Q

In the dental office, what should you do if your pt has a history of TB?

A

Degree of disease involvement
Type/duration of therapy received
Current status of disease activity
Med consult w/ PCP to obtain/confirm this info

75
Q

What disease?

Caused by a significantly decreased expiratory flow rate

A

COPD

76
Q

What disease?

Demographic is cig smokers

A

COPD

77
Q

What disease?

Damage is largely irreversible

A

COPD

78
Q

What disease?

6th leading cause of death in US

A

COPD

79
Q

What disease?

Caused by a significantly decreased expiratory flow rate in the large airways only

A

Chronic bronchitis

80
Q

What disease?

Caused by a significantly decreased expiratory flow rate in the acinus only

A

Emphysema

81
Q

What are the 2 subcategories of COPD?

A

Chronic bronchitis
Emphysema

82
Q

Low, moderate, or high risk?

Pts with known active, sputum-positive TB and/or symptoms of active TB

A

High risk

83
Q

Low, moderate, or high risk?

Pts with oral manifestations of TB

A

High risk

84
Q

Low, moderate, or high risk?

Pts with + TB skin test, but no evidence of active disease

A

Moderate risk

85
Q

Low, moderate, or high risk?

Pts with chest X-Ray findings suggestive of prior TB involvement, but no evidence of active disease

A

Moderate risk

86
Q

Low, moderate, or high risk?

Pts with inadequately treated TB, but no evidence of active disease

A

Moderate risk

87
Q

Low, moderate, or high risk?

Pts with known TB who have been adequately treated, with no evidence of active disease

A

Low risk

88
Q

Low, moderate, or high risk?

Pts with a history of exposure to TB, but - skin test and no evidence of active disease

A

Low risk

89
Q

What disease?

Caused by chronic inflammation of bronchi

A

Chronic bronchitis

90
Q

In chronic bronchitis, what does chronic inflammation of bronchi lead to?

A

Hypertrophy of mucous glands
Hypersecretion of mucous
Mucus plugging of bronchiolar lumen

91
Q

What disease?

Demographics include smokers, industrial workers, and exposure to pollutants

A

Chronic bronchitis

92
Q

What disease?

Clinical presentation includes productive cough, shortness of breath, wheezing

A

Chronic bronchitis

93
Q

What disease?

May experience hypercapnia, hypoxemia, cyanosis

A

Chronic bronchitis

94
Q

Increased CO2

A

Hypercapnia

95
Q

Low O2 in blood

A

Hypoxemia

96
Q

Bluish discoloration because of hypoxemia

A

Cyanosis

97
Q

What disease?

Eventually leads to pulmonary hypertension

A

Chronic bronchitis
Emphysema

98
Q

What disease?

Diagnosed by productive cough for at least 3 months in two consecutive years

A

Chronic bronchitis

99
Q

What disease?

Tx includes stop smoking, bronchodilators, corticosteroids, and O2 therapy

A

Chronic bronchitis

100
Q

What disease?

Caused by inflammation and oxidative stress due to smoking

A

Emphysema

101
Q

What disease?

Proteases are released from inflammatory and epithelial cells, leading to a break down of CT

A

Emphysema

102
Q

What disease?

Destruction of alveolar walls

A

Emphysema

103
Q

What disease?

Permanently enlarged air spaces

A

Emphysema

104
Q

What disease?

Demographics include smokers and alpha-1-antitrypsin deficiency

A

Emphysema

105
Q

Tissue-protective protein

A

Alpha-1-antitrypsin

(deficient in emphysema)

106
Q

What disease?

Clinical presentation is progressive dyspnea, prolonged expiration, weight loss, barrel-chest, tripod position, pulmonary hypertension

A

Emphysema

107
Q

Why do patients with emphysema have weight loss?

A

Increased metabolic rate

108
Q

Why do patients with emphysema have barrel-chest?

A

Trapped air in lungs

109
Q

Bent forward with arms on knees

A

Tripod position (emphysema)

110
Q

What disease?

Diagnosed by pulmonary function tests - reduced FEV1 and chest X-Ray showing hyperinflation

A

Emphysema

111
Q

Test showing amount of air exhaled in 1 second

A

FEV1

(used to diagnose emphysema)

112
Q

What disease?

Tx is stop smoking, bronchodilators, pulmonary rehab, O2 therapy in severe cases

A

Emphysema

113
Q

What are the 3 dental considerations of COPD?

A

Semisupine or upright chair position (avoid orthopnea)
Caution administering respiratory depressants (narcotic analgesics and benzos)
Pulse ox during tx (administer extra O2 if needed)

114
Q

Which of the following is a key characteristic of emphysema?

a. productive cough
b. alveolar wall destruction
c. increased mucus production
d. hyperreactive airways

A

b. alveolar wall destruction

115
Q

What disease?

Caused by exaggerated immune response of unknown etiology

A

Sarcoidosis

116
Q

What disease?

Caused by granulomatous inflammation in many tissues and organs

A

Sarcoidosis

117
Q

What disease?

Lungs affected in 90% of pts

A

Sarcoidosis

118
Q

What disease?

Demographics include african americans, women, 20-40 year olds, non-smokers

A

Sarcoidosis

119
Q

What disease?

Clinical presentation can be asymptomatic, respiratory symptoms, constitutional symptoms, peripheral lymphadenopathy, eye involvement, splenomegaly, hepatomegaly, skin lesions

A

Sarcoidosis

120
Q

What are the respiratory symptoms in sarcoidosis?

A

Shortness of breath
Dry cough

121
Q

What are the constitutional symptoms in sarcoidosis?

A

Fever
Fatigue
Weight loss

122
Q

Describe the skin lesions in sarcoidosis

A

Raised, red, tender nodules on legs

123
Q

What disease?

Diagnosed by chest X-Ray showing bilateral hilar lymphadenopathy and biopsy showing non-caseating granulomas

A

Sarcoidosis

124
Q

What is the major finding at presentation in most cases of sarcoidosis?

A

Chest X-Ray showing bilateral hilar lymphadenopathy

125
Q

What disease?

Tx is corticosteroids

A

Sarcoidosis

126
Q

What disease?

Pts may develop progressive pulmonary fibrosis and cor pulmonale

A

Sarcoidosis

127
Q

Atopic = allergic

A
128
Q

TH2 = main cell involved, makes IgE, activates more mast cells, more eosinophils

A
129
Q

asthma = chronic inflammation, will see more mast cells and eosinophils than usual

A
130
Q

What disease?

Caused by chronic airway inflammation and recurring episodes of reversible bronchoconstriction

A

Asthma

131
Q

What disease?

Triggered by allergens, exercise, environmental factors, respiratory infections, cold air

A

Asthma

132
Q

What type of asthma?

Exaggerated immune response to environmental allergens

A

Atopic asthma

133
Q

What type of asthma?

Production of IgE and activation of mast cells

A

Atopic asthma

134
Q

What type of asthma?

No clear antigen sensitization

A

Non-atopic asthma

135
Q

What is involved in the early phase of asthma?

A

Bronchoconstriction
Mucus production
Vasodilation

136
Q

What is involved in the late phase of asthma?

A

Smooth muscle hypertrophy
Mucus gland hyperplasia
Increased vascularity
Collagen deposition

137
Q

What disease?

Demographics are broad, genetic predisposition, increased incidence in recent decades

A

Asthma

138
Q

What disease?

Clinical presentation is recurring episodes, wheezing, shortness of breath, chest tightness, cough

A

Asthma

139
Q

What disease?

Diagnosed by pulmonary function test showing reversible airflow obstruction

A

Asthma

140
Q

What are the 3 categories of asthma?

A

Atopic
Non-atopic
Drug-induced

141
Q

What type of asthma?

Most common

A

Atopic asthma

142
Q

What type of asthma?

Begins in childhood

A

Atopic asthma

143
Q

What type of asthma?

Type 1 hypersensitivity rxn

A

Atopic asthma

144
Q

What type of asthma?

Triggered by environmental antigens

A

Atopic asthma

145
Q

What type of asthma?

Skin tests w/ antigen result in wheal and flare rxn

A

Atopic asthma

146
Q

What type of asthma?

No evidence of allergen sensitization (- skin tests)

A

Non-atopic asthma

147
Q

What type of asthma?

Less likely to have family history

A

Non-atopic asthma

148
Q

What type of asthma?

Common triggers are environmental pollutants and viral infections

A

Non-atopic asthma

149
Q

What type of asthma?

Commonly caused by aspirin and other NSAIDs

A

Drug-induced asthma

150
Q

What is the tx for asthma based on?

A

Severity

151
Q

What are the levels of severity for asthma?

A

Intermittent
Mild persistent
Moderate persistent
Severe persistent

152
Q

What disease?

Tx is lifestyle modification to avoid triggers, inhaled corticosteroids, and bronchodilators

A

Asthma

153
Q

How do you identify undiagnosed asthma?

A

Coughing, wheezing, SOB

154
Q

If your pt has a prior diagnosis of asthma, what should you evaluate?

A

Level of management (Asthma Control Test - ACT)

155
Q

An Asthma Control Test (ACT) of ______ or below indicates inadequately controlled asthma

A

19

156
Q

When should you make a med consult for asthma?

A

Suspicion of undiagnosed asthma
Poorly controlled asthma based on ACT score

157
Q

How can you avoid asthma attacks in your office?

A

Manage stress/anxiety
Avoid other known triggers (NSAIDs, LAs, strong odors)

158
Q

If your pt has a short-acting bronchodilator inhaler like albuterol, what should you make sure they do?

A

Bring to appt and place in easily accessible location

159
Q

What are the related oral conditions in pts with asthma?

A

Xerostomia
Increased caries risk
Oral candidiasis

160
Q

In atopic asthma, which immunoglobulin is
primarily involved in the allergic response?

A

IgE

161
Q

What disease?

Caused by smoking, radon exposure, and occupational exposure (asbestos)

A

Lung cancer

162
Q

85% of lung cancer cases is caused by what?

A

Smoking

163
Q

What disease?

Demographics are smokers and > 50 yrs old

A

Lung cancer

164
Q

What disease?

2nd most commonly diagnosed cancer in US

A

Lung cancer

165
Q

What disease?

Leading cause of cancer death in US

A

Lung cancer

166
Q

What are the tumor types found in lung cancer?

A

Carcinomas (95%)
Neuroendocrine carcinoma
Sarcomas
Lymphomas

167
Q

What are the 2 types of carcinomas found in lung cancer?

A

Adenocarcinoma
Squamous cell carcinoma

168
Q

Which type of carcinoma in lung cancer?

More common in women

A

Adenocarcinoma

169
Q

Which type of carcinoma in lung cancer?

Non-smokers

A

Adenocarcinomas

170
Q

Which type of carcinoma in lung cancer?

More common in men

A

Squamous cell carcinoma

171
Q

Which type of carcinoma in lung cancer?

Smokers

A

Squamous cell carcinoma

172
Q

What are the 2 types of neuroendocrine carcinomas in lung cancer?

A

Small cell carcinoma
Large cell carcinoma

173
Q

What disease?

Clinical presentation includes cough, sputum, weight loss, fatigue, dyspnea, hemoptysis, chest pain

A

Lung cancer

174
Q

What disease?

Diagnosed by chest X-Ray, CT scan, biopsy via bronchoscopy or needle aspiration

A

Lung cancer

175
Q

What disease?

Tx is dependent on stage

A

Lung cancer

176
Q

What disease?

Tx is surgical resection, chemo, radiation, immunotherapy

A

Lung cancer

D2 Fall (16 decks)

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