Histopathology 12 - Respiratory pathology Flashcards

1
Q

What are the 2 types of causes of pulmonary oedema?

A
  1. Leaky capillaries (drugs, inhalation of particles, pancreatitis)
  2. Back pressure from a failing left ventricle (left heart failure)
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2
Q

How does diffuse alveolar damage appear on CXR?

A

Firm and expanded lungs

“White out” in all lung fields

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3
Q

What are the acute features of the airway in asthma?

A

Acute bronchospasm
Acute mucosal oedema
Inflammation

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4
Q

What are the chronic features of the airway in asthma?

A

Muscular hypertrophy
Airway narrowing
Mucus plugging

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5
Q

What are the features of COPD?

A

Chronic bronchitis and emphysema

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6
Q

Describe the features of chronic bronchitis

A

Chronic cough productive of sputum

Most days for at least 3 months over at least 2 consecutive years

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7
Q

How does chronic hypoxia affect the heart?

A

Pulmonary hypertension —> right heart failure

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8
Q

What is emphysema?

A

Permanent loss of the alveolar parenchyma distal to the terminal bronchiole

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9
Q

What is the genetic association of emphysema?

A

Alpha 1 anti-trypsin deficiency

Alpha 1 anti-trypsin blocks the proteases and prevents lung destruction

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10
Q

Recall the pathophysiology of emphysema

A

Smoking causes inflammation
Neutrophil and macrophage involvement
Proteases recruited
Breakdown of epithelium

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11
Q

What does lung bullous rupture cause?

A

Pneumothorax

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12
Q

What is bronchiectasis?

A

Permanent abnormal dilatation of bronchi with inflammation and fibrosis into adjacent parenchyma

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13
Q

Recall the complications of bronchiectasis

A

Haemoptysis
Pulmonary HTN
RHF
Amyloidosis secondary to chronic inflammation

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14
Q

Which condition has the strongest association with bronchiectasis?

A

Cystic fibrosis

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15
Q

What is bronchopneumonia?

A

Inflammation centred around airway

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16
Q

Where does bronchopneumonia often affect?

A

Lower lobes

17
Q

Which type of pneumonia has become much rarer since ABx have been in use?

A

Lobar pneumonia

18
Q

What is empyema?

A

Infected pleural effusion

19
Q

Which type of pneumonia is most likely to cause interstitial inflammation?

A

Atypical pneumonias

20
Q

What are the most common lung tumours?

A

Epithelial tumours - non small cell and small cell

21
Q

What are the 3 subtypes of non-small cell lung cancer?

A

Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma

22
Q

Which 2 types of lung cancer are most associated with smoking?

A

Squamous cell

Small cell

23
Q

Where is squamous cell carcinoma most likely to develop in the lung?

A

Centrally

24
Q

Where do adenocarcinomas typically develop?

A

Peripherally

25
Q

Which mutations are smokers most likely to develop in adenocarcinomas?

A

K ras

p53

26
Q

Which mutations are non-smokers most likely to develop in adenocarcinomas?

A

EGFR

Enables targeted treatment with tyrosine kinase inhibitors

27
Q

Which type of lung cancer is assoiated with the most paraneoplastic syndromes?

A

Small cell

28
Q

Which mutations are most likely to develop in squamous cell carcinomas?

A

They’re not - it’s the adenocarcinomas that tend to get the mutations