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P&T Block 3 Pulm & GI > L66 > Flashcards

L66 Flashcards

1
Q

What is another term for diffuse (parenchymal) lung disease?

A

Interstitial lung disease

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2
Q 
Idiopathic pulm fibrosis
What is it
Path pattern
Localized or diffuse?
What layer of lung parenchyma is effected 
Lower or upper lobes?
A 
Diffuse scarring in lungs 
Worse over time 
Path = usual interstitial pna
1. Cobble stone pleural surface (fibrosis resulting in retraction)
2. Scar in between normal areas -> fibroblastic foci, heterogeneous 
3. Honeycombing = scar remodeling 
4. Diffuse + bilateral 
5. Subpleural 
6. Lower > upper lobes
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3
Q

What type of epithelium lines the remodeling of IPF?

A

Squamous lined cysts
- Lack of gas exchange contributes to hypoxemia
NOT pneumnocytes

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4
Q

Non-specific interstitial pna

  • Speed of progression // prognosis
  • Hetero or homogenous
A

Slower progression = better prognosis
Homogenous - scarring pretty much the same all over
Widened alveolar walls - thickening of alveolar septa w/ chronic inflam

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5
Q

Organizing pna
Path or clinical term
What is it

A

Pathologic term indicating intra-alveolar healing and fibrosis
Look for spindle cell = reactive fibroblasts

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6
Q

What is the idiopathic form of OP?
Treat
Progression

A

Cryptogenic OP
Responds to steroids
Might progress to pulm fibrosis

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7
Q

What prior medical history increases your risk for ILD?

A 
Most directly increases risk for UIP, NSIP pattern
Connective tissue diseases:
Lupus
RA
Scleroderma
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8
Q

What is sarcoid

A

Non-infectious, idiopathic granulomas

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9
Q

What are the most common locations for sarcoid granulomas

A 
Hilar LN
Skin
Uvea
Heart
Almost any organ
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10
Q

Where do sarcoid granulomas form in the lung?

A

Central - along airways
- Will move out by following lymphatics
Less common but can create consolidating pna like masses

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11
Q

If pulm sarcoid granulomas obstruct vessels - which vessels will be effected and what are the net results?

A

Veins
RV and LV hypertrophy
Pulm HTN + cor pulmonale

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12
Q

What cell are you looking for in a granuloma

A

Multinucleated giant cell

Asteroid body = condensation of protein material

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13
Q

What 4 lung diseases may result from asbestos exposure?

A

Asbestosis (pulm fibrosis)
Pleural plaques - most common
Carcinoma of the lung
Malignant mesothelioma

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14
Q

What is asbestosis

A

Diffuse parenchymal lung disease
Inflam + fibrotic
Fe deposited -> asbestos body

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15
Q

What is silicosis

A

Inhaled crystal silicon dioxide

Inflam + fibrosis that is less diffuse than asbestosis -> discrete nodules in parenchyma and hilar LN

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16
Q

Silicosis increases your risk of developing what infection

A

TB

17
Q

What is the name for black pigment in lung lymphatics (most mild form of coal miner’s pneumoconiosis)?

A

Anthracosis - most people have this from living in cities etc, not exclusive to coal miners

18
Q

Upper or lower lobes for simple coal miners pneumoconiosis

A

Upper

19
Q

What is complicated coal worker’s pneumoconiosis

A

Progressive massive fibrosis

20
Q

What is the histo triad for HST pneumonitis

A

Interstitial inflam
Loosely formed granulomas (no asteroid bodies // well formed of sarcoid)
Bronchiolitis/OP
NO eosinophils or mast cells like asthma

21
Q

What is smoking related interstitial lung disease? How does it differ from emphysema?
Histo

A 
= macrophage rxn to smoke
Net: resp bronchiolitis 
More scarring than emphysema
Histo:
1. Smoker's macrophages in clusters
2. Interstitial fibrosis
22
Q

What drugs are implicated for drug induced ILD? What does this kind of ILD look like?

A 
MTX
Amioderone
Bleomycin
Daptomycin
Can look like everything
23
Q

What does amiodarone tox look like on histo?

A

Pneumocytes lining alveolar are large w/ bubbles in cytoplasm

24
Q

What is pulm alveolar proteinosis?
Acquired vs secondary
Treat

A

Accumulation of acellular surfactant in alveolar spaces
Acquired = Ab vs granulocyte-macrophage CSF
Secondary due to some underlying other condition duh…
Treat: whole lung + GM CSF

25
Q

What does pulm alveolar proteinosis look like on histo?

A

PINK PINK PINK

Pink inside alveolar walls with normal alveolar speta

P&T Block 3 Pulm & GI (31 decks)

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