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Pathology > Lecture 10 Resp non-neoplastic > Flashcards

Lecture 10 Resp non-neoplastic Flashcards

1
Q

What are in the walls of trachea and bronchi?

A

Cartilage

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2
Q

What is in the wall of bronchioles?

A

Smooth muscle

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3
Q

What is in the upper airways?

A

Nose, accessory air sinuses, nasopharynx and larynx

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4
Q

What is in the lower airways?

A

Trachea, bronchi, bronchioles, terminal bronchioles, alveoli.

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5
Q

Define upper resp infections?

A

Acute inflammatory process that affects muscous membranes of the resp tract

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6
Q

Upper resp infection examples?

A

Rhinitis, laryngitis, tonsillitis and sinusitis.

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7
Q

What are the symptoms of an upper airway infection?

A

Malaise, headache, sore throat, discharge.

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8
Q

Upper resp infections are commonly…

A

Viral but can get secondary bacterial infections

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9
Q

How do virus’s cause symptoms?

A

Attach to resp mucosa, invading tissue causing necrosis, inflam and swelling

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10
Q

Define pneumonia

A

Inflammation of lung parenchyma caused by viral/bacterial infection where airsacs fill with pus& ?solid

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11
Q

How does pneumonia work?

A

Consolidation of affected part, exudate with inflam cells and fibrin in alveolar air spaces.

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12
Q

What causes pneumonia?

A

infectious agents, inhaled chemicals, chest wall trauma.

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13
Q

Clinical features of pneumonia?

A

Fever, rigours, SOB, pleuritic chest pain, purulent sputum, cough.

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14
Q

Morphology (forms) of pneumonia?

A

Lobar, multifocal/lobular (bronchopenumonia) or interstitial (focal diffuse)

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15
Q

What are the 6 categoies/settings for pneumonia?

A

Community acquired, hospital acquired, aspirational pneumonia, chronic pneumonia, necrotising pneumonia/lung abscesses. in immunocompromised

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16
Q

Which setting is relatively common?

A

Community

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17
Q

What is the most common cause for community acquired?

A

Strep.pnemonia

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18
Q

What 3 organisms cause community acquired?

A

Step. pnuemoniae, haemophilus influenzae, S.aureus

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19
Q

Morphology of community acquired?

A

Lobar or bronchopneumonia

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20
Q

What is hospital acquired pneumonia also know as?

A

nosocomial pneumonia

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21
Q

Define hospital acquired pneumonia

A

Any pneumonia contracted by patient at least 48-72 hrs postadmission

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22
Q

What organism usually cause hospital acquired?

A

Gram neg bacilli and S.aureas

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23
Q

Which pneumonia can be severe/fatal & is most common cause of death in ITU?

A

Hospital acquired pneumonia

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24
Q

Symptoms of hospital acquired pneumonia?

A

Fever, ^WCC, cough with purulent sputum. Chest x-ray changes

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25
Q

How does aspiration pneumonia develop?

A

After inhalation of foreign material. Elderly, strokes, dementia, anaesthetic

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26
Q

Morphology of aspiration pneumonia

A

Right middle and right lower lobe

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27
Q

What organisms causing aspiration pneumonia?

A

Oral flora +/- other bacteria

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28
Q

Define obstructive disorders?

A

Partial or complete obstruction at any level from the trachea to bronchioles

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29
Q

Examples of obstructive disorders?

A

Asthma, COPD (Emphysema and chronic bronchitis), Bronchiectasis

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30
Q

What is extrinsic asthma?

A

Responds to inhaled antigen - atopic

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31
Q

What is intrinsic asthma?

A

Non-immune, cold, exercise, aspirin.

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32
Q

What happens in the early phase of asthma?

A

Bronc constriction, ^ mucus, Vasodilation

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33
Q

What happens in late phase reaction?

A

Inflam, epithelial damage, more bronc-conc

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34
Q

Morphology of asthma?

A

Lung overinflation + small areas of atelectasis. Mucus plug in bronchi/bronchioles. Airway remodelled

35
Q

Define chronic bronchitis

A

Persistent cough with sputum production, for at least 2 consecutive years, no cause found.

36
Q

What causes chronic bronchitis (obstructive disorder)

A

Long-standing irritation from inhaled substances (e.g. smoke, dust, cotton, silica). 2) Hypertrophy of submuc glands& ^goblet cells. 3) mucus hypersecretion

37
Q

Morphology of chronic bronchitis?

A

Mucous membrane hyperaemia, swelling, oedema. Excess mucus. Bronchioles narrowed (mucus plug, inflam&fibrosis).

38
Q

Clinical signs of CB?

A

Persistent cough, productive sputum. Dyspnea on exertion. Hypercapnia, hypoxemia.

39
Q

What can chronic bronchitis lead to?

A

Cor pulmonale, cadiac failure, atypical metaplasia/dysplasia

40
Q

Define dyspnea?

A

Difficulty breathing

41
Q

Define hypercapnia?

A

CO2 retention

42
Q

Define hypoxemia?

A

Low O2 conc

43
Q

Define Cor Pulmonale

A

Abnormal enlargementof right side of heart as result of lung/pulmonary vessel disease

44
Q

Define emphysema?

A

Irreversible enlargement of the airspaces, distal to terminal bronchiole, wall destruction without obvious fibrosis

45
Q

Types of emphysema?

A

Centriacinar / panacinar / paraseptl / irregular

46
Q

Symptoms of emphysema?

A

Dyspnoea, cough, wheezing, weightloss, expiratory limitaions.

47
Q

What are pink puffers?

A

People who die from cor pumonale, congestive heart failureor pneumothorax

48
Q

Morphology of emphysema?

A

Largeapical bullae or blebs, voluminous lungs and large alveoli.

49
Q

What substances are imbalances in emphysema?

A

Protease-antiprotease. Oxidants and anti-oxidants

50
Q

Define bronchiectasis

A

Permanent destruction and dilation of airways associated with severe infections/obstructions

51
Q

Morphology of bronchiectasis

A

Dilated (as walls have been destroyed), and inflamed. Loss of cilla, increase mucus.

52
Q

Define aetiology

A

Causes of a disease

53
Q

Aetiology of bronchiectasis

A

CF, Kartageners, post infectious: TB, measles, bronchial obstruction (TB/FB)

54
Q

What is kartageners disease?

A

Defects in cilla action

55
Q

Symptoms of bronchiectasis?

A

Persistent cough, purulent sputum +++, haemoptysis

56
Q

What is haemoptysis?

A

Coughing up blood

57
Q

Define restrictive lung disease

A

Reduced expansion with decreased total lung capacity, inflammation and fibrosis of the pulmonary connective tissue.

58
Q

Define pneumonitis

A

Inflamof walls of alveoli

59
Q

With restrictive lung disease FVC…

A

is reduced. (amount of air that can be blown out after maximal inspiration.

60
Q

Clinical features of restrictive lung disease?

A

Dyspnea, tachypenea, end-inspiratory crackles. Cyanosis without wheezing. May lead to cor pulmonale.

61
Q

Morphology of restrictive lung disease. Xrays?

A

Bilateral infiltrative lesions - small nodules, irregular lines (ground glass shadows). Scarring and gross destruction of lung -> honeycomb lung.

62
Q

What disease results in ground-glass shadows and honeycomb lungs?

A

Restrictive lung disease

63
Q

Give 3 restrictive disorders

A

Chest wall abnormalities, connective tissue disorders and penumonconioses

64
Q

What are the two vascular disorders effecting breathing?

A

Pulmonary embolism and pulmonary oedema

65
Q

Define pulmonary embolism

A

blockage of main or branch pulmonary artery by an embolus.

66
Q

Where are emboli that cause pulmonary embolisms normally from?

A

DVT of the leg (95% of cases)

67
Q

What does the body compromise when suffering from pulmonary embolism?

A

Respiratory compromise and haemodynamic compromise

68
Q

Morphology of pulmonary embolism?

A

Central/peripheral emboli, pulmonary haemorrhage or pulmonary infarction

69
Q

What is the clinical course for vascular embolism

A

Abrupt onset pleuritic chest pain, SOB, hypoxia, ^ pulmonary resistance -> right ventricular failure.

70
Q

Define pulmonary oedema

A

Accumulation of fluid in the air spaces and paenchyma of the lungs

71
Q

What is pulmonary oedema due to?

A

Alveolar injury, infections, shock/trauma.

72
Q

What are the oedema of undetermined origin?

A

Neurogenic/high altitude

73
Q

What causes haemodynamic oedema?

A

^ venous pressure (left ventricle failure), decreased oncotic pressure (from nephrotic syndrome) or liver failure.

74
Q

Define dependent oedema

A

Initial fluid accumulation in basal regions

75
Q

Morphology of pulmonary oedema

A

Engorged alveolar capilaries, intra-alveolar granular pink precipitate, alveolar microhaemorrhages, hemosiderin-laden macrophages, heavy wet lungs

76
Q

Clinical features of pulmonary oedema?

A

SOB, punk frothy sputum, CXR findings.

77
Q

Name the two expansion disorders

A

pneumothorax and atelectasis

78
Q

Define pneumothorax

A

Air in pleural cavity -> collapse lung

79
Q

What ^ the risk of pneumothorax?

A

Emphysema, asthma, TB, trauma and idiopathic

80
Q

Define Atelectasis

A

Incomplete expansion of lungs which reduces oxygenation and predisposes to infection. REVERSIBLE

81
Q

What are the two types of respiratory failure?

A

Type I- hypoxia with normal or low PCO2

Type II- hypoxia with high PCO2

82
Q

What causes type I resp failure?

A

Pneumonia, pulmonary oedema, asthma, pulmonary fibrosis

83
Q

What causes type II resp failure?

A

Asthma, COPD, reduced resp drive, neuromuscular disease, thoracic wall disease (kyphoscoliosis).`

84
Q

Which type of resp disease should caution with O2 be taken?

A

Type II respiratory failure.

Pathology (25 decks)

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