Lecture 28 - Pulmonary Vascular and Pleural Disease Flashcards
Pulmonary ______ is caused by acute hemodynamic disturbance, such as heart failure. Pulmonary capillaries become _____ and full of blood.
Pulmonary Congestion
Dilated
Pulmonary edema is most often caused by ____-sided heart failure. It can also be caused by _____ stenosis, high altitude, volume overload, etc.
Left-sided
Mitral stenosis
How do pulmonary embolism and pulmonary thrombus differ, and how can you tell them apart on autopsy?
Pulmonary embolism originates outside the lungs, usually the legs, while thrombus occus within the lung. Embolism will have structure/formation that suggests it was formed elswhere and some time before death –> bc death occurs almost immediately, if it has this structure/formation, it likely formed before getting to the lungs. Thrombus will not have this structure/formation.
Patients with pulmonary embolus will present with sudden onset _____, chest pain, and possible hemoptysis. Keep in mind pulmonary emboli can arise from different sources, not always the blood. ____ ____ emboli can sometimes occur as a result of CPR. Amniotic or ____ emboli sometimes occur at birth.
Dyspnea
Bone Marrow
Air
Pulmonary infarction occus as a result of a combination of pulmonary artery occlusion and underlying ____ or ____ disease. These infarcts often appear as _____-shaped lesions. Where do they typically form in the lungs?
Heart or Lung disease
Wedge-shaped
They typically form at the periphery of the lung.
Some of the risks for forming DVT are blood ____ (common for people who have been seated for long periods of time, especially on flights), Tissue damage, pregnancy, oral ______, and of course deficiency of _________.
Blood Stasis
Oral Contraceptives
Anticoagulants
Pulmonary Hypertension is defined as Pulmonary pressure > ____ of systemic pressue. Small ____ and _______ in the lungs are most often affected –> there is thickening of the tunica _____ and fibrosis of the tunica _____. Atheromatous formation (calcified plaques in the pulmonary vessels) is pathognomonic for pulmonary hypertension as well.
1/4 of systemic pressure
Arteries and arterioles
Tunica Media
Tunica Intima
Only _____ pulmonery HTN is reversible. Once there is significant _____ _____, it is no longer reversible. End-stage pulmonary HTN is characterized by ______ changes (multiple small lumina in one vessel instead of one unobstructed/complete lumen).
Early
Medial Thickening
Plexiform
Non-inflammatory Pleural Effusions are most commonly caused by _____ _____ _____. They can also be caused by ruptured _____ aneurysm.
Congestive Heart Failure
Aortic aneurysm
______ pleural effusions are most commonly seen in patients with Lymphoma (basically leakage of lymph fluid into the pleural space secondary to lymph blockage).
Chylous
______ (basically pus/exudate collection) is a complication of pneumonia with pleural abcess formation. These patients are at risk for septicemia and _____ if the abcess resolves.
Empyema
Fibrosis
Localized fibrous (sometimes calcified) pleural and/or diaphragmatic plaques are pathognomonic for pleural disease due to ______ exposure. Patients who have had this exposure and who also smoke are at much higher risk for developing _______ carcinoma.
Asbestos
Bronchogenic carcinoma
When asbestos fibers are inhaled into the lung, the body coats them with _____ in an attempt to wall them off. Everyone has had some kind of asbestos exposure, but what determines whether or not it will cause disease (the most common being interstitial lung disease) is what?
Iron
The amount of fibers inhaled
Malignant Mesothelioma is characterized on imaging by a thickened _____ “rind.” Keep in mind in about 1/3 of patients, malignant mesothelioma will arise in the _______.
Pleural “rind”
Peritoneum
