Lung 2b

Question 1

What are the risk factors for PE?

Answer 1

a. obesity
b. stasis
c. hx of a previous PE
d. hypercoaguability
e. smoking
f. oral contraceptives

Question 2

What is the histological manifestation of ARDS?

Answer 2

diffuse alveolar damage with hyaline membrane

Question 3

In the ARDS repairs phase, what are two histological markers?

Answer 3

a. type II pneumocytes

b. hyaline membranes

Question 4

What increases risk of ARDS?

Answer 4

sepsis, diffuse pulmonary infections, compromised immune system, chemical injury, pacreatitis, etc.

Question 5

What is the mechanism of ARDS?

Answer 5

endo- or epithelial damage creates an inflammatory cascade that involes IL-8, IL-1, TNF (released from macs) and leukotrienes and proteases (from neutrophils) that make the capillaries leaky.

Question 6

What are the 5 classes of PH?

Answer 6

a. PAH where only small pulmonary arteries are affected.
b. PH due to LH failure
c. PH from lung parenchymal diseases
d. chronic thromboembolic events
e. PH of multifactorial reasons

Question 7

What is cor pulmonale

Answer 7

hypertrophy of the right ventricle

Question 8

What are the 4 types of emphysema?

Answer 8

a. panacinar
b. centricacinar
c. distal acinar
d. irregular

Question 9

What are the 3 types of mutations associated with Adenocarcinoma?

Answer 9

a. EGFR
b. kRAS
c. ALK

Question 10

Which form of cancer has keratin pearls and intercellular bridges?

Answer 10

squamous cell carcinoma.

Question 11

Which form of lung cancer is most aggressive?

Answer 11

small cell carcinoma.

Question 12

What is a pancoast tumor, and what syndrome might it cause?

Answer 12

A tumor that occurs in the apex of the lung. If it affects the cervical sympathetic plexus is can cause Horner’s Syndrome (meiosis, ptosis, anhidrosis).

Question 13

Which diseases have non-caseating granulomas, and which has a caseating granuloma?

Answer 13

non: sarcoidosis, hyper-sensitivity pneumonitis
caseating: TB

Question 14

Why does max. expiratory flow rate increase in fibrotic lung disease?

Answer 14

Increased radial traction keeps the lumen of the airways more open.

Question 15

What is the difference between the epithelial and endothelial cells?

Answer 15

Epi: in the alveoli
Endo: in the capillaries

Question 16

What is a metabolic method of compensation with increased PCO2 retention?

Answer 16

The kidneys start to retain bicarb.

Question 17

What are the different blood supplies for the parietal and visceral pleura?

Answer 17

parietal: various systemic arteries
visceral: bronchial and pulmonary arteries

Question 18

Where does the parietal and visceral pleura drain into?

Answer 18

parietal: SVC
visceral: pulmonary vein

Question 19

Which is better innervated, parietal or visceral pleura? What innervates it?

Answer 19

Parietal. (Visceral is poorly innervated and is insensitive to pain and touch.)

Costal segments innervated by intercostal nerves. Diaphragm by phrenic nerve.

Question 20

Does pleural effusion cause an increase or decrease in breath sounds? Does it cause fremitus (“Ninety-Nin”)?

Answer 20

Decrease in breath sounds.

Yes, there is fremitus.

Question 21

What is the most common CXR finding concurrent with asbestos exposure?

Answer 21

Pleural plaques.

Question 22

What are the three disease of the pleura?

Answer 22

a. pleural effusion
b. pneumothorax
c. mesothelioma