Lung and Pleura Flashcards
Type of pulmonary edema:
Imbalance of starling forces in pulmonary circulation
Increased hydrostatic pressure, decreased oncotic pressure
Transudate
Hemosiderin laden macrophages
Thickening of alveolar wall
Cardiogenic pulmonary edema
Most common causes of acute lung injury
Sepsis
Diffuse pulmonary infections
Gastric aspiration
What phase of ARDS?
Day 0-7
Alveolar edema, neutrophilic infiltrates, hyaline membranes
Usually mech vent dependent
Exudative
What phase of ARDS?
Day 7-21
Lymphocytic infiltrates, type 2 pneumocyte proliferation
Clinical improvement
Proliferative
What phase of ARDS?
>21 days
Alveolar duct and interstitial fibrosis
Long term O2 support
Fibrotic
FEV1/FVC ratio in restrictive lung disease
Normal to increased
FEV1/FVC ratio in obstructive lung disease
Decreased (<0.7)
COPD
Irreversible destruction of air spaces distal to terminal bronchioles
Due to smoking, a1 antitrypsin deficiency
Centriacinar fibrosis
Emphysema
COPD
Cough with sputum for at least 3 months for at least 2 consecutive years
Smoking, particles from dust etc
Hyperemia, swelling and edema of mucous membranes
Goblet cell hyperplasia
Squamous metaplasia
Chronic bronchitis
Emphysema type that is due to antiprotease deficiency
Involves respiratory bronchioles to alveoli
Panacinar emphysema
Most common type of emphysema
Involves respiratory bronchiole
Due to smoking
Inflammation and increase in proteases
Centriacinar
Chronic disorder of the conducting airways, usually caused by an immunologic reaction, marked by episodic bronchoconstriction due to increased airway sensitivity to a variety of stimuli, inflammation of bronchial walls and increased mucus secretion
Bronchial asthma
Whorls of shed epithelium in status asthmaticus
Curschmann spirals
Eosinophilic crystals in asthma
Charcot-Leyden crystals
Destruction of smooth muscle and elastic tissue by chronic necrotizing infections leading to permanent dilation of bronchi and bronchioles
Bronchiectasis
Bronchiectasis associated conditions
Kartagener syndrome (primary ciliary dyskinesia) Recurrent infection Bronchial obstruction
Dilated airways filled with mucopurulent secretions
Acute and chronic inflammatory exudates within the walls of bronchi and bronchioles
Squamous metaplasia
Fibrosis in chronic
Bronchiectasis
Patchy interstitial fibrosis with varying age
Honeycomb fibrosis
Fibroblastic focus
Usual interstitial pneumonia
Non neoplastic lung reaction to inhalation of mineral dusts encountered in the workplace
Pneumoconiosis
What mineral dust is involved:
Coal mining
Coal dust
What mineral dust is involved:
Metal casting work, sandblasting, hard rock mining, stone cutting
Silica
What mineral dust is involved:
Mining, milling, manufacturing, and installation and removal of insulation
Asbestos
Innocuous
Inhaled carbon pigments in alveolar macrophages
Anthracosis
Coal macules and nodules that contain carbon laden macrophages
Simple coal workers pneumoconiosis
Most common form implicated in silicosis is due to
Quartz and cement dust
Increased susceptibility to tuberculosis
Fine nodularities in upper lung zones
Eggshell calcification in lymph nodes
Silicosis
Localized fibrous plaques
Recurrent pleural effusions
Lung CA
Mesothelioma
Asbestos
Systemic granulomatous disease of unknown etiology
Noncaseating granulomas
Common organs affected: lymph node, lungs, spleen
Epitheloid giant cells
Sarcoidosis
Medial hypertrophy of pulmonary muscular and elastic arteries
Pulmonary arterial atherosclerosis
RVH
Pulmonary hypertension
Most common cause of CAP
S. pneumoniae
Most common bacterial cause of acute exacerbations of COPD
H.influenzae
M. catarrhalis
Cause of post viral pneumonia, lung abscess, empyema, pneumonia in IV drug users, HCAP
S.aureus
Most common cause of gram negative bacterial pneumonia
Chronic alcoholics
Currant jelly sputum
Klebsiella pneumoniae
Pneumonia in immunocompromised, HCAP
Propensity to invade blood vessels
P. aeruginosa
Pneumonia that flourishes in artificial aquatic environment
Legionella
Common cause of pneumonia in children and young adults
Mycoplasma pneumoniae
Local suppurative process that produces necrosis of lung tissue
Suppurative destruction of parenchyma within the central area of cavitation
Lung abscess
Most common type of Lung CA in never smokers
AdenoCA
Butterflies on a fence appearance
Bronchoalveolar CA
Associated with tobacco smoke lung CA Males Hypercalcemia Squamous dysplasia P53 mutations
Squamous Lung CA
Highest smoking association with Lung CA
SIADH, Cushing
RB gene loss
Small cell lung CA
Keratin pearls
Abundant pink cytoplasm
Distinct cell borders
Squamous cell lung CA
Small round blue cells Scant cytoplasm Increased NC ratio Nuclear molding Azzopardi effect- basophilic staining of vascular walls
Small cell lung CA
Salt and pepper nuclei
Neuroendocrine nature
Light criteria
EXUDATE
Pleural fluid/serum protein >0.5
Pleural fluid/ serum LDH >0.6
Pleural fluid LDH more than 2/3 the normal upper limit for serum
