Lung and Pleura Flashcards
[diagnosis]
abrupt onset of significant hypoxemia and bilateral infiltrates without heart failure
acute lung injury
type II pneumocyte necrosis can lead to hypoxemia due to decrease in
surfactant
[diagnosis: type of lung disease]
lung volume is increased
FEV1 severely decreased
FVC decreased
FEV1/FVC = <0.7
obstructive lung disease
[diagnosis: type of lung disease]
lung volume decreased
FEV1 decreased
FVC severely decreased
FEV1/FVC = normal to increased
restrictive lung disease
[diagnosis: type of lung disease]
Associated conditions are bronchial asthma, COPD, emphysema, chronic bronchitis, bronchiectasis
obstructive lung disease
[diagnosis: type of lung disease]
associated conditions include pulmonary fibrosing disease, chest wall disorders
restrictive lung disease
[diagnosis]
Irreversible destruction fo air spaces distal to terminal bronchiole, leading to their enlargement, without obvious fibrosis
abnormally large alveoli separated by thin septa with only focal centriacinar fibrosis
emphysema
[diagnosis]
cough with sputum production for at least 3 months at least 2 consecutive years without identifiable cause
chronic bronchitis
[type of emphysema]
most common, associated with smoking
centriacinar
[type of emphysema]
less common, from respiratory bronchiole to alveoli, associated with alpha 1 antitrypsin deficiency
panacinar
type on emphysema associated with spontaneous pneumothorax
distal acinar ir paraseptal
[diagnosis: type of COPD]
common in 40-45 y/o, infection is common, increased airway resistance, prominent vessels and enlarged heart, cor pulmonary is common
predominant bronchtis
[diagnosis: type of COPD]
common among 50-75 years old, occasional infection, not associated with cor pulmonale, airway resistance is increased, noted hyperinflation of lungs and small heart
predominant emphysema
[diagnosis]
chronic disorder of conducting airways, immunologic reaction, episodic bronchoconstriction due to increased airway sensitivity, inflammation of bronchial walls
Bronchial asthma
In bronchial asthma, the first exposure is associated with ___ response
TH2 response, IgE production and eosinophil recruitment
Subsequent exposure in bronchial asthma is associated with
mast cell degranulation
[diagnosis]
occlusion of bronchi and bronchioles by thick tenacious mucous plug; presence of curshmann spirals and charcot-leyden crystals
status asthmaticus
[diagnosis]
destruction of smooth muscle and elastic tissue; permanent dilation of bronchi and bronchioles
bronchiectasis
[diagnosis]
progressive interstitial pulmonary fibrosis and respiratory failure
idiopathic pulmonary fibrosis
[diagnosis]
patchy interstitial fibrosis with varying age; initially starts with fibroplastic focus later turn to honeycomb fibrosis
idiopathic pulmonary fibrosis
most common pneumoconiosis in the world
silicosis
[diagnosis; pneumoconiosis]
eggshell calcifications of LN, fine nodularities in the upper lung zone; increased susceptibility to tuberculosis
silicosis
most common malignancy associated with asbestosis
lung CA
[diagnosis]
non-caseating granuloma with giant cell; presence of schaumann bodies (concretions of Ca and proteins) and asteroid bodies (stellate inclusions in giant cells)
sarcoidosis
cut-off value for pulmonary hypertension
mean PA pressure >/25
[diagnosis]
BMPR2 LOF mutation; medial hypertrophy of the pulmonary muscular and elastic arteries, pulmonary arterial atherosclerosis, RVH
pulmonary hypertension
location of the cough center (specific location in the brainstem)
nucleus tractus solitarius
[adventitious breath sound]
discontinuous, intermittent, non-musical, brief
like dots in time
crackles or rales
[adventitious breath sounds]
continuous, >/ 250msec, musical, prolonged, like dashes in time; high pitch with hissing and shrill quality
wheeze
[adventitious breath sounds]
continuous, >/ 250msec, musical, prolonged, like dashes in time; low pitch, snoring quality
rhonchi
[diagnosis]
patchy consolidation, consolidated areas of acute suppurative inflammation, neutrophil-rich exudate that fills the ariways
bronchpneumonia
[stage of pneumonia]
red, heavy boggy, few neutrophils, numerous bacteria
congestion
[stage of pneumonia]
red, firm, airless, numerous neutrophils, RBCs and fibrin
red hepatization
[stage of pneumonia]
grayish brown; RBCs disintegrate, fibrinosuppurative exudate
gray hepatization
[stage of pneumonia]
Resorption of exudates or organization (fibrosis); ingestion by macrophages
resolution
[type of pneumonia]
mononuclear infiltrates (lymphocytes, monocytes, plasma cell)
viral pneumonia
[type of pneumonia]
predominance of neutrophil, intra-alveolar inflammation
bacterial pneumonia
suppurative destruction of the lung parenchyma with central area of cavitation
lung abscess
[diagnosis: PICH]
CMV, pneumocystis jirovicii, drug reaction cause ___ infiltrates
diffuse
[diagnosis: PICH]
G(-) bacteria, S. aureus, aspergillus, candida, malignancy cause ___ infiltrates
focal
[type of pneumonia: chronic or acute]
localized lesion without LN involvement
chronic
[lung CA]
most common, seen in never smokers and females, peripheral location
adenocarcinoma
[lung CA]
glandular differentiation with mucin production
adenocarcinoma
[lung CA]
second most common, common in males, central/hilar location
squamous cell CA
[lung CA]
causes paraneoplastic syndrome: hypercalcemia due to PTHrP
squamous cell
[lung CA]
keratinization (pearls or dyskeratotic cells), intercellular bridges
squamous cell CA
[lung CA]
third most common, highest association with smoking, located either central/hilar/peripheral
small cell CA
[lung CA]
salt and paper chromatin, necrosis, basophilic staining of vessel walls
small cell CA
[lung CA]
causes paraneoplastic syndrome: SIADH and Cushing syndrome
small cell CA
[lung CA]
no squamous or glandular differentiation, negative IHC stain for adenoCA and SCCA, large pleomorphic cell
large cell CA
[paraneoplastic syndrome]
enophthalmos, ptosis, miosis, anhidrosis, lung tumor on the superior sulcus
horner syndrome (pancoast tumor)
[paraneoplastic syndrome]
Autoantibodies agains neuronal calcium channel
lambert eaton myasthenic syndrome
[diagnosis]
intraluminal polypoid mass seen mostly on mainstem bronchi, collar button lesion; rosette-like arrangement of neoplastic cells; rare mitotic activity; regular cells
carcinoid
[diagnosis]
diarrhea, flushing, cyanosis
carcinoid syndrome
primary tumor that is notorious in producing massive hemorrhagic pleural effusion
mesothelioma
[diagnosis: pneumothorax]
rupture of alveoli in pulmonary disease
spontaneous
[diagnosis: pneumothorax]
young people, subpleural blebs, self limiting, recurrent attacks common
spontaneous idiopathic
[diagnosis: pneumothorax]
due to perforating injury to the chest wall
traumatic
[diagnosis: pneumothorax]
sufficient to cause circulatory compression to mediastinal structures
tension
[diagnosis: lung primary CA]
chest pain, dyspnea, recurrent pleural effusion
thick layer of soft, gelatinous, grayish pink tumor tissue enclosing affected ling
malignant mesothelioma
