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Repiratory > Lung - Path > Flashcards

Lung - Path Flashcards

1
Q

Pt ingests nitrates. Develops dusky skin color.

A

Fe oxidized to Fe3+. Stops binding O2, binds CN instead.

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2
Q

Treatment of CN? Mech?

A

1) Nitrates. Make Fe in heme oxidized to Fe3+. Hb will preferentially bind CN, clearing it from tissues
2) Thiosulfate. Takes cyanide from oxidized Hb to from thiocyanide, which can be renally excreted

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3
Q

Pulmonary HTN defined at pressures over? Leads to?

A

Over 25 mmHg. Leads to arteriosclerosis, medial hypertrophyy, and intimal fibrosis of pulmonary arteries

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4
Q

Primary pulmonary HTN. gene? Lesion?

A

inactivating mutation in BMPR2. Plexiform lesion.

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5
Q

Mechanisms for these causes of 2ndary pulmonary HTN?

COPD, mitral stenosis, thromboemboli, autoimmune dz, left-to-right shunt, high altitude

A

destruction of lung
backup of pressure
down surface area of vessel lumen
inflammation leads to fibrosis and medial hypertrophy
increased stress leads to endothelial damage
hypoxic vasoconstriction

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6
Q

Pt with chocolate colored blood?

A

Methemoglobin

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7
Q

Pt in a house fire?

A

up CO and CN in blood

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8
Q

CO - cyanosis?

A

No. masked by cherry red pigment of CO.

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9
Q

Pt with AIDS, increased methemoglobin. why?

A

increased PCP infections. Take sulfa drugs - cause methemoglobin

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10
Q

Give pt 100% O2. No improvement. Cause in child? adult?

A

Hyaline membrane Dz

ARDs

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11
Q

How pulmonary edema affects deep breathing?

A

fluid increases size of lung - J-receptors activated sooner, can’t take deep breath

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12
Q

Pt with Male infertitlity, situs inversus, sinusitis also likely to get?

A

Kartagner’s bronchiectasis

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13
Q

Fat embolus - triad? Usually caused by?

A

Pt with hypoxemia, neurologic abnormalities and petechial rash. Complication of. Caused by fracture of long bone and liposuction

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14
Q

Emboli that can lead to DIC?

A

Amniotic fluid emboli

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15
Q

How to distinguish pre vs post-mortem thrombi?

A

Lines of zahn in between layers of blood and fibrin

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16
Q

Causes of ARDS?

A

AP GU(ARDS)

Uremia, Pancreatitis, Amniotic fluid embolism, gastric aspiration

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17
Q

ARDs - initial damage due to?

A

1) release of neutrophilic substances toxic to alveolar wall
2) coagulation cascade
3) O2 derived free radicals

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18
Q

FEV1/FVC<80?

A

COPD

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19
Q

lung volumes COPD vs restrictive?

A

greater than normal vs less than normal

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20
Q

Obstructive sleep apnea - effects on lungs? heart? kidneys?

A

pul HTN; arrythmias; increased EPO release

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21
Q

Decreased breath sounds, dullness to percussion, decreased frenitus?

A

PE

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22
Q

Decreased breath sounds, dullness to percussion, decreased frenitus + trachial deviation toward side of lesion?

A

Atelecatsis

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23
Q

Decreased breath sounds, hyperresonant to percussion, decreased frenitus, + trachial deviation toward side of lesion

A

Spontaneous pneumothorax

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24
Q

Decreased breath sounds, hyperresonant to percussion, decreased frenitus, + trachial away from side of lesion

A

Tension pneumothorax

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25
Q

Late inspiratory crackles, dullness to percussion, increased fremitus?

A

Consolidation

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26
Q

Pt with cough, hemoptysis, noncalcified nodule on CT or coin lesion?

Most common type?

A

Lung cancer. Mets most common - from breast, colon, prostate, bladder.

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27
Q

Cancers not related to smoking?

A

Bronchioloalveolar (adenoCA from clara cells) and bronchial carcinod (central neuroendocrine tumor)

28
Q

Lung cancer - K-ras?

A

adenoCA

29
Q

Lung Cancer - Pt with clubbing r?

A

adenoCA

30
Q

Lung Cancer - peripheral location?

A

AdenoCA and Large cell CA

31
Q

Hazy infiltrates similar to pneumonia on CXR?

A

bronchioloalveolar cancer (subtype of adenoCA)

32
Q

Squamous cell CA - signs?

A

Cavitation
Cigarettes
hyperCalcemia (PTHrP)

33
Q

Small cell (oat) CA - Signs?

A

ACTH
ADH
Antibodies against Ca channels (Lambert-Eaton)
Amplification of myc oncogenes

34
Q

Lung Cancer - pleomorphic giant cells?

A

Large cell CA

35
Q

Lung Cancer - flushing, wheezing, diarrhea?

A

Bronchial carcinoid tumor

36
Q

Lung Cancer - chromogranin positive?

A

Bronchial carcinoid tumor

37
Q

Lung Cancer - inoperable?

A

Small Cell

38
Q

Lung Cancer - looks like thickened septal walls?

A

bronchioloalveolar (subtype of adenoCA). grows along alveolar septa -

39
Q

Lung Cancer - Complications?

A 
SPHERE
SVC syndrome (obstruction of SVC)
Pancoast Tumor
Horner's syndrome
Endocrine (paraneoplastic)
Recurrent laryngeal symptoms (horseness)
Effusions (pleural or pericardial)
40
Q

Lung Cancer - pleural?

A

Mesothelioma

41
Q

Lung Cancer - psammoma bodies?

A

Mesothelioma

42
Q

Lung Cancer - hemorrhagic pleural effusions

A

Mesothelioma

43
Q

Pt with JVD, upper extremity swelling, headaches, dizziness?

A

SVC syndrome.

44
Q

Intra-alveolar exudate and consolidation? Causes?

A

Lobar Pneumonia. S. pneumoniae and klebsiella

45
Q

Acute inflammatory infiltrates from bronchioles in adjacent alveoli. Patchy distribution involving 1+ lobes? causes?

A

Bronchopneumonia. Pneumococus, S aureus, H flu, klebsiella

46
Q

Diffuse patchy inflammation localized to interstitial areas at alveolar walls? Causes?

A

Interstitial (atypical) pneumonia. Viruses (influenza, RSV, adenoviruses), Mycoplasma, Legionella, Chlamydia

47
Q

Pt susceptible to lung abcess?

A

Alcoholics/epileptics

48
Q

microorganisms that cause lung abcess?

A

S aureus or anaerobes: (Bacteroides, fusobacterium, peptostreptococcus)

49
Q

Farmers or pt exposed to birds.

Type of reaction? Presents with?

A

Hypersensitivity pneumonitis. HSR III/IV. Dyspnea, cough, chest tightness, headache.

50
Q

Type of pleural effusion - decreased protein content? Causes?

A

Transudate. CHF, nephrotic, hepatic cirrhosis

51
Q

Type of pleural effusion - increased protein content. Causes?

A

exudate. Malignancy, pneumonia, CVD, trauma

52
Q

Type of pleural effusion - increased TGs. Causes?

A

Lymphatic. Thoracic duct injury/malignancy

53
Q

Tall thin male with rupture of apical bleb?

A

Spontaneous pneumothorax

54
Q

Airway Biopsy shows increased thickness of gland layer?

A

COPD

55
Q

Types of emphysema?

A

Centriacinar - smoking

Panacinar - a1-antitrypsin

56
Q

Mucus plugs and smooth muscle hypertrophy?

A

Asthma

57
Q

Dz where Crystals form by the breakdown of eosinophils in sputum?

A

Asthma

58
Q

Hemoptysis and purulent sputum. Chronic necrotizing infection of bronchi?

A

Bronchiectasis

59
Q

Restrictive lung disease by normal Aa gradient?

A

Poor muscular effort (Polio, myasthenia gravis)

Poor structural apparatus (scoliosis, morbid obesity)

60
Q

Restrictive lung dz and Eosinophilc granuloma ?

A

Langerhan’s cell histiocytosis

61
Q

Drugs that cause Restrictive lung dz?

A

Bleomycin,
busulfan
amiodarone
methotrexate

62
Q

Anthracosis? affects?

A

Coal miners lung (affects upper lobes)

63
Q

Mech of silicosis? increases risk for? Affects what part of lung?

A

Macrophages release fibrogenic factors - fibrosis. TB and bronchogenic CA. Upper lobes and egg-shell hilar findings.

64
Q

Foundries and Sandblasting increases risk for?

A

Silicosis

65
Q

Calcified pleural plaques found in?

A

Asbestosis

66
Q

yellowish fusiform rods resembing dumbbells? Increased risk for?

A

Asbestosis. Bronchogenic CA andb mesothelioma.

67
Q

Baby born C-section. Not enough surfactant compared to baby born vaginally. Why?

A

less release of fetal glucocorticoids during birth.

Repiratory (2 decks)

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