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Human Diseases Yr2 > Lung pathology > Flashcards

Lung pathology Flashcards

1
Q

What makes up the upper respiratory tract? anatomy (3)

A

Nose, nasopharynx, larynx

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2
Q

What makes up the lower respiratory tract? (anatomy) (4)

A

Trachea, bronchi, bronchioles and lungs

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3
Q

What is the carina?

A

Where the trachea bifurcates into the right and left bronchus.
The right bronchus has more vertical orientation, so if foreign body inhaled, likely to end up in right bronchus.

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4
Q

What epithelial lines the nasopharynx to the bronchioles?

A

psuedostratified, columnar ciliated epithelium.

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5
Q

How many lobes does each lung have?
what feature does left lung have?
What are the lungs surrounded by and what is the space between lung and X called?

A

Left = 2 lobes - cardiac notch
Right = 3 lobes
Lungs surrounded by pleura. Space = pleural cavity.
top of lung = apex, bottom = base

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6
Q

What are the 2 major groups of lung pathology?

A

Non neoplastic

Neoplastic (tumour - benign or malignant)
> primary (developed in tissue)
> secondary (started elsewhere and metastasised to respiratory tract)

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7
Q

Name some non-neoplastic diseases. (9)

A 
> infections
> pulmonary embolus
> pulmonary vascular disease
> pulmonary oedema
> COAD
> Bronchiectasis
> Interstitial lung disease
> Others e.g. Wegner's
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8
Q

Are lungs good at responding to insult?

Are lungs normally sterile?

A

Lungs have a limited ability to respond to insult
FIBROSIS IS DOMINANT
Yes, lungs are normally sterile.
> Continuous escalator of mucocilary clearance.

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9
Q

What is acute bronchitis caused by?
What are common viruses?
What does acute bronchitis cause?

A

Most caused by virus and may be associated with laryngitis (especially children).

Common - respiratory syncytial virus (RSV) and Haemophilius Influenzae, Streptococcus pneumoniae

Inflammation with retention of secondary secretions
> predispose to secondary infection

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10
Q

What is pneumonia?

A

inflammation of the lungs

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11
Q

What are the 3 ways you can classify pneumonia? (3)

A

anatomically
aspiration
causative organism

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12
Q

How can you classify pneumonia anatomically?

A

> Lobar (limited to lobe) - strep pneumoniae, Klebsiella

> Bronchopneumonia (originates in bronchioles, spreads radially) - elderly with compromised function.

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13
Q

What is pneumonia caused by aspiration?

A

material from stomach or mouth entering lungs

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14
Q

list 5 acute and 5 opportunistic causative organisms of pneumonia

A 
Acute organisms
\: strep pneumonia
\: klebsiella pneumonia
\: haemophilus influenze
\: mycoplasma pneumonia
\: legionella pneumophila
\: S. Aureus
Opportunistic
\: gram neg bacilli (e. coli)
\: aspergillus
\: cryptococcus
\: CMV
\: pneumocytis
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15
Q

What bacteria can cause chronic pneumonia?

A

mycobacterium tuberculosis

TB

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16
Q

A 60 year old non-smoker presents with new cough, thick green sputum, fever, and pleuritic chest pain. What is it?

A

Pneumonia
- new cough
- thick green sputum
- fever
- pleuritic chest pain.
- chest x-ray. lung is white out. - lung is filled with fluid, pus, is hard to ventilate)
> need antibiotics. normally older immunocompromised pt)

(not

  • bronchitis
  • lung cancer (less likely to present this acutely, non-smoker, so less likely to get lung cancer. would be a chronic cough that changes, less likely to be fever.)
  • pulmonary embolism (not thick green sputum. more likely to cough up blood. but would have pleuritic chest pain)
  • tuberculosis
17
Q

What causes a pulmonary embolus?

A

Mostly thrombotic origin (leg and pelvic veins)
DVT secondary to immobilisation
Travels with IVC to right heart to pulmonary vein and lodges in pulmonary arterial branch

18
Q

What are the signs and symptoms of pulmonary embollus?

A
  • small - maybe no symptoms
  • large - death
    : complete occlusion of circulation
    : cardiac arrhythmia
  • pulmonary infarct (lung congestion + oedema)
19
Q

What is pulmonary vascular disease?

A

Any condition that affects the blood vessels within the lungs.
Most common - pulmonary hypertension = high BP in pulmonary arteries/veins

20
Q

What are primary causes of pulmonary hypertension?

A

right sided heart failure and pleural effusion

21
Q

What are secondary causes of pulmonary vascular disease?

A

COAD
high altitude
congenital heart disease

22
Q

What is pulmonary oedema?

A

excess fluid in the lungs

23
Q

What are causes of pulmonary oedema?

A

HAEMODYNAMIC:

(e. g. mitral stenosis - left sided heart failure, neuphrotic syndrome)
- no lung abnormality
- imbalance btw forces pushing fluid into alveolar space + forces pulling back into circulation.

MICROVASCULAR:
‘shock lung’ or adult respiratory distress syndrome
septic shock, trauma, burns. pancreatitis, drugs, radiation
microvascular injury to the lungs

24
Q

What 2 conditions are involved in COPD/COAD?

A
  1. Emphysema

2. Chronic bronchitis

25
Q

What is chronic bronchitis?

A

Abnormal sputum production for more the 3 months a year for 2 years.
- continued insult to lungs (smoking)

26
Q

What is emphysema?

A

Permanent enlargement of alveolar spaces distal to terminal bronchiole.
Destruction lung tissue

There is a smaller surface area for gas exchange so pts with COPD has higher levels of CO2 and lower levels of oxygen in blood.

27
Q

What is asthma?

What causes asthma symptoms?

A

increased airway irritability and reversible airway obstruction.
due to smooth muscle contraction

28
Q

What is the most common type of asthma?

Describe how the symptoms occur - hypersensitivity

A

Atopic (allergy)

small airway smooth muscle contraction mediated by type I hypersensitivity.

IgE binds to mast cells which become sensitised to a specific antigen > When exposed, mast cells degranulate and release histamine + inflammatory mediators. > results in airway obstruction with wheezing, increased respiratory rate and breathlessness.

29
Q

What is interstitial lung disease?

A

Interstitium is tissue within septa of alveoli and tissues surrounding airways and blood vessels.

Interstitial lung disease is characterised by fibrosis and reduced lung compliance.

Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. Lung damage from ILDs is often irreversible and gets worse over time.

30
Q

What are the causes of interstitial lung disease?

A

pneumoconiosis (inhalation of dust e.g. coal)

extrinsic allergic - viral infections - drugs/toxins

31
Q

What is Wegner’s granulomatosis (granulomatosis with polygiitis)?
What are the oral manifestations?

A

immunological
lungs + kidneys

Granulomatosis with polyangiitis is an uncommon disorder that causes inflammation of the blood vessels in your nose, sinuses, throat, lungs and kidneys.

Oral manifestations:
\: hyperplastic gingivitis
\: ulceration
\: upper respiratory tract inflammation
\: strawberry gingivitis
32
Q

What is a neoplasm?

A

When an abnormal mass of tissue forms when there is abnormal cell growth and division.
they can be benign or malignant

33
Q

What percentage of lung cancers are malignant?
What origin are they?
Where do they normally arise?

A

95%
Normally epithelial in origin - squamous cell carcinoma or adenocarcinoma
Most carcinomas arise from the bronchus
rare benign are adenomas

note - common site for metastasis

34
Q

What is the epidemiology of lung cancers?

A
  • one of the most common
  • M+
  • usually over 50 years old
  • smoking related
  • often advanced at presentation - few signs and symptoms in early stage
35
Q

What are the histological types of lung cancer?

2 classes. with categories

A

Non small cell lung cancer (87%)
> squamous cell carcinoma
> adenocarcinoma
> large cell undifferentiated

Small cell lung cancer (13%)

36
Q

What do tumours appear as on radiogaphs?

A

white grey masses on chest x-ray

37
Q

What are the oral manifestations of lung cancer?

A

swelling on gingiva. was lung cancer that had metastasised.

38
Q

How do you stage cancer?

A

T - tumour size
N - disease in lymph nodes
M - metastases in distant organs

39
Q

What are the symptoms of lung cancer?

A

: appetite loss
: fatigue
: weight loss
: persistent cough or a change in long standing cough
: breathlessness or shortness in breath
: coughing up blood
: aches or pains when breathing or coughing
: persistent chest infections that don’t respond to medical treatment

Human Diseases Yr2 (20 decks)

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