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CPR Final > Lung Pathology > Flashcards

Lung Pathology Flashcards

1
Q

pathogens of infectious rhinitis?

A

rhinovirus, adenovirus, echovirus

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2
Q

infectious rhinitis is also known as?

A

the common cold

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3
Q

symptoms of infectious rhinitis

A

sneezing, congestion, runny nose

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4
Q

how is infectious rhinitis cured?

A

self-limiting

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5
Q

infectious rhinitis treatment?

A

symptomatic with anti-histamines and decongestants

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6
Q

allergic rhinitis is also known as

A

seasonal allergies

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7
Q

allergic rhinitis is caused by what?

A

type 1 hypersensitivity rxn such as through IgE or pollen

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8
Q

allergic rhinitis histology

A

inflammatory infiltrate and eosinophils

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9
Q

symptoms of allergic rhinitis

A

mucosal edema, redness, secretion

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10
Q

associations with allergic rhinitis

A

asthma, exzema

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11
Q

treatment for allergic rhinitis

A

saline rinse

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12
Q

what are nasal polyps

A

protrusion of edematous mucosa

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13
Q

histology of nasal polyps

A

hyperplastic or cystic mucous glands

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14
Q

nasal polyps caused by

A

recurrent rhinitis, CF, aspirin-induced asthma

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15
Q

effects of nasal polyps

A

impair airway and drainage

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16
Q

result of repeated attacks of infectious rhinitis

A

chronic rhinitis

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17
Q

causes of chronic rhinitis

A

microbial or allergic

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18
Q

symptoms of chronic rhinitis

A

desquamation, ulceration of mucosal epithelium, suppurative infections blocks air sinuses

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19
Q

risk of chronic rhinitis

A

deviated nasal septum, nasal polyps, impaired drainage

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20
Q

what is sinusitis

A

inflammation of paranasal sinusitis

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21
Q

causes of sinusitis

A

Viral, bacterial, fungal, allergic (commonly oral cavity microbes, strep, staph, influenza)

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22
Q

sinusitis symptoms

A

impaired drainage, suppurative exudate
Forms mucocele and empyema
Sx: pressure, pain, obstruction, productive cough at night

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23
Q

sinusitis is associated with what syndromes?

A

kartagener syndrome: mutation of the dynein arm of the cilia

bronchiectasis and situs inversus

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24
Q

pharyngitis tonsilitis is what?

A

acute inflammation

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25
Q

symptoms of pharyngitis tonsilitis

A

pain, anorexia, dysphagia, lymphadenopathy

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26
Q

pharyngitis tonsilitis treatment

A

antibiotics if culture is postiive

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27
Q

pharyngitis tonsilitis is caused by

A

strep A. viral infection (rhinovirus, echovirus, adenovirus)

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28
Q

nasopharyngeal angiofibroma is what?

A

a benign tumor of nasal mucosa

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29
Q

nasopharyngeal angiofibroma affects what?

A

large blood vessels

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30
Q

nasopharyngeal angiofibroma affects what population the most?

A

young males

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31
Q

nasopharyngeal angiofibroma has what symptoms?

A

epistaxis, hemorrhage

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32
Q

sinonasal papilloma

A

benign tumor of respiratory mucosa lining nasal cavity and sinuses

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33
Q

what is nasopharyngeal carcinoma

A

malignant tumor of nasalpharyngeal epithelium

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34
Q

nasopharyngeal carcinoma is associated with what virus?

A

herpes virus! EBV.

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35
Q

Nasopharyngeal carcinoma affects what populations?

A

African children and Chinese adults

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36
Q

Nasopharyngeal carcinoma histology:

A

pleomorphic keratin (+), epithelial cells (poorly differentiated squamous cell carcinoma)

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37
Q

nasopharyngeal carcinoma symptoms

A

enlarged cervical lymph nodes

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38
Q

laryngitis

A

inflammation of larynx

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39
Q

laryngitis symptoms

A

hoarseness, decreased volume of voice, pain, dysphagia

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40
Q

causes of laryngitis:

A

allergic, viral (URI), bacterial, chemical insults, overuse, persistant cough, GERD, smoking

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41
Q

treatment for laryngitis:

A

steam insulation and rest

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42
Q

epiglottitis

A

inflammation of epligottis

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43
Q

causes of epligottitis:

A

H. influenzae and bacteria (Strep/staph)

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44
Q

epligottitis symptoms:

A

fever, sore throat, drooling, dysphagia, muffled voice, inspiratory stridor, air obstruction

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45
Q

epiglottitis treatment

A

abx, protect airway

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46
Q

croup laryngotracheobronchitis

A

inflammaiton of upper airway

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47
Q

cause of Croup

A

parainfluenza virus

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48
Q

symptoms of Croup

A

hoarse, BARKING cough, inspiratory stridor, worse at night

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49
Q

xray of Croup

A

STEEPLE sign: narrowed trachea

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50
Q

Croup treatment

A

racemic (aerosol to inhale) epi, steroids, hydration, anti-pyretic

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51
Q

vocal cord nodules and polyps

A

reactive nodule on true vocal cord

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52
Q

histology of vocal cord nodules

A

myxoid degeneration

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53
Q

vocal cord nodules are caused by what and relieved with what?

A

over-use, resolves with rest

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54
Q

squamous papilloma is associated with what?

A

laryngeal papilloma

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55
Q

squamous papilloma is what?

A

benign epithelial tumor

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56
Q

causes of squamous papilloma?

A

HPV 6 AND 11

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57
Q

Symptoms of squamous papilloma

A

hoarse, breathy voice, dyspnea, aspiration, dysphagia, pain, otalgia, hemoptysis

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58
Q

treatment of squamous papilloma

A

visualization, CT, surgery for excision

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59
Q

papillomatosis

A

skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae

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60
Q

papillomatosis looks like

A

papillary projections of the epidermis= undulating surface

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61
Q

laryngeal carcinoma

A

squamous cell carcinoma of epithelial lining of vocal cord

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62
Q

risk population for laryngeal carcinoma

A

male, over 60yrs, alcohol, smoking, low SES, laryngeal papilloma

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63
Q

symptoms of laryngeal carcinoma

A

hoarseness, cough, stridor

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64
Q

what happens in chronic obstructive lung disease?

A

airway flow obstruction. The lung does not empty and air is trapped

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65
Q

Flow values for COPD: FVC, FEV1, FEV1/FVC and TLC?

A

decreased FVC, decreased FEV1, decreased FEV1/FVC (7L)

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66
Q

Emphysema is

A

an obstructive lung disease that destroys the alveolar airsacs

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67
Q

pathology of emphysema

A

loss of elastic recoil leads to collapse in exhale

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68
Q

obstruction in the throat leads to

A

trapped air

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69
Q

causes of emphysema:

A

smoking (inflammation/proteases) or A1AT deficiency (antiprotease)

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70
Q

smoking causes what emphysema pattern in which lobes?

A

centriacinar in upper lobes

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71
Q

A1AT causes what emphysema pattern in which lobes?

A

panacinar in lower lobes and associated liver cirrhosis

72
Q

emphysema symptoms

A

dyspnea, cough, long expiration, pursed lips, “pink puffer”, weight loss, barrel-chest, hypoxemia, cor pulmonale

73
Q

chronic bronchitis is defined as

A

cough for 3 months over 2 years

74
Q

cause of chronic bronchitis?

A

smoking

75
Q

histology of chronic bronchitis

A

hypertrophy of bronchial mucinous glands (Reid index >50%)

76
Q

symptoms of chronic bronchitis

A

excessive mucous, productive cough, cyanosis, BLUE BLOATER, mucous plugs, increased CO2, decrease O2, increased infections, cor pulmonale

77
Q

asthma is defined as

A

reversible bronchoconstriction

78
Q

symptoms of asthma

A

dyspnea, wheezing, productive cough, status asthmaticus, death

79
Q

histology of asthma

A

spiral shaped mucus plugs (Curschmann) and eosinophil-crystal (Charcot-Leyden)

80
Q

causes of asthma:

A

allergic type 1 hypersensitivity IgE, nonallergic cause (exercise, viral infection, exposure)

81
Q

allergic asthma is caused bye

A

TH2 CD4+ (makes IL4/5/10) and mast cells

in early phase rxn: histamine, leukotrienes (leads to bronchoconstriction, inflammation, edema)

82
Q

aspirin induced asthma triad:

A

asthma, bronchospasms, nasal polyps

83
Q

bronchiectasis definition:

A

permanent dilation of bronchioles/bronchi

84
Q

effect of bronchiectasis

A

loss of airway tone leads to trapped air

necrotizing inflammation leads to damage to airway walls

85
Q

causes of bronchiectasis

A

CF, kartagener syndrome (mutant dynein/cilia), tumor, FB, necrotizing infection, hypersensitivity rxn to aspergillus

86
Q

symptoms of bronchiectasis:

A

cough, dyspnea, foul-rotting sputum, hypozemia, cor pulmonale, secondary amyloidosis

87
Q

effects on FVC, FEV1, FEV1/FVC, TLC with restrictive lung diseases

A

decreased FVC, decreased FEV1, increased FEV1:FVC (>80%), decreased TLC (<7L)

88
Q

effect of restrictive lung disease

A

restricted filling

89
Q

causes of restrictive lung disease

A

interstitial lung disease (thick alveolar wall= decreased gas exchange) or chest wall abnormalities

90
Q

idiopathic pulmonary fibrosis

A

fibrosing disease

fibrosis of the lung interstitium

91
Q

causes of idiopathic pulmonary fibrosis

A

idiopathic, lung injury (TGF-B induces fibrosis), drugs, radiation

92
Q

symptoms of idiopathic pulmonary fibrosis

A

progressive dyspnea, cough

93
Q

CT of idiopathic pulmonary fibrosis

A

fibrosis, honeycomb lung

94
Q

treatment of idiopathic pulmonary fibrosis

A

lung transplant

95
Q

pneumoconioses is

A

interstitial fibrosis due to chronic exposure to small particles = fibrosis

96
Q

histology of pneumoconioses

A

macrophages wall off invaders

97
Q

types of pneumoconioses

A

coal worker’s lung, silica: sand blasters, beryllioses: aerospace workers, asbestos: mesothelioma and lung carcinoma

98
Q

sarcoidosis affects what?

A

systemic, multiple organs

99
Q

sarcoidosis is what

A

noncaseating granulomas and hilar lymph nodes

100
Q

who is stereotypically risk for sarcoidosis

A

AA females

101
Q

causes of sarcoidosis

A

idiopathic, CD4+ helper T cell

102
Q

histology of sarcoidosis

A

epitheliod histocytes (giant cells), asteroid bodies (stellate bodies)

103
Q

symptoms of sarcoidosis

A

dyspnea, cough, ACE increases, increased calcium/vitamin D (active 1-A hydroxylase

104
Q

treatment of sarcoidosis

A

resolves in 3 years without treatment, steroids if treatment is necessary.

105
Q

hypersensitivity pneumonitis

A

inhaled organic antigens = granulomas

106
Q

symptoms of hypersensitivity pneumonitis

A

fever, cough, dyspnea

107
Q

pulmonary HTN histology

A

atherosclerosis, SM hypertrophy, intimal fibrosis, plexiform lesions

108
Q

symptoms of pulmonary HTN

A

RV hypertrophy, cor pulmonale, exertional dyspnea, heart fail

109
Q

primary pulmonary HTN

A

young females, BMPR2 mutation (increases smooth muscle)

110
Q

secondary pulmonary HTN

A

Hypoxemia, increased volume in pulmonary circuit, recurrent PE

111
Q

epistaxis

A

bleeding from the upper airway/nose

112
Q

symptoms of epistaxis

A

bright red blood, cough, inability to clear throar

113
Q

the upper airway cough syndrome is associated most with what symptom?

A

post nasal drip

114
Q

what is the most common cause of cough?

A

upper airway cough syndrome

115
Q

pathophysiology for post nasal drip

A

allergies and infection -> nasal/sinus inflammation -> secretions down nasopharynx

116
Q

upper airway cough syndrome xray results and treatment?

A

normal xray, treatment is nasal steroid, antihistamine, decongestants &/or saline rinse

117
Q

What is GERD?

A

Gastroesophageal reflux disease: acidic gastric contents reflux into the esophagus

118
Q

symptoms and xray of GERD?

A

cough, aspiration into lungs, heartburn/indigestion, vocal cord erythema; xray is normal

119
Q

treatment for GERD

A

elevated head of bed, omeprazole, prevacid (proton pump inhibitor)

120
Q

what is the acute version of sarcoidosis?

A

Loefgren’s syndrome

121
Q

what are the symptoms of Loefgren’s syndrome?

A

triad: acute polyarthritis, erythema nodosum, hilar adenopathy; malaise, fever, joint disease, uveitis, parotitis

122
Q

Who is at risk for Loefgren’s syndrome?

A

scandinavian and irish women

123
Q

treatment for Loefgren’s

A

NSAIDs, self limited, rare elapse

124
Q

what causes hypersensitivity pneumonitis

A

inhaled organic antigens -> grnaulomas

125
Q

symptoms of hypersensitivity pneumonias

A

fever, cough, dyspnea

126
Q

histology and treatment of hypersensitivity pneumonitis?

A

eosinophils; resolves on its own

127
Q

effect of chronic hypersensitivity pneumonitis

A

interstitial fibrosis

128
Q

Goodpasture syndrome is known as an

A

anti-GBM antibody disease (autoimmune); a type of pulmonary-renal syndrome and glomerulonephritis + alveolar hemorrhage

129
Q

symptoms of goodpasture syndrome

A

dyspnea, cough, hemoptysis, fever, weight loss, hematuria, edema, fatigue

130
Q

labs for goodpasture syndrome are positive for

A

anti-glomerular basement membrane antibodies, cANCA

131
Q

who is at risk for goodpasture syndrome?

A

smoking, viral respiratory infection, men

132
Q

xray and treatment for goodpasture syndrome

A

infiltrates; plasmapharesis, corticosteroids, immunosuppressants

133
Q

what is pneumonia?

A

infection of the lung parenchyma

134
Q

who is at risk for pneumonia? what are the symptoms?

A

people with impaired defenses; fever, chills, PRODUCTIVE cough, yellow/green sputum, tachypnea, decreased breath sounds, pleuritic CP, dullness to percussion, high WBC

135
Q

xray, labs and treatment for pneumonia?

A

consolidation patterns on xray; sputum and blood culture show inflammation (neutrophils, macrophages) on labs, abx for tx

136
Q

what is lobar pneumonia?

A

consolidation of the entire lobe

137
Q

gross result of lobar pneumonia

A

intra-alveolar exudate

138
Q

what causes lobar pneumonia?

A

bacterial strep pneumoniae, klebsiella pneumoniae, legionella

139
Q

what are the gross stages of lobar pneumonia?

A

1- congestion, 2- red hepatization, 3- gray hepatization, 4- resolution

140
Q

bronchopneumonia

A

scattered patchy distribution around bronchioles

141
Q

histology of bronchopneumonia

A

acute inflammatory infiltrates from bronchioles into alveoli

142
Q

causes of bronchopneumonia

A

bacterial staph aureus, haemophilus influenzae, pseudomonas aeruginose, moraxella catarrhalis, legionella pneumophila

143
Q

(atypical) interstitial pneumonia

A

diffuse interstitial infiltrate (inflammatory cells in connective tissue wall of the alveolar air sac)

144
Q

what is the common location of aspiration pneumonia

A

right lower lobe abscess

145
Q

who is at risk for aspiration pneumonia?

A

alcoholics, comatose

146
Q

causes of aspiration pneumonia

A

anaerobic oropharynx bacteria (bacteroides, fusobacterium, peptococcus)

147
Q

what is a lung abscess?

A

collection of pus in the lung parenchyma

148
Q

causes of a lung abscess?

A

bronchial obstruction, cancer, aspiration, staph aureus and anaerobes

149
Q

xray, symptoms and treatment of lung asbcesses

A

air-fluid levels; cough, fever, sweats, eight loss; abx

150
Q

organism that causes tuberculosis

A

mycobacterium tuberculosis

151
Q

primary phase of tuberculosis

A

asymptomatic: positive PPD, Ghon complex forms, focally fibrosed, calcified hilar lymph nodes

152
Q

secondary phase of tuberculosis

A

reactivated primary TB, caseating granulomas in APEX of lung, fever, night sweats, cough, hemoptysis, weight loss, systemic spread to many tissues (miliary TB in liver)

153
Q

histology stain for secondary TB? what is seen on the slide?

A

acid fast bacilli (AFB stain); many white blood cells, many are lymphocytes, paucity of mesothelial cells

154
Q

acute respiratory distress syndrome affects what? how?

A

diffuse damage to alveolar-capillary interface

155
Q

ARDS histology

A

edema, cell debri, hyaline membranes

156
Q

ARDS symptoms

A

hypoxemia, cyanosis, resp distress, disruption of surfactant, collapse of air sacs, pulmonary HTN, scarring, fibrosus

157
Q

xray of ARDS

A

white out, diffuse bilateral infiltrates

158
Q

causes of ARDS

A

sepsis, infection, shock, aspiration, drugs, hypersensitivity rxn

159
Q

treatment of ARDS

A

PEEP: positive end expiratory pressure

160
Q

neonatal respiratory distress syndrome is caused by

A

low surfactant levels (type 2 pneumocytes). increase in surface tension, leads to alveolar collapse and hyaline membranes

161
Q

risk factor for neonatal RDS

A

Maternal diabetes, multi-fetal, prematurity (<34 wks), C-section

162
Q

symptoms of neonatal RDS

A

increased respiratory effort, accessory muscles, grunting, hypoxemia, cyanosis, patent ductus arteriosus (right to left shunt), blindness (retinopathy), bronchopulmonary dysplasia

163
Q

xray of neonatal RDS

A

hazy, granular

164
Q

benign tumors

A 
adenoma
hamartoma
myoblastoma
papilloma
fibroma
leiomyoma
lipoma
neurofibroma
schwannoma
sclerosing hemangioma
165
Q

symptoms of carcinomas

A

nonspecific, cough, eight loss, hemoptysis, pna, airway obstruction, pleuritic, pleural effusion, metastasis to other tissues

166
Q

local complications of carcinomas

A

local complication: SVC syndrome, recurrent larynmgheal or phrenic nerve palsy, pancoast tumor (shoulder/arm pain), horner syndrome (sympathetic chain compression)

167
Q

small cell carcinoma

A

location: central, submucosa of airways, perihilar
histo: poorly differentiated small neuroendocrine cells
risk: male smoker, radon
a/w: paraneoplastic inc ADH, ACTH, Eaton-Lambert syndrome (muscle weakness)
tx: chemo

168
Q

large cell carcinoma

A

location: peripheral
histo: poorly differentiated large cells
risk: smoking
poor prognosis

169
Q

squamous cell carcinoma

A

location: central, endobronchial
histo: keratin pearls or intercellular bridges
risk: male smoker
a/w: inc PTHrP and Ca

170
Q

adenocarcinoma

A

location: peripheral
hist: glands and mucin
risk: nonsmokers, females

171
Q

bronchioloalveolar carcinoma

A 
clara cells
location: peripheral
histo: columnar cells line bronchioles and alveoli
not related to smoking
xray: looks like pna consolidation
excellent prognosis
172
Q

carcinoid tumor

A 
neuroendocrine cells (bronchial mucosa)
location: polyp-like mass in bronchus
histo: chromogranin (+)
not related to smoking
rare, slow growing, low malignant
risk: 40’s-60’s
sx: asymptomatic, airway obstruction, pna, hemoptysis
a/w: Cushings, carcinoid syndrome (inflamm)
173
Q

Metastatic Tumors

A

most common: breast and colon

gross: multiple cannon-ball nodules

174
Q

Inflammatory Pleural Effusions

A

exudate

labs: Light’s critera: (fluid:serum LDH>.6)(fluid:serum total protein>.5)(fluid LDH> 2/3serum LDH)
tx: thoracentesis

175
Q

Noninflammatory Pleural Effusions

A

transudate

tx: treat underlying cause

176
Q

Pneumothorax

A

air in pleural space
spontaneous cause: bleb rupture in young men
tension pneumo: penetrating chest wall injury
sx: tracheal shift, sucking wound, dyspnea
tx: chest tube

177
Q

Malignant Mesothelioma

A

malignant neoplasm of mesothelial cells

cause: asbestos
sx: pleural effusion, dyspnea, cp, tumor encases the lung, spread through lymph

CPR Final (9 decks)

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