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OS 213 Respiratory Exam 2 > LUNG pathology > Flashcards

LUNG pathology Flashcards

1
Q

Respiratory system is an outgrowth from the____

A

Ventral wall of the foregut

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2
Q

Midline trachea develops two lateral outpocketings

A

Lung buds

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3
Q

How many branches arise from the Right lung bud?

A

3 (lobar bronchi)

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4
Q

How many branches arise from the left lung bud?

A

2 ( lobar bronchi)

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5
Q

Respiratory bronchioles + alveolar ducts + alveolar sacs

A

Acinus

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6
Q

3-5 terminal bronchioles + respective acinus

A

Pulmonary lobule

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7
Q

Histology of bronchial mucosa

A

pseudostratified, tall, columnar, ciliated epithelial cells

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8
Q

Alveolar epithelium

A

Flattened, plate-like Type 1 pneumocytes covering 95% of the alveolar surface

Rounded Type II pneumocytes; synthesize surfactant; contained in osmiophilic lamellar bodies

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9
Q

Entire lung and bronchial tree may be absent on one side

A

Pulmonary agenesis

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10
Q

Incomplete development of the lungs (Presence of rudimentary bronchi but no lung tissue)

A

Pulmonary Aplasia

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11
Q

Defective development of distal lung tissue of both lungs (can be bilateral but usually one may be more affected than the other)

A

Pulmonary hypoplasia

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12
Q

Decreased weight, volume, and acini disproportional to the body weight and gestational age

A

Pulmonary hypoplasia

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13
Q

Causes Pulmonary hypoplasia

A

abnormalities that compress the lungs or impede normal lung expansion in utero

(CDH and oligohydramnios)

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14
Q

Bowels enter the thoracic cavity and impede proper growth and development of the lung

A

Congenital diaphragmatic hernia

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15
Q

Abnormal communication between the trachea and the esophagus, Depending on the type, this can lead to severe and fatal pulmonary complications and aspirations

A

Tracheoesophageal Fistula

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16
Q

Most common type of Tracheoesophageal Fistula

A

H type variation

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17
Q

Suspected in a newborn baby who frequently coughs or regurgitate milk after bleeding

A

TEF

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18
Q

Vascular abnormalities

A

Pulmonary Arteriovenous malformations
Alveolar capillary dysplasia
Pulmonary Lymphagiectasia

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19
Q

Massive overinflation of one or more lung lobes occuring postnatally (compared to adult type emphysema wherin you have actual wall loss)

A

Congenital Lobar Emphysema

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20
Q

What lobe is mostly common in the congenital lobar emphysema

A

Upper lobes

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21
Q

Causes of vongenital lobar emphysema

A

Intrinsic absence or abnormality (bronchomalacia) of cartilaginous ring

External compression by a large pulmonary artery

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22
Q

Compression by a large pulmonary artery ..(Congenital Lobar emphysema)

A

Bronchi at the involved site may be devoid of cartilahe

Cardiac anomalies may be present

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23
Q

Abnormal detachment of the primitive foregut

A

Foregut cyst

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24
Q

Most often location of foregut cyst

A

hilum or the middle mediastinum

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25
Q

Classification of foregut cyst

A

Bronchogenic (most common)
Esophageal
Enteric

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26
Q

Foregut cyst

A

lined by ciliated pseudostratified columnar epithelium with squamous metaplasia. Wall contains bronchial glands, cartilage and smooth muscle

27
Q

Curative for Foregut cyst

A

Surgical Resection

28
Q

Also called Congenital Adenomatoid Malformation (CCAM)

A

Congenital airway malformation

29
Q

Defect in the development of the terminal bronchioles

A

Congenital pulmonary airway malformation

30
Q

Histologic categories of congenital pulmonary airway malformation

A

Macrocytic (13%)
Microcystic (73%)
Solid Cystic Adenomatoid Malformation (13%)

31
Q

Macrocystic CPAM

A

Best prognosis

One or more large (>5mm on prenatal ultrasound) cysts are lined with normal pseudostratified ciliated epithelium)

32
Q

Microcystic CPAM

A

Small cysts lined with ciliated columnar or cuboidal epithelium (similar to lining of more distal and terminal airways)

33
Q

Solid cystic Adenomatoid Malformation

A

Worst prognosis

Airless Tissue mass composed of cuboidal epithelium lined bronchioles

34
Q

Presence of a discrete mass of lung tissue without normal connection to the airway system

A

Pulmonary sequestration

35
Q

Blood supply of the pulmonary sequestration arise from??

A

aorta and its branches

36
Q

External to the lung, and may be located anywhere in the thorax or mediastinum, Obvious separate mass from the main lung lobe, Abnormal mass lesion in infants, associated with other congenital anomalies

A

Extralobar sequestration

37
Q

Within the lung substance, Usually in older children, often associated with recurrent localized infection or bronchiectasis

A

Intralobar sequestration

38
Q

Mucus gland hyperplasia, Hypersecretion, redi index of >0.4

A

Chronic Bronchitis

39
Q

Airway dilation and scarring, necrotizing inflammation of airway

A

Bronchiectasis

40
Q

Smooth muscle hyperplasia, excessive mucus inflammation, reversible narrowing/ obstruction of airway

A

Asthma

41
Q

Airspace enlargement; wall destruction

A

Emphysema

42
Q

Inflammatory scarring, obliteration of bronchioles

A

Small-airway disease/ Bronchiolitis

43
Q

Predominant Bronchitis

A 
Age: 40-45
Dyspnea: Mild; late
Cough: Early; copious sputum
Infections: Common
Respiratory Insufficiency: Repeated
Cor pulmonale : common
Airway Resitance: Increased
Elatic Recoil: Normal
Chest Radiograph: Prominent vessels;large heart
Appearance: blue Bloater
44
Q

Predominant Emphysema

A 
Age: 50-75
Dyspnea: Severel earlyl classic characteristic for emphysema
Cough: Late; scabty sputum
Infections: Occasional
Respiratory insufficiency: terminal
Cor pulmonale: Rare
Airway Resistance: Normal
Elastic Recoil: Low
Chest Radiograph: Hyperinflation; small heart
Appearance: Pink puffer
45
Q

Abnormal permanent enlargement of the airspaces distal to the terminal bronchioles

A

Emphysema

Destruction of their walls without obvious fibrosis in contrast to overinflation

46
Q

Overinflation

A

Enlargement of airspaces not accompanied by destruction

47
Q

Emphysema types according to its anatomic distribution within the lobule:

A

Centriacinar
Panacinar
Distal acinar
Irregular

48
Q

Centriacinar

A

Clinically significant
20x more common than panacinar
Distal acinar are usually spared

49
Q

Panacinar

A

Clinically significant

50
Q

Distal acinar and irregular types

A

not clinically significant but are pprone to develop pleural blebs, causing pneumothorax in younger people

51
Q

Tobacco

A

causes production of ROS, induce inflammation, increase neutrophils that secrete elastases; ROS also inactivate anti-proteases, activating tissue disruption

52
Q

Reversible bronchoconstriction, Airway hyperresponsiveness

A

ASTHMA

53
Q

Th2 and immunologic reaction to environmental allergens. Has acute phase and late phase

A

Atopic asthma

54
Q

Th2 cytokines in atopic asthma

A

IL-4, IL-5, IL-13

55
Q

Whorls of shed epithelium

A

Curschmann spirals

56
Q

Collections of crystalloids made up of eosinophil proteins

A

Charcot Leyden crystals

57
Q

Irreversible component of asthma, Sub basement membrane thickening, hypertrophy of bronchial glands and smooth muscle

A

Airway Remodeling

58
Q

Persistent productive cough for at least 3 consecutive months in at least 2 consecutive year

A

Chronic bronchitis

59
Q

Hypersecretion of mucus. Airflow obstruction due to (small airway disease and coexistent emphysema)

A

Hyersecretion of mucus

60
Q

Morphology of large airway in chronic Bronchitis

A 
Hyperemic and swollen mucosal lining
Mucinous or mucopurulent secretions
Enlargement of mucus secreting glands
Reid index of >0.4
THickness of submucosal gland layer to bronchial wall
Chronic and acute inflammation of mucosa
Eosinophils not a prominent feature
61
Q

Morphology of chronic bronchiolitis

A

Goblet cell metaplasia
Mucus plugging
Inflammation
Fibrosis

62
Q

Permament dilation of bronchi and bronchioles due to ulcerating inflammation. Caused by destruction of the muscle and elastic tissue

A

Bronchiectasis

63
Q

Primary ciliary dyskinesia

A

Kartegener syndrome

OS 213 Respiratory Exam 2 (15 decks)

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