Lung & Pleura Flashcards
This pattern of emphysema is seen in smokers?
Centriacinar
Panacinar emphysema is mainly seen in patients with what condition?
a-1 antitrypsin deficiency
Silicosis is due to exposure to what substance ?
Quartz
Lung tropism of the SARS -CoV-2 virus is due to what receptors found on pulmonary alveolar epithelial cells?
ACE 2 receptors
This condition is characterized by chronic airway inflammation and variable expiratory outflow obstruction?
Bronchial asthma
What do you call the permanent dilation of bronchi and bronchioles due to destruction of smooth muscle and elastic tissue by inflammation associated with persistent severe infection?
Bronchiectasis
What are the four stages of inflammation seen in lobar pneumonia?
- Congestion
- Red hepatization
- Gray hepatization
- Resolution
Which type of lung cancer is most commonly found in females and never smokers?
Adenocarcinoma
What are the 2 common paraneoplastic syndromes associated with small cell lung cancer?
SIADH
Cushing Syndrome
This syndrome is characterized by enophthalmos, ptosis, myosis, and anhidrosis. What do you call the tumors that usually give rise to this syndrome given its characteristic location?
Horner Syndrome, Pancoast tumor
Asbestosis exposure is associated with what cancer?
Malignant Mesothelioma
What is the cytokine secreted by TH1 cells that leads to formation of granulomas?
IFN-y
45/M smoker, Mass location Central (left bronchus). CT guided biopsy- Core: Sheets of atypical cells with eosinophilic cytoplasm, intercellular bridges, and dyskeratotic cells. Immunohistochemistry: p40, p63 (+). What’s the diagnosis?
Squamous Cell Carcinoma
39/F non-smoker. mass location: Peripheral CT guided biopsy (Core): Atypical cells forming papillary structures, glands, and solid nests withous mucin. Immunohistochemistry: TTF-1, Napsin A (+). What’s the diagnosis?
Invasive Non-mucinous Adenocarcinoma
60/M Smoker. Mass location : Central , CT Guided biopsy shows sheets of small, round, blue cells with crushing artifact on a markedly necrotic background. Immunohistochemistry: Synaptophysin, CD56 (+). What is the diagnosis?
Small Cell ( Oat cell) Carcinoma
35/M concert-goer present with sore throat, cough, colds, and anosmia. What is the diagnosis?
COVID-19
Unvaccinated by COVID-19. Developed with progressive dyspnea with white out lungs on radiography. She eventually expired. What is expected histologic finding in the lungs?
Diffuse Alveolar Damage
A 50/M smoker presents with dyspnea. His spirometry showed FEV1/FVC ratio <0.7. What is the nature of the pulmonary disease?
A. Obstructive
B. Restrictive
Obstructive
55/M , retired miner, presents with dyspnea. Chest Xray shows eggshell calcifications in mediastinal nodes and fine nodularities in both upper lung zones. What’s the Diagnosis?
Silicosis ( Quartz)
55/M Smoker present with long standing dyspnea and dry cough, expired due to vehicular accident. Autopsy shows large numbers of alveolar macrophages with dusty brown pigment within alveolar spaces and minimal fibrous thickening of alveolar walls. Diagnosis
Desquamative Interstitial Pneumonia (DIP)
Smoker, presents with dyspnea & barrel chest. What’s the most likely diagnosis?
Emphysema , Centriacinar
48/M farmer presents with fever, dyspnea, and cough during harvest season. Sputum culture is negative. What is the most likely diagnosis?
Hypersensitivity pneumonitis
What is the non-obstructive cause of atelectasis?
Loss of surfactant
Diminished breath sounds in the left lower lobe with trachea shifted to the left?
Resorption Atelectasis ( toward the affected)
Note:
Compression atelectasis: away from affected lung
Contraction atelectasis: Prevents full lung expansion
Smoker with chronic cough suddenly experienced hemoptysis. Cytology shows atypical cells with hypercheomatic nuclei and orang-pink cytoplasm. Lab test shows slightly elevated calcium and slightly decreased phosphosous. What would the chest X-ray show?
Large hilar mass
Airway dilatation and scarring is seen in which airflow obstruction disorder?
Bronchiectasis
Airway dilatation and scarring is seen in which airflow obstruction disorder?
Bronchiectasis
Pathophysiology of emphysema?
- Neutrophil elastase activity results in connective tissue damage.
- Proteolytic enzymes are released by macrophages.
- Mainly an eosinophilic inflammatory response in the airways.
Characteristics of bronchopneumonia?
- Neutrophilic suppurative exudation in bronchi
- Fibrinopurulent empyema
- Patchy exudative consolidation
- Fibrous thickening and adhesions of pleura
What ABG is consistent with acute respiratory acidosis?
High pCO2
Normal Bicarbonate
Low pH
Which of the following is not a water soluble gas?
Nitrous oxide
Morphologic features of chronic bronchitis ?
- Marked narrowing of bronchioles
- Mucus hypersecretion
- Hyperplasia of mucus gland
- Increase Reid Index
What type of cell is dominant in the development of PTB?
Macrophages
Most malignant and aggressive form of lung cancer?
Small cell carcinoma
Hormones predominantly produced by small cell carcinoma ?
ACTH and ADH
Apical lung cancers that invade the cervical sympathetic ganglia and produce Horner Syndrome?
Pancoast Tumor
Patient presenting with unilateral enophthalmos, miosis, anhidrosis, ptosis of the left eye and face with chest X-ray finding of left upper lobe opacity and destruction of first rib, presenting with left upper chest pain?
Bronchogenic Carcinoma ( Pancoast Tumor) Horner Syndrome
Jeepney driver who developed acute cough productive of phlegm with pathology in his lower lung airways?
Bronchitis
Underlying pathologic disease which can cause mediastinal shirt?
Distal acinar emphysema underlies many cases of spontaneous pneumothorax.
Pathology of Rhonchi?
Obstruction of medium sized airways
Clinical problem present with obstruction of the lung airways as the pathology.
Asthma
Pathology present in a patient with obstructive lung disease ghaving pulsus paradoxus!
Significant negative intrathoracic pleural pressure required for ventilation.
Pneumonia characterized by diffuse interstitial infiltrates?
Atypical pneumonia
Pneumonia characterized by scattered patchy consolidation centered around bronchioles.
Bronchopneumonia
Pneumonia characterized with consolidation of an entire lobe of the lung?
Lobar pneumonia
Pneumonia characterized by hypertrophy of bronchial mucous glands?
Chronic bronchitis
