Lungs

Question 1

AKA lung collapse, what is caused by inadequate expansion of airspaces and gives rise to hypoxia?

Answer 1

Atelectasis

*Obstruction, pleural effusion, etc.

Question 2

What results from progression of acute lung injury and results in recruitment of activated neutrophils that damage alveolar epithelium/vasculature?

Answer 2

Acute Respiratory Distress Syndrome (ARDS)

Question 3

Which common airway disease category includes emphysema, chronic bronchitis, asthma, and bronchiectasis?

Answer 3

Chronic Obstructive Pulmonary Disease (COPD)

*Main cause is Cigarette Smoke

Question 4

What results from destruction of alveolar walls, leading to permanent enlargement of airspaces and can be caused by smoking, a-1 antitrypsin deficiency or air pollution?

Answer 4

Emphysema

*Hyperinflation with barrel chest, cough, wheeze, long expiration w/ pursed lips

Question 5

What are 4 aspects of emphysema etiology?

Answer 5

1-IMbalance of proteases/anti-proteases
2-Neutrophils and macrohages releasing elastase and free radicals
3-Inflammation due to smoking
4-Smoking inhibits a-1 antitrypsin

Question 6

When the branches leading to the alveoli are damaged but the alveoli themselves are intact it is called?

Answer 6

Centrilobular Emphysema

*smoking causes this

Question 7

When branches and alveoli are destroyed it is which type of emphysema?

Answer 7

Panacinar emphysema

Question 8

A persistent productive cough for 3 months in 2 consecutive years cause by smoking or air pollution is called?

Answer 8

Chronic bronchitis

Question 9

What is the pathology of chronic bronchitis?

Answer 9

Hyper secretion of mucus in airways, often accompanied by microbial infection

Question 10

What results from obstruction of the bronchi and persistent necrotizing infection and has a persistent foul smelling cough, and hemoptysis?

Answer 10

Bronchiectasis

*TB, Staph, Klebsiella

Question 11

Reactive airway disease that has paroxysmal narrowing of airways is called?

Answer 11

Asthma

Question 12

What are the two types of Asthma?

Answer 12

1-Atopic (Type I hypersensitivity)

2-Non-atopic (Non-immune mechanism, drugs, virus or exposure induced)

Question 13

What are 6 pathological characteristics of Asthma

Answer 13

1-Hyper inflated lungs 
2-thick mucus plugs in airways 
3-hyperplasia of bronchial glands 
4-thick basement membrane
5-smooth muscle hypertrophy 
6-eosinophilic infiltration

Question 14

What condition is characterized by reduced lung compliance (stiff) requires more efforts to expand lungs, and shows ground glass infiltrates on images?

Answer 14

Restrictive Disease

*Less common than COPD but can cause respiratory failure

Question 15

What are 4 types of restrictive disease?

Answer 15

1-Usual Interstitial Pneumonitis
2-NSIP
3-RB-ILD and DIP (smokers)
4-Collagen vascular disease

Question 16

What are the 3 most common causes of Pneumoconiosis Occupational Lung disease?

Answer 16

1-Coal workers (antracotic/carbon dust)
2-Silicosis (Sandblasters/hard rock miners)
3-Asbestosis (lung carcinoma and mesothelioma)

Question 17

What multi system disease is believed to be driven by abnormally stimulated CD4 helper T cells, and has non-caseating granulomas with reduced elastic properties?

Answer 17

Sarcoidosis

*African Americans have 10 x greater risk

Question 18

What immune mediated response to inhaled antigen may be acute reaction or result in end stage lung disease?

Answer 18

Hypersensitivity Pneumonitis

Question 19

What are 3 Iatrogenic causes of pulmonary fibrosis?

Answer 19

1-Chemotherapeutic agents (bleomycin, busulfan)
2-Radiation
3-IV drugs

Question 20

What are 3 types of vascular diseases of the lungs?

Answer 20

1-Pumonary emboli
2-Pulmonary hypertension
3-Vasculitis

Question 21

What can cause sudden death with occlusion of the main pulmonary artery from a clot that may originate in the deep veins of the legs?

Answer 21

Pulmonary Embolus

Question 22

What are two diffuse alveolar hemorrhage syndromes?

Answer 22

1-Goodpasture Syndrome

2-Granulomatosis with polyangiitis (Wegener Granulomatosis)

Question 23

Which alveolar hemorrhage syndrome is due to antibodies against a3 chain of collagen IV resulting in glomerulonephritis and pulmonary hemorrhage?

Answer 23

Goodpasture Syndrome

Question 24

Which alveolar hemorrhage syndrome is due to necrotizing granulomas and vasculitis, has a C-ANCA positive test and causes upper respiratory and pulmonary manifestations?

Answer 24

Granulomatosis with Polyangiitis (Wegner Granulomatosis)

Question 25

What are 4 pulmonary infections?

Answer 25

1-Community Acquired pneumonia
2-Community acquired atypical pneumonia (walking pneumonia)
3-Hospital acquired pneumonia
4-Aspiration pneumonia

Question 26

Which pulmonary infection has acute onset, chills, fever, productive cough and is caused by bacteria?

Answer 26

Community acquired pneumonia

Question 27

Which pulmonary infection is more nonspecific with low grade fever, non-productive cough and is caused by mycoplasma or viruses?

Answer 27

Community acquired Atypical pneumonia

Question 28

Which pulmonary infection Is caused by gram negative rods and S aureus and possible antibiotic resistant?

Answer 28

Hospital Acquired Pneumonia

Question 29

Which pulmonary infection usually involves the right lower love and can be abscess forming?

Answer 29

Aspiration Pneumonia

Question 30

Which disease is chronic granulomatous caused by Mycobacterium, usually involves lungs, and has fever, night sweats and hemoptysis?

Answer 30

Tuberculosis

Question 31

What are three fungal infections that affect the lungs?

Answer 31

1-Histoplasma Capsulatum
2-Cocciodiodes immitis
3-Blastomycoses dermatiditis

Question 32

Which fungal infection is endemic to ohio river valley and arises from bat/bird droppings?

Answer 32

H. Capsulatum

Question 33

Which fungal infection is endemic in california’s San Joaquin Valley and is known as valley fever?

Answer 33

C. Immitis

Question 34

Which fungal infection is endemic in the US in a pattern similar to histoplasmosis?

Answer 34

B. dermatiditis

Question 35

Which virus has owl eye intranuclear inclusions, may cause neonatal infection and is commonly seen in immunocompromised patients?

Answer 35

CMV

Question 36

What are three subtypes of lung carcinoma?

Answer 36

1-Non-small cell carcinoma (adenocarcinoma and squamous cell carcinoma)
2-Large cell neuroendocrine carcinoma
3-Small Cell carcinoma

*smokers 10-55 x greater risk