Lungs

Question 1

Resorption atelectasis

Answer 1

Obstruction from any cause (mucous plug common)

Question 2

Compression atelectasis

Answer 2

Accumulation of fluid, blood, and air in the plural cavity

Question 3

Microatelectasis:

Answer 3

loss of surfactant

Question 4

Contraction atelectasis (cicatrization)

Answer 4

Fibrotic process in lung or pleura

Question 5

Acutre Respiratory Distress Syndrome is characterized by

Answer 5

Diffuse alveolar capillary damage
Respiratory failure
Hypoxemia (↓ O2) refractory to O2 therapy
Absence of clinical evidence showing left-sided heart failure

Question 6

Obstructive Lung Disease FEV1, FVC, FEV1/FVC

Answer 6

decreased, normal/increased, decreased

Question 7

Restrictive Lung disease FEV1, FVC, FEV1/FVC

Answer 7

decreased, decreased, no change

Question 8

what happens during obstructive diseases?

Answer 8

air can’t get out of lung

Question 9

asthma

Answer 9

reversible, caused by external stimuli

Question 10

extrinsic asthma (immune)

Answer 10

hypersensitivty rxn involving IgE and eosinophils

atopic is most common

Question 11

intrinsic asthma

Answer 11

cold air, exercise, infection/virus

Question 12

sputum findings of asthma

Answer 12

Curschmann spiral : Inspissated sputum and epithelial cells

Charcot leyden crystal.

Question 13

chronic bronchitis is associated with

Answer 13

Smoking (mcc)
Air pollution (Sulfur dioxide and Nitrogen) dioxide)
Infection
Genetics

Question 14

emphysema

Answer 14

Destruction of alveolar wall by smoking (mcc) or alpha-1 antitrypsin deficiency

Question 15

centiacinar emphysema

Answer 15

Characteristic in smoking-related emphysema

Destruction of the central or proximal parts of the acinus

Location: Upper lobes (apical)

Question 16

panacinar emphysema

Answer 16

Etiology: alpha 1-antitrypsin deficiency

Basal zones of lungs

Question 17

Distal Acinar or Paraseptal EmphysemaAKA: Bullous Emphysema

Answer 17

Located near to the pleura
Location: upper lobe of the lungs
Complication: blebs form and can result in pneumothorax

Question 18

blue bloaters are seen in…

pink puffers….

Answer 18

chronic bronchitis

emphysema

Question 19

Bronchiectasis

Answer 19

Obstruction + Infection
permanent
seen in lower lobes w/saccular appearance

Question 20

predisposing factors of bronchiectasis

Answer 20

Cystic fibrosis
Immunodeficiency states
Kartagener syndrome-defect in cilia motility

Question 21

what happens during restrictive lung diseases?

Answer 21

Reduced expansion of the lung and reduced total lung capacity
Lungs are stiff (fibrotic disease)
Chest wall is very stiff
Respiratory muscles are weak (prevent adequate lung expansion)

Question 22

Idiopathic Pulmonary Fibrosis

Answer 22

chronic inflammation and fibrosis of the alveolar wall

Question 23

sarcoidosis

Answer 23

disease with non-caseating granulomas (can involve any organ)
CD4:CD8 ratio > 3.5
commonly involves hilar lymph nodes
shuamann body and asteroid body

Question 24

pneumoconiosis

Answer 24

Environmental diseases caused by inhalation of organic dust, mineral dust, fumes or vapor

Question 25

asbestos

Answer 25

Parietal Pleura: dense hyalinized fibrocalcific plaque

Question 26

Goodpasture’s syndrome

Answer 26

Necrotizing, hemorrhagic interstitial pneumonitis with progressive glomerulonephritis

Question 27

pulmonary HTN leads to

Answer 27

right ventricular hypertrophy

Question 28

primary exposure to TB causes....

Answer 28

hypersensitivity, creating a granuloma lesion called a Ghon focus

Question 29

most primary lung tumors arise from

Answer 29

bronchial epitheleum

Question 30

non-smokers can get this type of lung cancer

Answer 30

adenocarcinoma, KRAS mutations seen

Question 31

this cancer is seen exclusively in smokers

Answer 31

small cell carcinoma

Question 32

Non-Small Cell Lung Carcinoma (NSCLC)

Answer 32

70-75% of all lung Ca cases p16/CDKN2A & K-RAS mutations p53 mutation

Question 33

Small Cell Lung Carcinoma (SCLC)

Answer 33

20-25% | TP53 & RB gene mutations

Question 34

lung cancer metastasis

Answer 34

Distant: Brain, Liver, Bone Adrenals (Addison’s disease is common) Plural and pericardial involvement Superior vena caval syndrome (congestion of veins in neck and face)

Question 35

SCC effects on other organs...

Answer 35

secrete PTH like hormone leads to hypercalcemia

Question 36

small cell carcinoma effects on other organs

Answer 36

secrete ACTH, cushing syndrome | secrete ADH, SIADH

Question 37

malignant carcinoid effect on other organs

Answer 37

secrete serotonin, carcinoid syndrome

Question 38

origin of bronchial carcinoid

Answer 38

Enterochromaffin cells aka Kulchitsky cells