Lungs and Pleura

Question 1

Abrupt onset of HYPOXEMIA and BILATERAL PULMONARY EDEMA in the ABSENCE of CARDIAC FAILURE

Answer 1

Acute Lung Injury

Question 2

MCC of Acute Lung Injury/ARDS

Answer 2

Sepsis
Diffuse pulmonary infections
Gastric aspiration
Mechanical trauma (head)

Question 3

Obstructive Lung Diseases

super decreased FEV1
decreased FVC
increased lung volumes
decreased FEV1/FVC ratio <0.7

Answer 3

Bronchial asthma
Emphysema
Chronic bronchitis
Bronchiectasis

Question 4

Restrictive Lung Diseases

decreased expansion of the lung parenchyma with decreased TLC

super decreased FVC
decreased lung volumes and FEV1
normal to increased FEV1/FVC

Answer 4

Pulmonary Fibrosing Diseases
Chest Wall Disorders

Question 5

Irreversible enlargement of the airspaces distal to the terminal bronchiole

RISK FACTORS:
smoking
a-1 antitrypsin deficiency

Answer 5

EMPHYSEMA

GROSS
voluminous lungs
large alveoli

HISTO
abnormally large alveoli

Question 6

Persistent cough with sputum production for at least 3 mos in at least 2 consecutive years in the absence of any other cause

RISK FACTORS:
smoking
particles from dust, grain and silica

INCREASED REID INDEX
*ratio of the thickness of the mucus gland layer to the wall thickness
*normal = 0.4

Answer 6

CHRONIC BRONCHITIS

GROSS
hyperemia, swelling, and edema of the mucous membrane
excessive mucinous or mucopurulent secretions

HISTO
fibrosis
goblet cell hyperplasia
enlargement of mucus secreting glands of the trachea and bronchi
BRONCHILITIS OBLITERANS
squamous metaplasia and dysplasia

Question 7

MC form of emphysema
smoking - risk factor

Answer 7

Centriacinar

Question 8

Less common form of emphysema
a1-antirypsin deficiency - risk factor

Answer 8

Panacinar

Question 9

Type of emphysema associated with SPONTANEOUS PNEUMOTHORAX