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Systems Pathology Final > Lungs Part 2 > Flashcards

Lungs Part 2 Flashcards

1
Q

What is a chronic Intersitial Lung disease?

A

group of disorders that have decreased compliance

diffuse, bilateral, patchy fibrosis

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2
Q

What does the lung look like during an MRI if they have chronic interstitial lung disease?

A

they have “ground glass shadows” and “honeycomb lung”

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3
Q

Do we know the cause of chronic intersitial lung diseases?

A

most commonly, no

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4
Q

What is the hallmark feature of intersitial lung disease?

A

reduced compliance

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5
Q

What does damage to alveolar epithelium and interstitial vasculature do in chronic interstitial lung disease?

A

leads to hypoxia, dyspnea and pulmonary HTN (cor pulmonale), respiratory failure

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6
Q

What is idiopathic pulmonary fibrosis characterized by?

A

progressive bilateral interstitial fibrosis, can result in severe hypoxemia and cyanosis

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7
Q

What are the symptoms of idiopathic pulmonary fibrosis?

A

nonproductive cough, velcro-like crackles (rales)

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8
Q

Who is affected the most with idiopathic pulmonary fibrosis?

A

males, MC greater than 60 years

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9
Q

What is the survival rate for those with idiopathic pulmonary fibrosis?

A

less than 3 years

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10
Q

What is the treatment for idiopathic pulmonary fibrosis?

A

lung transplant

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11
Q

What is the radiologic and histologic pattern of fibrosis referred to as?

A

usual interstitial pneumonia

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12
Q

What is pneumoconiosis?

A

a non-neoplastic lung reaction to inhalation of mineral dusts

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13
Q

Who usually gets pneumoconiosis?

A

those who work where there is mineral dusts, fums and vapors

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14
Q

What are the 3 most common mineral dusts that contribute to pneumoconiosis?

A

coal dust, silica, asbestos

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15
Q

Is there an increase in cancer with coal worker’s pneumoconiosis?

A

no, coal mining has decreased since the 1800s

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16
Q

Which is the most common pneumoconiosis?

A

silicosis

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17
Q

Is silicosis a risk for lung cancer?

A

yes

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18
Q

What jobs can contribute to silicosis?

A

sandblasting, rock mining, rock quarries, ceramics, cutting stone

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19
Q

What kind of cancer are people who work with asbestos at risk for?

A

mesothelioma

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20
Q

What are the jobs that contribute to mesothelioma?

A

asbestos insulation, mining, milling

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21
Q

What are the different types of coal worker’s pneumoconiosis?

A

anthroacosis, simple coal worker’s pneumoconiosis, progessive massive fibrosis

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22
Q

What is anthracosis?

A

a pigment (carbon) that accumulates in the lungs

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23
Q

Does anthracosis have symptoms?

A

no, asymptomatic, no inflammation or dysfunction

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24
Q

Who gets anthracosis?

A

most city dwellers and smokers

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25
Describe simple coal worker's pneumoconiosis.
an accumulation of macrophages, little-to-no dysfunction, coal macules/nodules
26
What is progressive massive fibrosis?
massive black scars on the lungs that have extensive fibrosis and decreased lung function with pulmonary HTN (cor pulmonale)
27
What is the most common chronic occupational disease in the world?
silicosis
28
What is silicosis caused by?
inhalation of crystalline silica from occupational settings
29
Which kind of silica is the most toxic and fibrogenic?
crystalline forms (quartz, cristobalite, tridymite)
30
What does silicosis do to the lungs?
destroys alveoli which causes hypoxia/dyspnea pulmonary HTN which causes cor pulmonale possible progressive massive fibrosis
31
What is cor pulmonale?
abnormal enlargement of the right side of heart as a result of a disease of the lungs
32
People who have silicosis are at a bigger risk for what?
lung cancer, tuberculosis
33
When is silicosis most commonly detected?
on routine X ray, if it is caught late, the patient is experiencing dyspnea
34
What do you see on X rays for silicosis?
egg shell calcifications, Hilar lymph nodes, upper lung fields
35
What can asbestos cause?
asbestosis, fibrotic pleural plaques, pleural effusion, mesothelioma, bronchogenic carcinoma, laryngeal carcinoma
36
What is the MC effect of asbestos?
fibrotic pleural plaques
37
When exposed to asbestos, you have a ___x increase of contracting mesothelioma.
1000
38
When exposed to asbestos, you have a 5x increase of contracting what?
bronchogenic carcinoma
39
When exposed to asbestos and smoking, what is your cancer risk?
50x more than normal
40
Who can receive asbestos exposure?
family members of workers
41
What is asbestosis?
a result of asbestos exposure that causes interstitial fibrosis and begins in lower lungs/pleura
42
What distinguishes usual interstitial pneumonitis from asbestosis?
asbestos bodies
43
What are asbestos bodies?
small brown nodules
44
What are the signs and symptoms of asbestosis?
progressive cough and dyspnea, possible cor pulmonale
45
When does one typically see asbestosis?
10-20 years after exposure
46
What does asbestosis give one the increase risk of?
mesothelioma and lung cancer
47
What kind of disorder is sarcoidosis?
multisystem disease of unknown etiology characterized by noncaseating granulomas in many tissues and organs
48
Which organs does sarcoidosis most commonly involve?
lungs, skin, eyes, liver, spleen
49
Within the lungs, where does sarcoidosis take place?
hilar lymph nodes 90% of the time (bilaterally)
50
Within the skin, where does sarcoidosis take place?
erythema nodosum 25% of the time
51
When you biopsy, what do you find that is indicative of sarcoidosis?
noncaseating granulomas
52
What is the most common symptom of sarcoidosis?
asymptomatic
53
If there are symptoms of sarcoidosis, what would they be?
substernal chest pain, dry cough, fever, dyspnea
54
Who are more commonly going to get sarcoidosis?
``` African Americans (10x), Danish, Swedish age 20-40 years MC among non-smokers and females ```
55
What percent of people recover from sarcoidosis?
70%
56
What percent of people have moderate dysfunction from sarcoidosis?
20%
57
10% of people who contract sarcoidosis develop what?
progressive pulmonary fibrosis and possible cor pulmonale
58
What is the treatment for sarcoidosis?
watchful waiting, corticosteroids, lung transplant
59
How does a pulmonary embolism occur?
clot-->embolism-->lodges in pulmonary artery-->pulmonary infarction
60
What is the morbidity for pulmonary embolisms in the US?
50,000 deaths/year
61
What do most pulmonary embolisms start as?
deep vein thrombosis in popliteal or femoral veins
62
How many pulmonary embolisms are diagnosed before death?
~25%
63
What are the risks with pulmonary embolisms?
immobility, dehydration, trauma, lupus surgery, congestive heart failure, oral contraception, metastasis, burns, fracture, hypercoagulabilities
64
If people have a pulmonary embolism, what percent of people have recurring pulmonary embolisms?
30%
65
What are the consequences of pulmonary embolisms?
increased pulmonary artery pressure (HTN) tissue ischemia and infarction
66
What are the steps of a pulmonary embolism?
sudden pulmonary HTN-->diminished cardiac output-->acute cor pulmonale-->hypoxia/death
67
Cardiogenic shock is associated with what disease?
pulmonary embolism
68
What percent of PE cause an infarction?
~10%, rare
69
Why is a pulmonary embolism that causes an infarction so rare?
because there is dual blood supply (pulmonary and bronchial arteries)
70
Along with a pulmonary embolism, what else increases the chances of an infarction?
decreased pulmonary blood supply or decreased cardiac function
71
What is the name of a large pulmonary embolism?
saddle embolism
72
How much of the arterial supply does a saddle embolism take up?
occlusion of greater than 60% of pulmonary arterial supply, which causes circulatory collapse and shock
73
What percent of pulmonary embolisms are clinically silent?
60-80%
74
Why are most pulmonary embolisms clinically silent?
because they are small and readily removed by body and the bronchial arteries provide collateral blood supply
75
How can you prevent a pulmonary embolism?
walk after surgery, birth or inactivity, elastic stockings, pneumatic compression, isometrics
76
What does a large embolus do?
straddles the pulmonary artery bifurcation and produces acute cor pulmonale
77
What are the symptoms for the remaining 15-35% that actually have symptoms of a pulmonary embolism?
sudden onset dyspnea (MC), cough, chest pain (worse with breathing), hemoptysis, cyanosis, collapse
78
How do you diagnose a pulmonary embolism?
clinical features, D-dimer (clot breakdown), CT pulmonary angiogram, electrocardiogram
79
What is a normal pulmonary blood pressure?
1/8 of systemic blood pressure | 15/10
80
What is the measure of pulmonary HTN?
1/4 of systemic blood pressure | 30/20
81
pulmonary HTN is secondary to what?
decrease in cross-sectional area of pulmonary vascular bed or increased pulmonary vascular blood flow (left to right shunt [VSD], congestion [mitral valve senosis])
82
What age can pulmonary HTN occur?
any age, mechanisms vary by age
83
What origins do pulmonary HTN commonly have?
pulmonary or cardiac origin
84
What vascular alterations occur throughout the pulmonary tree?
atherosclerosis, smooth muscle hypertrophy
85
What type of pulmonary HTN has no pulmonary pathology?
primary pulmonary hypertension
86
How do you diagnose primary pulmonary HTN?
exclusion of other diseases
87
What percent of primary pulmonary HTN is genetic?
6%
88
What is the probable underlying basis for most forms of pulmonary HTN?
pulmonary endothelial cell and/or vascular smooth muscle dysfunction
89
Who most commonly contracts primary pulmonary HTN?
young adult females
90
What are the symptoms of primary pulmonary HTN?
dyspnea, fatigue, exertional syncope, angina, possible severe respiratory insufficiency/cyanosis, decompensated cor pulmonale
91
What is the treatment for primary pulmonary HTN?
lung transplant
92
What kind of prognosis does primary pulmonary HTN have?
poor prognosis

Systems Pathology Final (5 decks)

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