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NBDE PART 1 MICRO/PATH > Micro/Path Lung Disorders > Flashcards

Micro/Path Lung Disorders Flashcards

1
Q

irreversible enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of their walls without obvious fibrosis
is what condition

A

emphysema

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2
Q

in emphysema the air sacs are unable to completely inflate/deflate

A

deflate: hyperinflation = therefore unable to fill with fresh air to ensure adequate oxygen supply to the body.

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3
Q

a person with emphysema will have __ breathing and increased susceptibility to

A

labored breathing

infection

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4
Q

in emphysema, the lungs are FIXED in inspiration/expiration

A

inspiration

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5
Q

in emphysema the lungs have ___ so much that they no longer adequate to accomplish normal gas exchange

A

deteriorated

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6
Q

the distinguishing characteristic of emphysema is air flow limitation caused by lack of

A

elastic recoil in the lungs

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7
Q

emphysema causes an increase/decrease in lung compliance

A

increase

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8
Q

compliance is

A

change in volume per unit of pressure change across an elastic structure

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9
Q
  1. emphysema is linked with what habit

2. what two groups most susceptible

A
  1. heavy cigarette smoking

2. African americans and women

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10
Q
  1. fibrosis is associated with a ___ in pulmonary compliance.
  2. emphysema/COPD may be associated with an ___ in pulmonary compliance due to the loss of alveolar and elastic tissue
A
  1. decrease
  2. increase

think: fibrosis, air sacs not expanding so volume lower = lower compliance

emphysema, sacs are hyperinflated, lack of elastic recoil of lungs = so pressure doesn’t decrease as much as it should bc volume doesn’t decrease so increase in compliance

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11
Q

4 types of emphysema:
centriacinar (centrilobular)/panacinar (panlobular)/paraseptal (distal acinar)/irregular:

match
1. acinus is irregularly involved, associated with SCARRING
2. causes pneumothorax in young adults
(Pneumothorax occurs when air leaks into the space between your lungs and chest wall)
3. destroys alveoli and alveoli ducts (LOWER LOBES OF LUNGS AFFECTED, ASSOCIATED WITH AGING AND ALPHA-1-ANTITRYPSIN deficiency)
4. associated with chronic bronchitis and smoking, destroys bronchioles (UPPER lobes) affected and MOST COMMON FORM

A
  1. irregular emphysema = scarring
  2. paraseptal = pneumothorax young pp
  3. panacinar =lower lobes alveoli and ducts destruction, associated w/aging and anti-tryspisin deficiency
  4. centriacinar = most common, upper lobes. associated with Chronic bronchitis and cigarettes (THINK C-entriacinar = Cigarettes, Chronic bronchitis, most Common = all the c’s) also think c comes before p so c is higher = upper lobes
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12
Q
  1. a naturally occurring substance in lungs called alpha 1 antitrypsin may protect against?
  2. pp with deficiency are at increased risk for?
A

emphysema.

emphysema

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13
Q

symptoms of emphysema include

A

shortness of breath, cough and limited exercise tolerance

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14
Q

COPD = chronic obstructive pulmonary disease refers to what 2 conditions

A

emphysema and chronic bronchitis.

in most cases these two occur together

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15
Q

Match:

a. emphysema/ b. small airway disease, bronchitis/c. bronchiectasis/
d. asthma/e. chronic bronchitis

  1. smooth muscle hyperplasia, excess mucus, inflammation
  2. mucous gland hyperplasia, hypersecretion
  3. airspace enlargement, wall destruction
  4. airway dilation and scarring
  5. inflammatory scarring/obliteration
A
  1. asthma = smooth muscle hyperplasia, excess mucus, inflammation
  2. chronic bronchitis = mucous gland hyperplasia, hypersecretion
  3. emphysema = airspace enlargement, wall destruction
  4. bronchiectasis = airway dilation and scarring
  5. airway disease, bronchitis = inflammatory scarring/obliteration
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16
Q

persistent cough with sputum production for at least 3 month in at least 2 consecutive years in absence of any identifiable cause. mucous hypersecretion bc neutrophils release proteases such as elastase and cathepsin matrix metalloproteinass = stimulate hypersecretion

A

chronic bronchitis

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17
Q

COPD groups emphysema and chronic bronchitis together since overlapping features of damage at both the acinar level =___ and bronchial level _____, almost certainly because of what one extrinsic factor common to both

A
  1. acinar level = emphysema
  2. bronchial level = bronchitis
    cigarette smoking
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18
Q

small airway disease is a variant of chronic bronchitis is known to contribute to obstruction in both

A

emphysema and chronic bronchitis

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19
Q

Dyspnea = ___

A

shortness of breath

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20
Q

asthma, chronic bronchitis, bronchiectasis, small airway disease (bronchiolitis) affects the bronchus/acinus

A

bronchus

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21
Q

the only disorder that affects the acinus

A

emphysema

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22
Q
  1. the disorder that causes SMOOTH MUSCLE HYPERPLASIA and INFLAMMATION
A

asthma. no others produce inflammation/muscle hyperplasia.

note it does produce excess mucous like chronic bronchitis

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23
Q

the only disorder that causes MUCOUS GLAND HYPERPLASIA

A

chronic bronchitis =

hyperplasia and hypersecretion of mucous gland

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24
Q

the two that cause scarring

A

bronchiolitis (small airway disease) and bronchiectaisis

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25
Q

which one is the cause of persistent or sever infections

A

bronchiectasis = cough purulent sputum and fever are signs and symptoms

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26
Q

which ones caused by tobacco smoke, air pollutants?

A

chronic bronchitis and bronchiolitis

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27
Q

this disorder signs are: episodic WHEEZING, cough, dyspnea

A

asthma

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28
Q

this disorder signs are cough, sputum production

A

chronic bronchitis

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29
Q

this disorder signs are cough and dyspnea

A

small airway disease (bronchiolitis)

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30
Q

this disorder signs are dyspnea only

A

emphysema

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31
Q

this disorder signs are cough purulent sputum and fever

A

bronchiectasis

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32
Q

Dermatitis or eczema is

A

inflammation of the skin.

33
Q

atopic/non-atopic asthma

  1. which one means evidence of allergen sensitization
  2. which one means without evidence of allergen sensitization
A
  1. atropic

2. non atropic

34
Q

ON BOARDS: cor pulmonale =

A

enlargement of the right ventricle of the heart

also known as pulmonary heart disease, is enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance or high blood pressure in the lungs (pulmonary hypertension

35
Q

cor pulmonale, airway narrowing and obstruction and squamous metaplasia of the bronchial tree are common results of

A

chronic bronchitis

36
Q

characteristic pathological change in ___ is hyperplasia of submucosal glands and
hypertrophy of smooth muscle which can be quantified by the ___ which is a ratio of gland thickness to bronchial wall thickness

A

chronic bronchitis

Reid index

37
Q

patients with chronic bronchitis may be predisposed to

A

lung cancer (bronchogenic carcinoma)

38
Q

chronic lung abscess, TB, lobular pneumonia, pulmonary embolis and bronchogenic carcinomas all present with

A

productive cough = cough containing sputum

39
Q
  1. ___, occurs when the heart is unable to provide sufficient pump action to maintain blood flow to meet the needs of the body.
  2. When edema is present in addition to the above it is called ___
A
  1. Heart failure/chronic heart failure

2. congestive heart failure or congestive cardiac failure

40
Q

Orthopnea is shortness of breath (dyspnea) which occurs when ___ causing the person to have to ___
It is the opposite of platypnea. It is commonly seen as a late manifestation of heart failure,

A

lying flat

sleep propped up in bed or sitting in a chair.

41
Q

bronchiectasis is irreversible abnormal ___ of the bronchioles caused by infection. it is common in children with

A

dilation

cystic fibrosis

42
Q

most common symptom of ___ is productive chronic cough with a FOUL SMELLING, PURULENT SPUTUM

A

bronchiectasis

43
Q

bronchiectasis most often involves the lower/upper lobes of lungs

A

lower

44
Q

Atelectasis = ?

A

incomplete expansion of the lungs or collapse of inflated lung

45
Q

neonatal atelectasis is common in __ infants because

A

premature infants bc lack of surfactant

46
Q

malabsorption of ___ is common in pt with cystic fibrosis

A

fat soluble vitamins = bc cystic fibrosis patients often have impaired exocrine pancreas function

47
Q

the most common fatal genetic disease in white children

A

cystic fibrosis

48
Q

cystic fibrosis is disorder of __

A

ion transport in epithelial cells that affects fluid secretion in exocrine glands and epithelial lining of the respiratory, GI and reproductive tracts

Cystic fibrosis is caused by defects in a protein found in many tissues, including the airways and the sweat glands.

49
Q

primary defect in cystic fibrosis results from abnormal function of an epithelial __ channel protein encoded by CFTR gene on chromosome 7q31.2

A

chloride (think C ystic = Chloride Channel)

50
Q

sweat test is used to diagnose

A

cystic fibrosis:
The sweat test measures the amount of chloride in the sweat. People with CF have more chloride (salt) in their sweat than someone who does not have CF Due to defective chloride channels (CFTR). For normal salt reabsorption to occur, individual ions of sodium and chloride must be taken from the sweat and moved back into cells of the sweat duct. These ions are moved by transporters called ion channels. In the case of sodium, there is a sodium channel; for chloride, there is a chloride channel called CFTR. In cystic fibrosis, the CFTR chloride channel is defective, and does not allow chloride to be reabsorbed into sweat duct cells.

51
Q

in cystic fibrosis: ___ by sweat glands of Cl- and Na+ is normal and ___ is impaired

A

secretion normal

reabsorption is impaired

52
Q

hemangioma

A

hem = blood, angio = vessel, oma = tumor

is a benign and usually self-involuting tumor (swelling or growth) of the endothelial cells that line blood vessels, and is characterised by increased number of normal or abnormal vessels filled with blood. It usually appears in the first weeks of life and grows most rapidly over the first six months. Usually, growth is complete and involution has commenced by twelve months. Half of all infantile hemangiomas have completed involution by age five, 70% by age seven, and most of the remainder by age twelve.[1] In more severe cases hemangiomas may leave residual tissue damage. In infancy, it is the most common tumor

53
Q

___disease =
hemangiomas of the retina and cerebellum
also associated with cysts of the liver, kidney adrenal glands and pancreas

A

Von Hippel Lindau disease

54
Q

___ syndrome = uncommon hereditary CT disorder that results in abnormalities of the eyes, bones, heart, and blood vessels. patients are tall and thin with abnormally long legs and arms and spider-like fingers

A

Marfan’s syndrome

55
Q

Familial hypercholesterolemia = genetic defect in ___. can result in atherosclerosis.

A

LDL receptors

56
Q

anthracosis = inhalation of

A

carbon dust

57
Q

pneumoconiosis =

A

environmental diseases = prolonged inhalation of inorganic dust particles

58
Q

Coal worker’s pneumoconiosis = inhale

A

coal dust = carbon and silica

59
Q

two types of Coal worker’s pneumoconiosis:

  1. simple = coal macules around the bronchioles. causes/doesn’t cause disability
  2. progressive massive fibrosis = fibrotic nodules filled with ___
A
  1. doesn’t
  2. necrotic black fluid. can = bronchiectasis pulmonary hypertension or death from respiratory failure or right sided heart failure
60
Q

Silicosis (stone mason’s disease) = inhalation of?

A

silica dust

61
Q

Most common and most serious pneumoconiosis and associated with increased susceptibility to TB - ?

A

silicosis. silicotuberculosis

62
Q

asbestosis - inhale ___. leads to ?

A

asbestos fibers, diffuse interstitial fibrosis in lower lobes.

63
Q

which pneumoconiosis = predisposition to bronchogenic carcinoma and malignant mesothelioma

A

asbestosis

64
Q

berylliosis = inhaled

A

beryllium particles

65
Q

pneumonia = inflammation due to infection in pulmonary parenchyma - characterized by symptoms?

A

chills and fever

productive cough, bloody sputum, hypoxia, shortness of breath and sometime cyanosis

66
Q
  1. lobular pneumonia most often caused by ___
A

strep pneumoniae

67
Q

interstitial pneumonia caused by (2)

A

mycoplasma pneumonia or viruses

68
Q

bronchopneumonia is caused by

A

a variety of diseases (patchy distribution)

69
Q

empyema

A

An empyema (“abscess”) is a collection of pus within a naturally existing anatomical cavity. common to PNEUMONIA

70
Q

which kind of pneumonia is worse

A

bacterial

71
Q

most common bacterial pneumonia

A

strep pneumonia (pneumococcus)

72
Q

the most common fatal infection acquired in the hospital

A

strep pneumoniae

73
Q

Most common cause of pneumonia in young children (2-3y)

A

respiratory viruses ex. influenza virus, adenovirus, rhinovirus)

74
Q

clinical findings in ___: crackles on auscultation (Crackles heard in the lungs), hypoxia and infiltrate in xray

A

pneumonia

75
Q

most frequent cause of lung abscess

A

aspiration of infective material

76
Q

pulmonary abscess more common on right/left

A

right bc more vertical right bronchus

77
Q

single most common condition predisposing person to lung abscess is

A

alcoholoism

78
Q

foul smelling purulent sputum, FLUID FILLED LUNG cavity, cough and fever are signs of

A

lung abscess

79
Q

60% of cases of lung abscess organism come from

A

oral cavity.

staph and strep are the most common along with others like bacteroides, fusobacterium peptococcus

NBDE PART 1 MICRO/PATH (20 decks)

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