Micro/Path Lung Disorders Flashcards
irreversible enlargement of the airspaces distal to the terminal bronchiole accompanied by destruction of their walls without obvious fibrosis
is what condition
emphysema
in emphysema the air sacs are unable to completely inflate/deflate
deflate: hyperinflation = therefore unable to fill with fresh air to ensure adequate oxygen supply to the body.
a person with emphysema will have __ breathing and increased susceptibility to
labored breathing
infection
in emphysema, the lungs are FIXED in inspiration/expiration
inspiration
in emphysema the lungs have ___ so much that they no longer adequate to accomplish normal gas exchange
deteriorated
the distinguishing characteristic of emphysema is air flow limitation caused by lack of
elastic recoil in the lungs
emphysema causes an increase/decrease in lung compliance
increase
compliance is
change in volume per unit of pressure change across an elastic structure
- emphysema is linked with what habit
2. what two groups most susceptible
- heavy cigarette smoking
2. African americans and women
- fibrosis is associated with a ___ in pulmonary compliance.
- emphysema/COPD may be associated with an ___ in pulmonary compliance due to the loss of alveolar and elastic tissue
- decrease
- 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
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
- irregular emphysema = scarring
- paraseptal = pneumothorax young pp
- panacinar =lower lobes alveoli and ducts destruction, associated w/aging and anti-tryspisin deficiency
- 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
- a naturally occurring substance in lungs called alpha 1 antitrypsin may protect against?
- pp with deficiency are at increased risk for?
emphysema.
emphysema
symptoms of emphysema include
shortness of breath, cough and limited exercise tolerance
COPD = chronic obstructive pulmonary disease refers to what 2 conditions
emphysema and chronic bronchitis.
in most cases these two occur together
Match:
a. emphysema/ b. small airway disease, bronchitis/c. bronchiectasis/
d. asthma/e. chronic bronchitis
- smooth muscle hyperplasia, excess mucus, inflammation
- mucous gland hyperplasia, hypersecretion
- airspace enlargement, wall destruction
- airway dilation and scarring
- inflammatory scarring/obliteration
- asthma = smooth muscle hyperplasia, excess mucus, inflammation
- chronic bronchitis = mucous gland hyperplasia, hypersecretion
- emphysema = airspace enlargement, wall destruction
- bronchiectasis = airway dilation and scarring
- airway disease, bronchitis = inflammatory scarring/obliteration
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
chronic bronchitis
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
- acinar level = emphysema
- bronchial level = bronchitis
cigarette smoking
small airway disease is a variant of chronic bronchitis is known to contribute to obstruction in both
emphysema and chronic bronchitis
Dyspnea = ___
shortness of breath
asthma, chronic bronchitis, bronchiectasis, small airway disease (bronchiolitis) affects the bronchus/acinus
bronchus
the only disorder that affects the acinus
emphysema
- the disorder that causes SMOOTH MUSCLE HYPERPLASIA and INFLAMMATION
asthma. no others produce inflammation/muscle hyperplasia.
note it does produce excess mucous like chronic bronchitis
the only disorder that causes MUCOUS GLAND HYPERPLASIA
chronic bronchitis =
hyperplasia and hypersecretion of mucous gland
the two that cause scarring
bronchiolitis (small airway disease) and bronchiectaisis
which one is the cause of persistent or sever infections
bronchiectasis = cough purulent sputum and fever are signs and symptoms
which ones caused by tobacco smoke, air pollutants?
chronic bronchitis and bronchiolitis
this disorder signs are: episodic WHEEZING, cough, dyspnea
asthma
this disorder signs are cough, sputum production
chronic bronchitis
this disorder signs are cough and dyspnea
small airway disease (bronchiolitis)
this disorder signs are dyspnea only
emphysema
this disorder signs are cough purulent sputum and fever
bronchiectasis
Dermatitis or eczema is
inflammation of the skin.
atopic/non-atopic asthma
- which one means evidence of allergen sensitization
- which one means without evidence of allergen sensitization
- atropic
2. non atropic
ON BOARDS: cor pulmonale =
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
cor pulmonale, airway narrowing and obstruction and squamous metaplasia of the bronchial tree are common results of
chronic bronchitis
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
chronic bronchitis
Reid index
patients with chronic bronchitis may be predisposed to
lung cancer (bronchogenic carcinoma)
chronic lung abscess, TB, lobular pneumonia, pulmonary embolis and bronchogenic carcinomas all present with
productive cough = cough containing sputum
- ___, occurs when the heart is unable to provide sufficient pump action to maintain blood flow to meet the needs of the body.
- When edema is present in addition to the above it is called ___
- Heart failure/chronic heart failure
2. congestive heart failure or congestive cardiac failure
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,
lying flat
sleep propped up in bed or sitting in a chair.
bronchiectasis is irreversible abnormal ___ of the bronchioles caused by infection. it is common in children with
dilation
cystic fibrosis
most common symptom of ___ is productive chronic cough with a FOUL SMELLING, PURULENT SPUTUM
bronchiectasis
bronchiectasis most often involves the lower/upper lobes of lungs
lower
Atelectasis = ?
incomplete expansion of the lungs or collapse of inflated lung
neonatal atelectasis is common in __ infants because
premature infants bc lack of surfactant
malabsorption of ___ is common in pt with cystic fibrosis
fat soluble vitamins = bc cystic fibrosis patients often have impaired exocrine pancreas function
the most common fatal genetic disease in white children
cystic fibrosis
cystic fibrosis is disorder of __
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.
primary defect in cystic fibrosis results from abnormal function of an epithelial __ channel protein encoded by CFTR gene on chromosome 7q31.2
chloride (think C ystic = Chloride Channel)
sweat test is used to diagnose
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.
in cystic fibrosis: ___ by sweat glands of Cl- and Na+ is normal and ___ is impaired
secretion normal
reabsorption is impaired
hemangioma
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
___disease =
hemangiomas of the retina and cerebellum
also associated with cysts of the liver, kidney adrenal glands and pancreas
Von Hippel Lindau disease
___ 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
Marfan’s syndrome
Familial hypercholesterolemia = genetic defect in ___. can result in atherosclerosis.
LDL receptors
anthracosis = inhalation of
carbon dust
pneumoconiosis =
environmental diseases = prolonged inhalation of inorganic dust particles
Coal worker’s pneumoconiosis = inhale
coal dust = carbon and silica
two types of Coal worker’s pneumoconiosis:
- simple = coal macules around the bronchioles. causes/doesn’t cause disability
- progressive massive fibrosis = fibrotic nodules filled with ___
- doesn’t
- necrotic black fluid. can = bronchiectasis pulmonary hypertension or death from respiratory failure or right sided heart failure
Silicosis (stone mason’s disease) = inhalation of?
silica dust
Most common and most serious pneumoconiosis and associated with increased susceptibility to TB - ?
silicosis. silicotuberculosis
asbestosis - inhale ___. leads to ?
asbestos fibers, diffuse interstitial fibrosis in lower lobes.
which pneumoconiosis = predisposition to bronchogenic carcinoma and malignant mesothelioma
asbestosis
berylliosis = inhaled
beryllium particles
pneumonia = inflammation due to infection in pulmonary parenchyma - characterized by symptoms?
chills and fever
productive cough, bloody sputum, hypoxia, shortness of breath and sometime cyanosis
- lobular pneumonia most often caused by ___
strep pneumoniae
interstitial pneumonia caused by (2)
mycoplasma pneumonia or viruses
bronchopneumonia is caused by
a variety of diseases (patchy distribution)
empyema
An empyema (“abscess”) is a collection of pus within a naturally existing anatomical cavity. common to PNEUMONIA
which kind of pneumonia is worse
bacterial
most common bacterial pneumonia
strep pneumonia (pneumococcus)
the most common fatal infection acquired in the hospital
strep pneumoniae
Most common cause of pneumonia in young children (2-3y)
respiratory viruses ex. influenza virus, adenovirus, rhinovirus)
clinical findings in ___: crackles on auscultation (Crackles heard in the lungs), hypoxia and infiltrate in xray
pneumonia
most frequent cause of lung abscess
aspiration of infective material
pulmonary abscess more common on right/left
right bc more vertical right bronchus
single most common condition predisposing person to lung abscess is
alcoholoism
foul smelling purulent sputum, FLUID FILLED LUNG cavity, cough and fever are signs of
lung abscess
60% of cases of lung abscess organism come from
oral cavity.
staph and strep are the most common along with others like bacteroides, fusobacterium peptococcus
