Overview Of Lung Disease (6)-Leah* Flashcards
Four ways to classify pulmonary diseases
according to etiology, histology, PFT, and symptoms/ CXR
7 pulmonary disease classifications based on etiology
I think this doesn’t need to be fully memorized, just read it a time or two
- immune (i.e. vasculitis)
- infectious
- genetic
- neoplasm
- exposure (ie silica)
- pneumothorax
- venous thromboembolus
5 general histo patterns of lung disease
- interstitial inflammation
- “airway disease”
- vasculitis
- focal
- granulomatous
For all of the above remember that there is overlap
Coccidiomycosis is assc with what state?
Arizona; can cause fungal pneumonia
1 cause of cough
viral infection of the respiratory tract; post infectious
Cough with sputum: upper or lower respiratory tract?
with sputum- think lower, although this is NOT correct in EVERY case
Non-pulmonary causes of dyspnea (4)
cardiac problems
anemia
neuromuscular disorders
metabolic disturbances/ electrolyte disturbances
1 cause of hemoptysis
bronchitis
General causes of hempotysis (5)
- bronchitis
- malignancy
- bleeding disorder
- vascular disorder (end stage and associated with RF)
- TB
If a person has massive/ frank hemoptysis, what would you see clinically? (2)
- hypoxia
- CXR infiltrates
Chest pain is generally NOT caused by what?
Two pulmonary causes of chest pain that are gradual? Two pulmonary causes of sudden chest pain?
- -chronic lung disease does NOT = chest pain.
- infectious process or neoplasm = gradual chest pain
- -PE and pneumothorax = sudden chest pain
Rhonchi:
whats the sound, whats the cause?
- lower pitched “musical noises”.
- obstruction, usually with mucus secretions.
- May be seen in acute CHF (which can cause transudate in the airways)
Wheezing:
whats the sound, whats the cause?
example?
- higher pitched noises
- obstruction, usually with swelling
i. e. asthma
What are crackles/ rales? Common assc (3)?
suggest fluid in the lung parenchyma– compresses/ pops the alveoli
-clasically assc with CHF, chronic pulm edema, infection
When might you get fine/ dry crackles?
when there is scarring (severe interstitial disease)
describes as “velcrow”
How do effusion and consolidation effect resonance?
^^ fluid- HYPOresonance
because sound travels better through GAS than solids/liquids.
How do pneumothorax and emphysema effect resonance?
^^ air- HYPERresonance
When is a pneumothorax life threatening?
What do you do?
“Tension” pneumothoraxes are life threatening; cause rapid cardiopulmonary failure.
- air ENTERS chest but cannot exit through lung or some outside wound= compression of organs.
- Needs chest tube, stat
What is ruptured in a pneumothorax (PTX)?
visceral pleura
What are some causes of PTX? (3)
- spontaneous esp in COPD/ tall people
- trauma
- iatrogenic
What is a pleural effusion?
What causes it? (3)
fluid under the lung/ in the pleural space
caused by any inflammatory process, esp tumor, infection, heart failure
Pulmonary nodules- #1 cause; 3 others
#1- benign from environmental allergens also early malignancy, CT disease, infection
Three tumors that may met to the lung?
testicular, thyroid, kidney
Remember that colon cancer will go to the liver first; this is intuitive if you think about the anatomy and portal circulation
Most common pulmonary pathology of all….
viral illnesses
HE WILL ASK THIS A LOT: Give a quick one word assc for each of these sounds: 1. rales 2. fine/ dry crackles 3. rhonchi 4. wheezing
rales/ wet crackles- edema
fine/ dry crackles- interstitial
rhonchi- secretions
wheezing- swelling
MENTIONED 3 FRICKIN’ TIMES
What is the word for wheezing heard in the upper airway?
stridor! this is what you would call snoring.
common viral infection in smokers
rhinovirus
URI vs LRI: which is most likely to be bacterial?
LRI more commonly bacterial; URI mostly viral
Influenza infection predisposes the lung to what other pathogen?
strep pneumo bacterial pneumonia
What three pathogens can act as super antigens?
What do super antigens incite?
staph aureus, strep pnuemo, influenza= super antigens
super antigens= sepsis
“crackles at the base of the lung”
What is this a classic description of?
CHF
“Hyporesonance and pain at the base of lung”
What is this a classic description of?
Pleural effusion
**“I WILL PROBABLY GIVE YOU A QUESTION LIKE THIS.” - Meadows
What would you see on CXR in the case of a pneumothorax?
black area without lung lines
What would a PFT show in the case of a pleural effusion?
-would present like a restrictive disease;
normal FEV1:FVC, low TLC/ DLOC
What percentage of RA patients have lung involvement?
nearly half.
What do acute and chronic heart failure sound like in the lung?
Acute: fluid transudate–> ronchi
Chronic: WET CRACKLES at lung base
Three causes of finger clubbing?
Congenital heart disease, pulm. fibrosis, lung cancer
What does it mean if you see an ^ AP diameter on PE?
chronic hyperinflation (COPD, emphysema)
How long would a cough due to RT irritation typically last in an asthmatic or a smoker?
3-8 weeks; will be self limited and you can differentiate this from interstitial disease based on hx
note that when patients say they feel like they need to cough up mucus in this case it is actually just infammation in the airway
Phrenic nerve paralysis: how does this present?
What is a common cause?
Common on lt side after CABG
You will hear HYPOresonace on percussion exam because you are hitting the liver and the paralyzed diaphragm does not allow lung to expand and fill w air …
1 cause of lung cancer ww?
biomass smoke– i.e. wood burning stove; think women in honduras
