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UWorld - Respiratory > Path/Pathophys > Flashcards

Path/Pathophys Flashcards

1
Q

What is a pleural effusion?

What are the 3 types?

A

An accumulation of fluid between pleural layers

  1. Transudate
  2. Exudate
  3. Lymphatic
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2
Q

Exudate Effusion

  1. Is there increased protein in the fluid?
  2. How is it caused?
A
  1. Increased Protein

(Pleural fluid protein / serum protein ratio > .5)

(Pleural fluid LDH / serum

2.

Increased Vascular permeability

(Inflammation, pneumonia, malignancy)

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3
Q

Transudate Effusion

  1. Is there increased protein in the fluid?
  2. How is it caused?
A
  1. Decreased Protein

(Pleural fluid protein / serum protein ratio < .5)

(Pleural fluid LDH / serum LDH < .6)

2.

Increased Hydostatic Pressure (eg. HF)

Decreased oncotic pressure (eg. Nephrotic Syndrome)

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4
Q

Lymphatic Effusion (Chylothorax)

  1. Is there increased protein in the fluid?
  2. How is it caused?
A
  1. No, there will be increased Triglycerides

2.

Thoracic duct injury

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5
Q

When is tactile fremitus increased?

A

When there is alveolar consolidation (alveoli are filled with neutrophil-rich fluid)

This occurs during lobar pneumonia and pulmonary edema

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6
Q

When are the lungs hyperresonant on percussion?

A

When there is a pneumothorax

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7
Q

In a patient with cystic fibrosis how would the following be affected in the nasal mucosa:

  1. Secretion of Na+
  2. Secretion of Cl-
A

The secretion of both sodium and chloride will be decreased leading to abnormally thick mucus

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8
Q

In a patient with Sarcoidosis:

  1. What would be seen on biopsy?
  2. Which labs will be elevated?
  3. Which cell type mediates this disease?
A
  1. Non caseating granulomas and hilar adenopathy
  2. Elevated ACE and Calcium
  3. CD4 T-Helper Cells
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9
Q

Asthma

  1. What type of hypersensitivity is it?
  2. What is the first mediator released during the pathogeneis of asthma?
A
  1. Type I hypersensitivity

2.

Histamine from preformed granules

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10
Q

Superior Vena Cava Syndrome

  1. Where would be the location of this lung tumor?
  2. How would it present?
A

1. Mediastinal Mass

2.

Facial swelling, distended neck veins

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11
Q

Horner Syndrome

  1. Where would be the location of this lung tumor?
  2. How would it present?
A

1. Superior Sulcus (Pancoast Tumor)

2.

Ptosis, miosis (constricted pupil), anhydrosis

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12
Q

A newborn has a green fecal mass obstructing the distal illeum.

What disorder is this most associated with?

What complication is most likely to his cause of mortality?

A

This patient has Meconium Illeus.

It is highly associated with Cystic Fibrosis

Due to CF, this patient will likely die from pneumonia

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13
Q

A patients lung is pictured below.

  1. Likely diagnosis
  2. Likely cause
  3. Biopsy of cells would most likely be positive for what?
A
  1. Mesothelioma
  2. Asbestosis
  3. Cytokeratin
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14
Q

Silicosis

  1. What population is this usually seen in?
  2. What are the pathological findings?
A
  1. Sandblasters and Silica miners

2.

Calcification of the hilar lymph nodes (not granulomas)

Birefrigent particles in hilar lymph nodes on biobsy

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15
Q

Berylliosis

  1. What population is this usually seen in?
  2. What are the pathological findings?
A
  1. Aerospace Industry

2.

Noncaseating granulomas of the hilar lymph nodes, lungs, and other organs

(can be confused with sarcoidosis which will also have elevated calcium and ACE levels)

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16
Q

A patients lungs are pictured below

  1. What is the likely diagnosis?
  2. Which histopathological changes would be expected?
A
  1. Emphysema

(due to the pleural blebs)

  1. Alveolar Destruction
17
Q

What gives the pus/sputum in a bacterial infection its greenish colour?

A

Myeloperoxidase

18
Q

What is the likely diagnois of this chest x-ray?

A

Lobar Pneumonia

19
Q

SIADH (Syndrome of Inappropriate ADH)

  1. What lung cancer is it associated with?
  2. How does it affect:
    - serum sodium levels
    - serum osmolality
    - urine osmolality
A

Small Cell lung cancer

  • decreased Na (hyponatremia) and decreased serum osmolality due to increased absorption of free water
  • increased urine osmolality
20
Q

A woman presents with cough, dyspnea and chest pain.

A lung biopsy is performed and shown below.

What is the likely diagnosis?

A

Sarcoidosis due to the:

  • non caseating granulomas
  • giant multinucleated giant cells
21
Q

A patient presents with ptosis, facial weakness and difficult breathing.

What is the most likely diagnosis?

How is it caused?

A

Myasthenia Gravis

caused by antibodies against the postsynaptic Ach receptors at the neuromuscular junction

22
Q

How is a lung abscess formed after prolonged infection?

A

Neutrophils release cytotoxic lysosomal granules

23
Q

What would be seen on histopathology in a patient who died from asbestosis?

A

Ferruginous bodies

(golden brown fibers coated with iron-protein complexes)

24
Q

How would the following be affected in an obese patient:

  1. FEV1
  2. FVC
  3. ERV
  4. RV
  5. TLC
A
  1. decreased FEV1
  2. decreased FVC
  3. decreased ERV
  4. normal RV
  5. decreased TLC
25
Q

What can sillicosis of the lung impair?

What does this increase the risk of infection of?

A

Macrophage function by impairing phagolysosome formation

This increases the risk of mycobacteria infection

(mainly Mycobacterium Tuberculosis)

26
Q

Asbestosis causes which type of cancer(s)?

Which is most common?

A

Mesothelioma & Bronchogenic Carcinoma

Brochogenic is the more common

(Mesothelioma is more specific to Asbestosis however)

27
Q

A patient is diagnosed with lung cancer.

Light microscopy is shown in the picture below.

What type of lung cancer is this?

A

Adenocarcinoma of the lung

28
Q

Based on the picture, what formula should be used to calculate the severity of a patients COPD?

A

C / (B + C + D)

UWorld - Respiratory (2 decks)

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