Path/Pathophys Flashcards
What is a pleural effusion?
What are the 3 types?
An accumulation of fluid between pleural layers
- Transudate
- Exudate
- Lymphatic
Exudate Effusion
- Is there increased protein in the fluid?
- How is it caused?
- Increased Protein
(Pleural fluid protein / serum protein ratio > .5)
(Pleural fluid LDH / serum
2.
Increased Vascular permeability
(Inflammation, pneumonia, malignancy)
Transudate Effusion
- Is there increased protein in the fluid?
- How is it caused?
- 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)
Lymphatic Effusion (Chylothorax)
- Is there increased protein in the fluid?
- How is it caused?
- No, there will be increased Triglycerides
2.
Thoracic duct injury
When is tactile fremitus increased?
When there is alveolar consolidation (alveoli are filled with neutrophil-rich fluid)
This occurs during lobar pneumonia and pulmonary edema
When are the lungs hyperresonant on percussion?
When there is a pneumothorax
In a patient with cystic fibrosis how would the following be affected in the nasal mucosa:
- Secretion of Na+
- Secretion of Cl-
The secretion of both sodium and chloride will be decreased leading to abnormally thick mucus
In a patient with Sarcoidosis:
- What would be seen on biopsy?
- Which labs will be elevated?
- Which cell type mediates this disease?
- Non caseating granulomas and hilar adenopathy
- Elevated ACE and Calcium
- CD4 T-Helper Cells
Asthma
- What type of hypersensitivity is it?
- What is the first mediator released during the pathogeneis of asthma?
- Type I hypersensitivity
2.
Histamine from preformed granules
Superior Vena Cava Syndrome
- Where would be the location of this lung tumor?
- How would it present?
1. Mediastinal Mass
2.
Facial swelling, distended neck veins
Horner Syndrome
- Where would be the location of this lung tumor?
- How would it present?
1. Superior Sulcus (Pancoast Tumor)
2.
Ptosis, miosis (constricted pupil), anhydrosis
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?
This patient has Meconium Illeus.
It is highly associated with Cystic Fibrosis
Due to CF, this patient will likely die from pneumonia
A patients lung is pictured below.
- Likely diagnosis
- Likely cause
- Biopsy of cells would most likely be positive for what?
- Mesothelioma
- Asbestosis
- Cytokeratin
Silicosis
- What population is this usually seen in?
- What are the pathological findings?
- Sandblasters and Silica miners
2.
Calcification of the hilar lymph nodes (not granulomas)
Birefrigent particles in hilar lymph nodes on biobsy
Berylliosis
- What population is this usually seen in?
- What are the pathological findings?
- 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)
A patients lungs are pictured below
- What is the likely diagnosis?
- Which histopathological changes would be expected?
- Emphysema
(due to the pleural blebs)
- Alveolar Destruction
What gives the pus/sputum in a bacterial infection its greenish colour?
Myeloperoxidase
What is the likely diagnois of this chest x-ray?
Lobar Pneumonia
SIADH (Syndrome of Inappropriate ADH)
- What lung cancer is it associated with?
- How does it affect:
- serum sodium levels
- serum osmolality
- urine osmolality
Small Cell lung cancer
- decreased Na (hyponatremia) and decreased serum osmolality due to increased absorption of free water
- increased urine osmolality
A woman presents with cough, dyspnea and chest pain.
A lung biopsy is performed and shown below.
What is the likely diagnosis?
Sarcoidosis due to the:
- non caseating granulomas
- giant multinucleated giant cells
A patient presents with ptosis, facial weakness and difficult breathing.
What is the most likely diagnosis?
How is it caused?
Myasthenia Gravis
caused by antibodies against the postsynaptic Ach receptors at the neuromuscular junction
How is a lung abscess formed after prolonged infection?
Neutrophils release cytotoxic lysosomal granules
What would be seen on histopathology in a patient who died from asbestosis?
Ferruginous bodies
(golden brown fibers coated with iron-protein complexes)
How would the following be affected in an obese patient:
- FEV1
- FVC
- ERV
- RV
- TLC
- decreased FEV1
- decreased FVC
- decreased ERV
- normal RV
- decreased TLC
What can sillicosis of the lung impair?
What does this increase the risk of infection of?
Macrophage function by impairing phagolysosome formation
This increases the risk of mycobacteria infection
(mainly Mycobacterium Tuberculosis)
Asbestosis causes which type of cancer(s)?
Which is most common?
Mesothelioma & Bronchogenic Carcinoma
Brochogenic is the more common
(Mesothelioma is more specific to Asbestosis however)
A patient is diagnosed with lung cancer.
Light microscopy is shown in the picture below.
What type of lung cancer is this?
Adenocarcinoma of the lung
Based on the picture, what formula should be used to calculate the severity of a patients COPD?
C / (B + C + D)
