PATHOLOGY Flashcards
How far down do the most inferior portions of a lung normally go?
They are usually level with the cardiac apex
When is pulmonary hypoplasia fatal?
If the disease is bilateral
What are the two general (major causes) of hypoplasia of the lung?
Oligohydramnios or decreased intrathoracic space
What are 4 causes of decreased intrathoracic space?
A diaphragmatic hernia (i.e. of Bochdalek/Morgnani), Cystic adenomatoid malformation, lethal form of osteogenesis imperfecta causing chest wall deformity, and chronic effusion such as hydrops fetalis
What is the lining of a foregut cyst? What are they from?
Pseudostratified columnar epithelium; detached part of embryonic foregut
What is the arterial supply/venous drainage of pulmonary sequestrations?
Both extralobar and intralobar are supplied by aorta NOT pulmonary artery, and drained by azygous system
Why is polydramnios an issue in utero? With which type of pulmonary sequestratant is it associated?
Because the excess volume can lead to strangulation; it is associated with EXTRALOBAR pulmonary sequestration
Differentiate the pleural linings of extralobar and intralobar sequestrants:
Extralobar are outside of the lung but have their own pleural lining, intralobar are within the lung and have the same pleural lining as the lung
What are the three types of atelectasis and in which way does the mediastinum shift?
Resorptive/Obstructive atelectasis shifts the mediastinum towards it; Compression atelectasis shifts the mediastinum away; and contraction atelectasis does NOT shift the mediastinum
In which way does the most common cause of atelectasis shift the mediastinum? What is the most common cause of this atelectasis?
Resorption/Obstruction atelectasis shifts mediastinum towards it; most common cause is EXCESSIVE SECRETION because it leads to a blockage
What are the treatments of the reversible causes of atelectasis?
Obstructive/resporption can be treated by removing the blockage and compression can be removed by sucking out the intrapleural compression (air, fluid, etc)
How long does it take to achieve an airless state in obstruction atelectasis and why?
It takes a few hours because the air that is in the aveolus will be absorbed by the blood vessels
A tension pneumothorax would shift the mediastinum in which direction?
Toward the healthy side, this is because tension pneumo is a form of compression atelectasis
What is the major cause of contraction atelectasis? What is the treatment?
Fibrotic changes of lung or pleura? No Tx.
What is the major cause of hemodynamic pulmonary edema?
Increased hydrostatic pressure, as in left heart failure
What kind of pulmonary edema can amphotericin B (amphoterrible) and heroin cause?
Microvascular injury pulmonary edema
What kind of pulmonary edema would be caused by an obstruction of pulmonary veins?
Hemodynamic pulmonary edema
What kind of edema is caused by near drowning?
Microvascular injury pulmonary edema
What is seen in long standing pulmonary edema?
Fibrosis of the alveoli
Why doesn?t administration of oxygen help in ARDS?
Because the hallmark of ARDS is hyaline change and hyaline is waxy/thick and creates a diffusion barrier in the blood-air membrane
Why are there more macrophages than neutrophils in Hamman-Rich syndrome?
Because this is ACUTE INTERSTITIAL PNEUMONIA–the lungs are NOT infected, this is a pnuemonia secondary to something somewhere else in the body like a liver laceration leading to hypovolemic or septic shock
Where is the most common origin of a pulmonary embolus? What kind of thrombus may form from an indwelling central catheter?
Most (95%) come from deep leg veins; an indwelling central catheter can cause a right atrial thrombus
Trousseau’s sign and protein C/S deficiency are risk factors for what? Why?
Pulmonary embolus (or any thrombotic event, really) because they indicate systemic hypercoagulability
What kind of heart failure will a patient with pulmonary embolism display? Sx?
ACUTE cor pulmonale (right heart failure)–JVD, peripheral edema, pulsatile liver, hepatic ascites (nutmeg liver)
