Pathology - Lecture 1

Question 1

FEV1

Answer 1

Volume of air exhaled with force during the 1st second

Question 2

FVC

Answer 2

Volume of air exhaled with force following maximal inhalation

Question 3

DLCO

Answer 3

used to assess whether there is a problem with diffusion barrier

Question 4

DLCO is reduced if:

Answer 4

increased thickness of diffusion barrier (fibrosis, fluids)
- loss of surface area (emphysema)

Question 5

Cardiogenic Pulmonary Edema

Answer 5

-increased hydrostatic pressure
-CHF/mitral stenosis
-Transudate/heart failure cells
-Bilateral bibasilar infiltrates (dependent edema)

Question 6

Pulmonary Edema - non cardiogenic - ARDS

Answer 6

-Abrupt onset of dyspnea (within 1 week of insult)
• Hypoxemia (on ABG)
• Bilateral pulmonary edema
-injury to pneomocytes (direct) or pulmonary endothelium (indirect for e.g sepsis )
-increased vascular permeability
-

Question 7

ARDS Pathogenesis

Answer 7

-endothelial cells are activated after injury
-Neutrophils adhere to the activated endothelium and migrate into the Inflammatio interstitium and alveoli
-Alveolar inflammation : loss of diffusion and surfactant deficiency + debris organizes into hyaline membrane

Question 8

Resolution of injury for ARDS

Answer 8

-fibrosis of alveolar walls
-type 2 pneomocytes proliferate to replace the type 1
-endothelial restoration due to proliferation of uninjured capillary endothelium

Question 9

Morphology of ARDS - day 1-7 (acute and educative phase )

Answer 9

-edema
-hyaline membranes

Question 10

Morphology of ARDS - day 7-21(organizing phase )

Answer 10

-proliferation of type 2 cells
-interstitial inflammation
-fibrosis