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Pulmonology > Pathology of the Lung > Flashcards

Pathology of the Lung Flashcards

1
Q

What is Atelectasis?

A

Incomplete Expansion of the lung or collapse of previously inflated lung. Usually reversible, hypoxia, predisposes to infection

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2
Q

What are the types of Atelectasis?

A

Resorption
Compression
Patchy
Contraction

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3
Q

What is the cause of Pulmonary Congestion and Edema?

A

Hemodynamic Disturbances

Edema coused by Microvascular injury.(capillaries of alveolar septa)

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4
Q

What causes hemodynamic pulm edema?

A

Inc Hydrostaic Pressure(Left sided CHF)

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5
Q

What are the different obstructive lung diseases?

A

Emphysema
Chronic Bronchitis
Asthma
Bronchiectasis

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6
Q

Where does Bronchitis occurr vs EMphysema

A

Br: Large Airways, Small airways
Em: Acinus

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7
Q

Which volume is increased in obstructive lung disease?

A

Residual Volume

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8
Q

What happens to FEV1/FVC ratio in Obstructive vs Restrictive Diseases?

A

Obs: Dec FEV1 and FEV1/FVC ratio
Rest: Dec TLC but FEV1/FVC normal

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9
Q

At what point are symptoms appreciated in Emphysema?

A

1/3 of pulmonary parenchyma incapacitated

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10
Q

What is definition of emphysema?

A

Irreversible enlargement of airspaces distal to terminal bronchioles, no obvious fibrosis

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11
Q

How does smoking cause emphysema?

A

Stimulates release of elastase (macrophage elastase not inhibited by a1-AT
Cigarettes inhibit antiproteases

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12
Q

What is the genotype of a1-AT deficiency?

A

PiMM normal
PiMZ carrier
PiZZ affected

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13
Q

What are the different types of Emphysema?

A

Centriacinar
Panacinar
Paraseptal: Adjacent to areas of fibrosis, scarring or atelectaisis
Irregular: Associated with Scarring

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14
Q

What area of the lung is associated with panacinar Emp?

A

Basilar Portions of the lung

With Centriacinar emp.

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15
Q

What area of the lung is associated with Distal Acinar Emp?

A

Adjacent to Pleura and scarring

Associated with Spontaneous pneumothorax

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16
Q

What is the associated dangerous pathology associated with bullous Emp?

A

Pneumothorax

17
Q

What is the usual cause of death in Emphysema?

A

Resp acidosis and Coma
Right sided HF
Massive collapse of lungs 2/2 pneumothorax

18
Q

What is the Tx of Emp?

A

Bronchodilators, steroids, bullectomy, lung volume reduction surgery, lung transplant, subs of a1-AT

19
Q

What is Chronic Bronchitis?

A

Persistent cough with production of sputum for at least 3 months of the year for 2 consec years

Chron irritation by inhaled subs (smoking)(middle aged male smokers)

20
Q

What is the Morphologic Change seen in Chron Bronchitis?

A

Goblet Cell Metaplasia

Hypertrophy of submucosal glands of trachea and bronchi (reid index >.4)

21
Q

What are cancerous changes associated with CB?

A

Squamous metaplasia/dysplasia

22
Q

What Bacterial and Viral infections are associated with CB?

A

Bact: H. Influenzae, Strep Pneumo
Vir: Adenovirus, RSV

23
Q

What are the different types of asthma?

A

Atopic (Extrinsisc) Asthma

Non-Atopic Asthma

24
Q

Which Cytokines are released by TH2 Cells in Allergic asthma?

A

IL-4, IL-5

25
Q

What is the observed morphology in asthma?

A

Ovrdistended, hyperinflated lungs, some atelectaisis
Curchmann spirals
Charcot-Leyden Crystals

26
Q

What is Bronchiectaisis?

A

Permanent dilation of Bronchi and bronchioles caused by destruction of muscle and elastic supporting tissue.

27
Q

What are the 2 required causes of Bronchiectaisis?

A

Obstruction and Chronic Persistent infection

28
Q

What are the congenital conditions that can cause Bronchiectaisis?

A

Cystic Fibrosis

Immunodeficiency, and immotile cilia syndrome

29
Q

What infections can cause bronchiectasis?

A

S Aureus, Klebsiella, Post TB

30
Q

What is Kartagener Syndrome?

A

Loss of radial spokes in cilia. Decreased Motility
Leads to situs inversus, and Dextrocardia
Infertile males

31
Q

What are the clinical Features of Bronchiectaisis?

A

Chronic Productive Cough, hemoptysis, foul smelling sputum
Dyspnea and hypoxemia, pneumonia, lung abcess
Non-specific systemic symptoms

32
Q

What are the complications related to bronchiectasis?

A

Pulm HTN
Brain Abcess
Cor Pulmonale (rare)
Amyloidosis

Pulmonology (18 decks)

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