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Year 2 Respiratory > Pathology of the lung I > Flashcards

Pathology of the lung I Flashcards

1
Q

definition: atelectesis

A

incomplete expansion of lungs or collapse of previously inflated lung substance, usually reversible

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2
Q

definition: resorptive atelectasis

A

excessive secretions, mediastinal shift toward atelectic lung

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3
Q

what is the cause of resorptive atelectesis?

A

complete airway obstruction

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4
Q

definition: compression atelectesis

A

excessive air, fluid, blood, or tumor in pleural space, mediastinum shifts away from affected lung

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5
Q

definition: patchy atelectesis

A

loss of surfactant, RDS, postsurgical

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6
Q

definition: contraction atelectesis

A

fibrosis around lung

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7
Q

what are the four types of atelectesis?

A

resorption
compression
patchy
contraction

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8
Q

what are the primary causes of pulmonary congestion and edema?

A

hemodynamic disturbances (hydrodynamic or cardiogenic pulmonary edema)

edema caused by microvascular injury (direct increases in capillary permeability due to microvascular injury)

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9
Q

what is the most common cause of hemodynamic pulmonary edema?

A

increased hydrostatic pressure

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10
Q

what is the mechanism of edema caused by microvascular injury?

A

injury to capillaries of alveolar septa

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11
Q

COPD usually refers to what conditions?

A

COPD

chronic bronchitis

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12
Q

what are the spirometry value changes seen in obstructive disease?

A

decreased FEV1
normal (or increased) TLC and FVC
decreased FEV1 / FVC

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13
Q

what are the spirometry value changes seen in restrictive disease?

A

decreased TLC
decreased FVC
FEV1 / FVC normal

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14
Q

smoking stimulates the release of what significant compound from neutrophils in the lung? why is it significant?

A

elastase

macrophage elastase is NOT inhibited by a1AT

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15
Q

what are the four types of emphysema?

A

centriacinar
panacinar
paraseptal
irregular

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16
Q

centriacinar emphysema is mostly caused by what condition?

A

chronic bronchitis

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17
Q

what is affected most in centriacinar emphysema?

A

respiratory bronchioles

18
Q

where is the greatest severity in centriacinar emphysema?

A

apical segments of upper lobes

19
Q

panacinar emphysema is associated mostly with what condition?

A

a1AT deficiency

20
Q

where is the greatest severity in panacinar emphysema?

A

basilar

21
Q

paraseptal emphysema

A

enlargement with destruction of distal portion of acinus, usually worse in upper zones

22
Q

where is the greatest severity in paraseptal emphysema?

A

adjacent to pleura, septae, lobule margins, scarring, fibrosis, atelectesis

23
Q

paraseptal emphysema is associated with what condition?

A

spontaneous pneumothorax

24
Q

what is bullous emphysema?

A

subpleural emphysematous spaces more than 1-2 cm in diameter

25
Q

what are the features of death in emphysema?

A

respiratory acidosis and coma
right sided heart failure
massive collapse of lungs secondary to pneumothorax

26
Q

what are the treatment options for emphysema?

A

bronchodilators
steroids
lung volume reduction surgery
lung transplantation

27
Q

blue bloaters

A

chronic bronchitis

28
Q

pink puffer

A

emphysema

29
Q

cor pulmonale typically occurs more in patients with chronic bronchitis or emphysema?

A

chronic bronchitis

30
Q

what are the features of chronic bronchitis microscopically?

A
  1. hypertrophy of submucosal glands of trachea and bronchi (Reid index)
  2. goblet cell metaplasia
31
Q

what are the bacterial etiologies of chronic bronchitis?

A

H. influenza

Strep pneumo

32
Q

what are the viral etiologies of chronic bronchitis?

A

adenovirus

respiratory syncitial virus

33
Q

what is the status of elastic recoil in bronchitis? emphysema?

A

bronchitis - normal

emphysema - low

34
Q

initial sensitization for type I hypersensitivity asthma is due to what cell type?

A

CD4+ cells of Th2 type

35
Q

TH2 cells release what cytokines in response to type I hypersensitivity asthma?

A

IL4, IL-5

36
Q

what are curschmann spirals?

A

whorls of shed epithelium

37
Q

what are charcot-leyden crystals?

A

crystalloids made of eosinophilic proteins

38
Q

definition: bronchiectasis

what is the cause?

A

permanent dilation of bronchi and bronchioles

caused by destruction of muscle and elastic supporting tissue, resulting from or associated chronic necrotizing infections - IRREVERSIBLE

39
Q

what two conditions are required for bronchiestasis?

A

obstruction and chronic persistent infection

40
Q

what are the general associations for bronchiestasis?

A

obstructive
congenital or hereditary conditions
necrotizing (suppurative) pneumonia

41
Q

what is the hereditary pattern of kartegener syndrome?

A

AR

42
Q

what is the mechanism of kartagener syndrome?

A

structural defect in cilia, decreased motility and loss of radial spokes and dynein arms

Year 2 Respiratory (34 decks)

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