Pathology of the lung I

Question 1

definition: atelectesis

Answer 1

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

Question 2

definition: resorptive atelectasis

Answer 2

excessive secretions, mediastinal shift toward atelectic lung

Question 3

what is the cause of resorptive atelectesis?

Answer 3

complete airway obstruction

Question 4

definition: compression atelectesis

Answer 4

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

Question 5

definition: patchy atelectesis

Answer 5

loss of surfactant, RDS, postsurgical

Question 6

definition: contraction atelectesis

Answer 6

fibrosis around lung

Question 7

what are the four types of atelectesis?

Answer 7

resorption
compression
patchy
contraction

Question 8

what are the primary causes of pulmonary congestion and edema?

Answer 8

hemodynamic disturbances (hydrodynamic or cardiogenic pulmonary edema)

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

Question 9

what is the most common cause of hemodynamic pulmonary edema?

Answer 9

increased hydrostatic pressure

Question 10

what is the mechanism of edema caused by microvascular injury?

Answer 10

injury to capillaries of alveolar septa

Question 11

COPD usually refers to what conditions?

Answer 11

COPD

chronic bronchitis

Question 12

what are the spirometry value changes seen in obstructive disease?

Answer 12

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

Question 13

what are the spirometry value changes seen in restrictive disease?

Answer 13

decreased TLC
decreased FVC
FEV1 / FVC normal

Question 14

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

Answer 14

elastase

macrophage elastase is NOT inhibited by a1AT

Question 15

what are the four types of emphysema?

Answer 15

centriacinar
panacinar
paraseptal
irregular

Question 16

centriacinar emphysema is mostly caused by what condition?

Answer 16

chronic bronchitis

Question 17

what is affected most in centriacinar emphysema?

Answer 17

respiratory bronchioles

Question 18

where is the greatest severity in centriacinar emphysema?

Answer 18

apical segments of upper lobes

Question 19

panacinar emphysema is associated mostly with what condition?

Answer 19

a1AT deficiency

Question 20

where is the greatest severity in panacinar emphysema?

Answer 20

basilar

Question 21

paraseptal emphysema

Answer 21

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

Question 22

where is the greatest severity in paraseptal emphysema?

Answer 22

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

Question 23

paraseptal emphysema is associated with what condition?

Answer 23

spontaneous pneumothorax

Question 24

what is bullous emphysema?

Answer 24

subpleural emphysematous spaces more than 1-2 cm in diameter

Question 25

what are the features of death in emphysema?

Answer 25

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

Question 26

what are the treatment options for emphysema?

Answer 26

bronchodilators steroids lung volume reduction surgery lung transplantation

Question 27

blue bloaters

Answer 27

chronic bronchitis

Question 28

pink puffer

Answer 28

emphysema

Question 29

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

Answer 29

chronic bronchitis

Question 30

what are the features of chronic bronchitis microscopically?

Answer 30

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

Question 31

what are the bacterial etiologies of chronic bronchitis?

Answer 31

H. influenza | Strep pneumo

Question 32

what are the viral etiologies of chronic bronchitis?

Answer 32

adenovirus | respiratory syncitial virus

Question 33

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

Answer 33

bronchitis - normal | emphysema - low

Question 34

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

Answer 34

CD4+ cells of Th2 type

Question 35

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

Answer 35

IL4, IL-5

Question 36

what are curschmann spirals?

Answer 36

whorls of shed epithelium

Question 37

what are charcot-leyden crystals?

Answer 37

crystalloids made of eosinophilic proteins

Question 38

definition: bronchiectasis what is the cause?

Answer 38

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

Question 39

what two conditions are required for bronchiestasis?

Answer 39

obstruction and chronic persistent infection

Question 40

what are the general associations for bronchiestasis?

Answer 40

obstructive congenital or hereditary conditions necrotizing (suppurative) pneumonia

Question 41

what is the hereditary pattern of kartegener syndrome?

Answer 41

AR

Question 42

what is the mechanism of kartagener syndrome?

Answer 42

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