Pathology of the lung I Flashcards
definition: atelectesis
incomplete expansion of lungs or collapse of previously inflated lung substance, usually reversible
definition: resorptive atelectasis
excessive secretions, mediastinal shift toward atelectic lung
what is the cause of resorptive atelectesis?
complete airway obstruction
definition: compression atelectesis
excessive air, fluid, blood, or tumor in pleural space, mediastinum shifts away from affected lung
definition: patchy atelectesis
loss of surfactant, RDS, postsurgical
definition: contraction atelectesis
fibrosis around lung
what are the four types of atelectesis?
resorption
compression
patchy
contraction
what are the primary causes of pulmonary congestion and edema?
hemodynamic disturbances (hydrodynamic or cardiogenic pulmonary edema)
edema caused by microvascular injury (direct increases in capillary permeability due to microvascular injury)
what is the most common cause of hemodynamic pulmonary edema?
increased hydrostatic pressure
what is the mechanism of edema caused by microvascular injury?
injury to capillaries of alveolar septa
COPD usually refers to what conditions?
COPD
chronic bronchitis
what are the spirometry value changes seen in obstructive disease?
decreased FEV1
normal (or increased) TLC and FVC
decreased FEV1 / FVC
what are the spirometry value changes seen in restrictive disease?
decreased TLC
decreased FVC
FEV1 / FVC normal
smoking stimulates the release of what significant compound from neutrophils in the lung? why is it significant?
elastase
macrophage elastase is NOT inhibited by a1AT
what are the four types of emphysema?
centriacinar
panacinar
paraseptal
irregular
centriacinar emphysema is mostly caused by what condition?
chronic bronchitis
what is affected most in centriacinar emphysema?
respiratory bronchioles
where is the greatest severity in centriacinar emphysema?
apical segments of upper lobes
panacinar emphysema is associated mostly with what condition?
a1AT deficiency
where is the greatest severity in panacinar emphysema?
basilar
paraseptal emphysema
enlargement with destruction of distal portion of acinus, usually worse in upper zones
where is the greatest severity in paraseptal emphysema?
adjacent to pleura, septae, lobule margins, scarring, fibrosis, atelectesis
paraseptal emphysema is associated with what condition?
spontaneous pneumothorax
what is bullous emphysema?
subpleural emphysematous spaces more than 1-2 cm in diameter
what are the features of death in emphysema?
respiratory acidosis and coma
right sided heart failure
massive collapse of lungs secondary to pneumothorax
what are the treatment options for emphysema?
bronchodilators
steroids
lung volume reduction surgery
lung transplantation
blue bloaters
chronic bronchitis
pink puffer
emphysema
cor pulmonale typically occurs more in patients with chronic bronchitis or emphysema?
chronic bronchitis
what are the features of chronic bronchitis microscopically?
- hypertrophy of submucosal glands of trachea and bronchi (Reid index)
- goblet cell metaplasia
what are the bacterial etiologies of chronic bronchitis?
H. influenza
Strep pneumo
what are the viral etiologies of chronic bronchitis?
adenovirus
respiratory syncitial virus
what is the status of elastic recoil in bronchitis? emphysema?
bronchitis - normal
emphysema - low
initial sensitization for type I hypersensitivity asthma is due to what cell type?
CD4+ cells of Th2 type
TH2 cells release what cytokines in response to type I hypersensitivity asthma?
IL4, IL-5
what are curschmann spirals?
whorls of shed epithelium
what are charcot-leyden crystals?
crystalloids made of eosinophilic proteins
definition: bronchiectasis
what is the cause?
permanent dilation of bronchi and bronchioles
caused by destruction of muscle and elastic supporting tissue, resulting from or associated chronic necrotizing infections - IRREVERSIBLE
what two conditions are required for bronchiestasis?
obstruction and chronic persistent infection
what are the general associations for bronchiestasis?
obstructive
congenital or hereditary conditions
necrotizing (suppurative) pneumonia
what is the hereditary pattern of kartegener syndrome?
AR
what is the mechanism of kartagener syndrome?
structural defect in cilia, decreased motility and loss of radial spokes and dynein arms
