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PATHOphys Exam 2 > Pulm 1 Shea > Flashcards

Pulm 1 Shea Flashcards

1
Q

What are the 4 diseases which compromise COPD?

A
  • Chronic Bronchitis
  • Emphysema
  • Bronchial Asthma
  • Bronchiectasis

(may coexist w/ one another)

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2
Q

A clinical term used for lung diseases characterized by chronic airway obstruction w/ increased resistance to air flow.

A

COPD

(chronic obstructive pulmonary disease)

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3
Q

What is the #1 bronchogenic carcinoma?

A

Squamous Cell Carcinoma

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4
Q

A chronic cough and production of sputum for a set time. What are the time parameters and which disease is this?

A
  • Chronic Bronchitis
  • Minimum of 3 months/year for at least 2 consecutive years
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5
Q

What causes 90% of cases of chronic bronchitis?

A
  • Smoking, it correlates w/ # of cigarettes (pack year)
  • Clinical sxs improve w/ cessation
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6
Q

What other 4 things play a role in the development or not of Chronic Bronchitis?

A
  • Good genetics may prevent people of smoke from getting COPD
  • Air polution
  • Exposure to toxic fumes
  • Pneumonias
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7
Q

Pathology of which disease?

  • Fibrous thickening of the walls of the bronchi and bronchiole
  • Their lumens are completely filled w/ thickened mucous
  • Hypertrophy of bronchial mucous glands
  • Increased # of goblet cells
  • Mucosa is infiltrated w/ which 3 things??
A
  • Chronic Bronchitis
  • Mucosa contains:
    • lymphocytes
    • macrophages
    • plamsa cells
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8
Q

Pathology of which disease?

  • Surface epithelium w/ time may show focal ulcerations or metaplasia of columnar epithelium into –> stratified squamous epithelium
A

Chronic Bronchitis

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9
Q

Which disease?

  • Increased mucous production causing prolonged coughing, expectoration of thick tenacious or purulent sputum and dyspnea
  • Hypoxia may be so pronounced during coughing that it causes cyanosis.
A

Chronic Bronchitis

(Blue Bloaters)

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10
Q
  • What is Cor Pulmonale?
  • Which disease predisposes a patient to developing this?
A
  • Right heart failure
  • Chronic Bronchitis can lead to CHF/right heart failure/Cor Pulmonale
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11
Q

Which disease can lead to pulmonary hypertension?

A

Chronic Bronchitis

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12
Q

Is the pulmonary vasculature involved in chronic bronchitis?

A

Yes, the pulm vasculature is affected by the peribronchial fibrosis which results in pulm HTN and Cor Pulmonale.

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13
Q

Enlargement of airspaces distal to the _____ bronchioles w/ destruction of alveolar walls.

A
  • Emphysema
  • Terminal bronchioles
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14
Q

Which disease is rare in “non-smokers” except in patients w/ a ____ deficiency of _____?

A
  • Emphysema
  • Genetic deficiency
  • Alpha 1 Antitrypsin
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15
Q

Pathology of which disease?

  • Irritants in smoke provoke an influx of inflammatory cells into alveoli
A

Emphysema

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16
Q

W/ Emphysema, what causes the alveolar walls to be destroyed, leading to enlargement of the alveolar spaces?

A
  • Leukocytes release proteolytic enzymes which causes destruction of the alveolar walls
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17
Q

W/ Emphysema, what accounts for the loss of elastin fibers in the alveolar walls?

A

Increased activity of leukocyte-derived elastases in the lungs

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18
Q

Pathology of which disease?

  • Grossly, lungs are enlarged and remain filled w/ air and DO NOT collapse
  • Lungs are whiter than normal, billowy, and touch in the chest midline
A

Emphysema

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19
Q

Subpleural air-filled spaces formed by rupture alveoli which can rupture into the pleural cavity causing a _____.

( a small collection of air between the lung and the outer surface of the lung (visceral pleura) usually found in the upper lobe of the lung. )

A
  • Bleb
  • causing a pneumothorax
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20
Q

Parenchymal air filled spaces greater than 1 cm in diameter

(Lung parenchyma is the portion of the lung involved in gas transfer - the alveoli, alveolar ducts and respiratory bronchioles. )

A

Bullae

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21
Q

Which disease?

  • No bronchial obstruction
  • Compensatory tachypnea, why?
  • Over-expanded chest
  • “Barrel-Shaped” chest
  • What position are they in and why?
A

Emphysema

  • Tachypneic bc/ of reduced respiratory surface
  • Hunched forward to engage auxiliary respiratory muscles
22
Q

Are emphysema patients hyperventilating or hypoventilating?

A

Hyperventilating, they oxygenate the blood adequately, so they are not blue and have no brain anoxia.

“Pink Puffers”

23
Q

What are the 6 chest x-ray findings of a pt w/ emphysema?

A
  • Clear lung fields
  • Over inflated lungs
  • Barrel Shaped chest
  • Increased interstitial markings
  • Flattened diaphragm
  • Long AP diameter
24
Q
  • Some dyspnea
  • Terrible cough
  • Mucopurulent sputum
  • Cyanosis
  • Pulm HTN
  • Peripheral edema
  • Densities on radiograph
A

Bronchitis

25
Q
  • Bad dyspnea
  • Mild cough
  • +/- sputum
  • Mucoid sputum if any
  • No cyanosis
  • No pulm HTN
  • No peripheral edema
  • Overinflation of radiograph
A

Emphysema

26
Q

Which of the COPD diseases have (Hypertrophy and Hyperplasia)?

A
  • Chronic Bronchitis
  • Bronchial Asthma
27
Q
  • Which 2 of the 4 COPD diseases have the most mucous production? (overabundance of mucus in the lumen)
  • And which of the 2 has more mucus than the other?
A
  • Chronic Bronchitis (way more mucus)
  • Bronchial Asthma
28
Q

Which of the COPD diseases have lungs described as pink and billowy which touch midline?

A
  • Emphysema
  • Bronchial Asthma
29
Q

Increased responsiveness of the bronchial tree to variety of stimuli

A

Bronchial Asthma

30
Q

3 sxs of bronchial asthma

A
  • wheezing during expiration
  • cough
  • dyspnea
31
Q

Age and sex most affected by Bronchial Asthma

A
  • 50% of cases develop in childhood
  • Males 2X more
32
Q

Mucus containing whorls of shed epithelial cells

A

Curschmann Spirals

(Bronchial Asthma)

33
Q

A patient w/ which disease needs to worry about getting an acute PNA?

A

Bronchiectasis

34
Q

A permanent dilatation of the bronchi, which is the most common complication of chronic bronchitis

A

Bronchiectasis

35
Q

Which disease?

  • Abnormally dilated bronchi
  • Bronchioles filled w/ mucopurulent material which stagnates (cannot be cleared by coughing)
  • Infected occurs due to stagnation, spreads to adjacent alveoli, recurrent PNAs are common
  • Hematogenic spread of infection to other organs
  • Adhesions between lobes may occur
A

Bronchiectasis

36
Q
  • While auscultating lung fields of a 45 yr old patient w/ bronchiectasis, the patient has an exam finding significant for their diagnosis.
  • What is this exam finding which is due to the mucous sitting stagnant in the bronchiole tubes?
A

Halitosis (bad breath)

37
Q

Inflammation of lung that occurs in 2 major forms

A

Pneumonia

  • Alveolar PNA
  • Intersitial PNA
38
Q

Inflammation of the lung marked by intra-alveolar inflammation

A

Alveolar PNA

39
Q

What are the 2 types of Alveolar PNA?

A
  • Bronchopneumonia (patchy)
  • Lobar pneumonia (diffuse - confluence)
40
Q
A
41
Q

Inflammation of the lung which primarily involved the alveolar septae

A

Interstitial pneumonia

42
Q

Which PNA is bacterial?

A

Alveolar PNA

43
Q

Which PNA is viral?

A

Interstitial PNA

44
Q

Which type of PNA has PMN leukocytes inside the alveolus?

A

Alveolar (bacterial) PNA

45
Q

Which type of PNA has a layer of fibrin along the alveolus?

A

Intersitial (viral) PNA

46
Q

2nd largest protein in the body?

A

Fibrinogen

47
Q

Which type of PNA has no neutrophils or bacteria?

A

Intersitial (viral) PNA

48
Q

Which PNA can be classified as either focal or diffuse?

A

Alveolar PNA (bacterial)

49
Q

Which PNA may be limited to the alveoli or may involve the alveoli and the bronchi?

A

Alveolar PNA

50
Q
A

PATHOphys Exam 2 (22 decks)

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