Pulm 2.0 Flashcards
Lung CA
most common
Adenocarcinoma
Lung CA
Central, Necrosis and cavitation
Squamous cell carcinoma
Lung CA
Peripheral
Gynecomastia
Large Cell
Coin Lesion
hyaline cartilage, connective tissue, smooth muscle, fat
Hamartoma
What must you have to ddx sarcoidosis
lung biopsy w/ non-caseating granuloma
Baby is born with no surfactant and given o2 as rx. Complications?
o2 therapy in baby–> retinal damage–> blindness
likely mediated by VEGF
*Major cause of blindness in developed world
In V/Q what does v and q mean
v= ventilation
q= blood flow
Describe lung zone 1 pressures
apex
alveolar> arterial> venous
Describe zone 3 pressures
arterial> venous> alveolar
Describe lung zone 2 pressure
arterial> alveolar> venous
when airway pressure is 0 you are in a resting state. What is the intrapleural pressure
-5 cm H20
How can pleura pull air into the lung
resting pleural presure= -5
inspiration= -7.5
-7.5 creates a negative alveolar pressure that draws air into the lung
A lot of stuff causes allergic asthma, but rx vs receptor only works for these two things
LTC4, LTD4, LTE4
AcH
Do histamine antags help in asthma
No
Describe the irritation and changes smoking does to lungs
Normal: pseudostratified ciliated columnar cells
Smoking: columnar is replaced by squamous
What does osmium tetroxide do
Stains fat black
What stains hemosiderin macs
prussian blue shows iron
What strains platelets purple
write stain
Who has increased FEV1/FVC
restrictive disease
Who has decreased FEV1/FVC
obstructive disease
Why is systemic partial pressure o2 less than alveolar partial pressure
because bronchial deoxygenated blood drains into the oxygenated pulm vein
Where is there always a left shift in oxy curve
Lungs shift left
↓ H, 2,3 DPG, and Temp
What causes a right shift oxy heme curve
↑ H, 2,3- DPG, and temp
What can attract PMNs
Leukotriene B4 (and some precursor)
C5a
Il-8
What 3 cytokines cause systemic inflammation
Il-1, IL-6, TNF-a
What does bradykinin do
Vasodilation
Contracts smooth muscle
mediates pain
↑ Permeability
Where is epo made
peritubular cells of kidneys
What does platelet- activating factor do
It does a lot…
vasoconstriction bronchoconstriction platelet stimulation enhanced leukocyte adhesion chemotaxis phagocytosis degranulation
What makes ESR happen
high levels of freely circulating fibrinogen
What is SVC syndrome
a mass compresses the SVC and causes facial swelling and upper extremity issues
What does second hand smoke do to babies
low birth weight
asthma
middle ear syndrome
SIDS
What is characteristic of Primary TB
Ghon complex and ipsilateral hilar adenopathy
What causes tracheal deviation TOWARD the lesion
Lung Collapse - atelectasis
ex: bronchus obstruction–> obstructive atelectasis–> trachea PULLED in
What causes tracheal deviation away from lesion
Tension pneumothorax (air cannot exit) excess air/fluid PUSHES trachea
What is a pleural effusion
excess fluid in pleural layers
What is a pneumothorax
Air in pleural space
Meconium plug obstructing the intestine preventing the passage of stool
meconium ileus
Seen in CF
What part of the type 2 pneumocyte makes surfactant
lamellar bodies
what are the most common malignancy from asbestos
1- most common: bronchogenic carcinoma
2- mesothelioma
How do you measure the severity of bronchitis
reid index-measurement of mucus enlargement
ratio = mucus glands / (epithelial + mucus + ct)
normal is 40%
does not include thickness of cartilage
What causes TB caseous necrosis
macs, giant cells, and CD4 t lymph aggregate–> granulomatous caseous necrosis
WBC activation–> collateral tissue damage–> cavitary
Why does pancreatitis –> ARDS
pancreatitis has large amount of inflammatory cytokines and panc enzymes in circulation
PMNs invade lungs–> leaky alveoli and injury
pancreatitis is MAJOR risk factor for ARDS
what will small cell lung CA stain for
SCC has neuroendocrine differentiation
stains: Chromogranin, synaptophysin, enolase
What is hypersensitivity pneumonitis
inhalation of organic material
diffuse nodular infiltrates
What is responsible for the green color of puss
myeloperoxidase of PMNs
what does RA typically do to the lungs
tends to cause a idiopathic interstitial pneumonia like interstitial lung disease- restrictive
What is anergy
failure to generate a response with t cells
Why does it matter that ACTH and opioids are derived from the same thing
supports theory that stress and opioid axis are related
