pulm Flashcards
Kerley B lines
> fluid in the interlobular septa as seen in cardiogenic edema
cuffing in cardiogenic edema
> an increase in perivascular and peribronchial fluid
cause of “whiteout” lungs
> non-cardiogenic edema
absorptive atelectasis
> obstructive atelec. such as mucous
air distal to the obstruction is absorbed
mediastinum shifts TOWARD the collapse
compression atelectasis
> fluid in the pleural cavity increases pressure
> mediastinum shifts AWAY the collapse
contraction atelectasis
> fibrosis causes collapse
patchy atelectasis
> seen in newborns with hyaline membrane Dz
> collapse from lack of surf.
Charcot- Leyden crystals
> crystals from membranes of eosinophils in asthma
Curschman spirals
> spirals of shed epithelium in mucous plugs of smaller airways
seen in microscopic exam of sputum
asthma
can contain Charcot-Leyden crystals
Ghon complex
> primary TB
> subpluerual lesion near fissure between upper/lower lobes and enlarged caseous lymph nodes that drain the lesion
plexiform lesions
> vascular lesion
consists of intraluminal angiomatous tufts that form webs
diagnostic of pulmonary HTN
Churgg-Strauss
> allergic vasculitis
necrotizing granulomas
p-ANCA
wegener granulomatosis
> c-ANCA
large and serpinginous areas of necrosis
peripheral palisading of macrophages
bronchiectasis
> abnormal, permanent dilation of the bronchi filled with mucus and neutrophils
NFL and necrosis of bronchials walls
alveolar fibrosis
chronic bronchitis morphology
> hyperplasia of the bronchial submucosal glands
centrilobular emphysema
> proximal acinus
respiratory bronchioles
most severe in apical segments
paraseptal emphysema
> distal acinus
resp. bronchioles and terminal blind alveoli
most severe in upper half of lungs
panlobular emphysema
> entire acinus
associated with alpha 1 AT
most severe at lung bases
bronchopneumonia
> patchy consolidation
> aka “lobular pneumonia”
4 stages of lobar pneumonia
> congestive
red hepatization
gray hepatization
resolution
T/F firbrosis decreases the diffusion of oxygen and CO2
false. CO2 diffuses 20 times faster, so it remains (generally) unchanged
bronchopulmonary sequestration
> lung tissue without a normal connection to the airway system
appear as mass lesions in infants
cor pulmonales
> pulm. press. reaches 25% of the systemic
> normal is ~12%
plexogenic pulmonary arteriopathy
> primary pulmonary HTN or congenital heart Dz
> has L to R shunts
Goodpasture’s syndrome Sx
> glomerulonephritis
> necrotizing, hemorrhagic interstitial pneumonitis
chronic bronchitis criteria
> persistant cough
AND
sputum production for at least 3 months in 2 consecutive years
pneumoconioses
> non neoplastic lung Dz.
> reaction to inhaled mineral dusts
anthracosis
> type of coal worker’s pneumoconiosis
> carbon pigment in CT around lymphatics
if you are going to get coal worker lung, which type do you want? what type should you avoid?
> anthracosis
> complicated CWP
caplan’s syndrome
> RA + nodular lesions of pneumoconiosis
silicosis
> most prevalent chronic occupational Dz
slow progressing
NODULAR
fibrosing pneumoconiosis
asbestosis
> crystalline, hydrated silica that forms fibers
has two morphologic types with different features
commonly manifests with pleural plaques
amphiboles
> more malignant (mesotheloma)
straight, stiff fibers
insoluble
DIFFUSE INTERSITIAL PROCESS
asbestos synergy
there is a synergy between tobacco smoking and asbestos leading to BRONCHOGENIC carcinoma
asbestos bodies
> golden brown
fusiform or beaded rods
coated with iron containing protein (macrophage ferritin)
honeycomb lung
> distorted airspaces
> thick, fibrous walls
sarcoidosis
NONCASEATING granulomas
Schaumann’s bodies
> of sarcoidosis
laminated concretions made of
>calcium
>proteins
asteroid bodies
> stellate inclusions of sarcoidosis
> within giant cells
farmer’s lung
> actinomyces spores in hay
> hypersensitivity pneumonitis
pigeon breeder’s lung
> bird proteins
> hypersensitivity pneumonitis
hypersensitivity pneumonitis
> response to organic inhaled antigens
bronchiolitis obliterans
> chronic NFL after prologed effort to resolve pulmonary injury
bronchiolar repair/injury ==> filling of small airways (bronchioles) with inflammatory fibrous exudate (loose fibrous plugs)
KARTAGENER syndrome
what is wrong?
what are the clinical finds?
> primary ciliary dyskinesia >>> sinusistis >>> bronchitis >>> situs inversus >>> male infertility
singer’s nodule
benighn laryngeal polyp
> induced by chronic irritation
laryngeal papilloma
benign neoplasm on true vocal cords
> UNILATERAL in adults
> MULTIPLE in kids after HPV and can recur
nasopharyngeal carcinoma
EBV
> usually a squamous cell carcinoma,
> could also be adenocarcinoma
> malignant
bloody pleural effusion is usually from
bloody pleural effusion (serosanguinous)
> malignancy
> TB
> trauma
