Pulm Flashcards
What is defective in cystic fibrosis?
CFTR: cystic fibrosis transmembrane regulator
Delta F508 is most common mutation –> abnormal protein folding
Cause of spontaneous pneumothorax
Rupture of subpleural blebs (tall thin males)
COPD
Trachea deviates towards affected side
Tension pneumothorax
Air enters pleural space but cannot leave
Trachea deviates away from affected side
Usually due to trauma
Common causes of transudative effusion
CHF
Nephrotic syndrome
Common causes of exudative effusion
Malignancy
Pneumonia
Light’s criteria for exudate effusion
Plural protein/serum protein >.5
Pleural LDH/serum LDH >.6
Plural LDH > 2/3rd upper limits of normal
Mesothelioma
Pleural tumor from asbestos
Pleural thickening and pleural effusion (slow onset)
Pulmonary embolisms are caused by
a hypercoagulable state
Most commonly thrombi from DVT
Increased D-dimer can point towards a diagnosis of
DVT/PE
What leads to a fat embolism
Symptoms?
Long bone fracture
ARDS
Confusion
Petechiae
Sarcoidosis
Hilar lymphadenopathy, cough, erythema nodosum, uveitis, hypercalcemia, and high ACE levels
Hallmark: non-caseating granulomas
Accumulation of TH1 CD4 cells (IL-2, IFN gamma)
Which pulmonary cells are regenerative?
Type II pneumocytes
They also produce surfactant
What should be given to a preterm infant to reduce the risk of surfactant deficiency?
Corticosteroids
Highest resistance to flow
Lowest resistance to flow
Medium bronchi
Terminal bronchioles
Chronic bronchitis
Hypertrophy of mucus glands due to smoking
Blue bloaters
Anti-trypsin Deficiency
Panacinar emphysema due to destruction of elastin
Liver cirrhosis
Bronchiectasis
Large airways are dilated but obstructive disease
Due to chronic inflammation
Have hemoptysis and mucus production
Seen in Kartageners syndrome and ABPA
Low DLCO
Interstitial lung disease (fibrosis)
Emphysema
PE or pulm HTN
Silicosis
Involves macrophages (failed phagolysosome formation) Increased risk of TB
Air fluid level in lungs
Lung abscess
Usually caused by anaerobes (Bacteroides), staph aureus, or klebsiella
Small cell lung cancer
Neuroendocrine tumors
Paraneoplastic syndromes: ACTH, ADH, Lambert Eaton
Squamous cell carcinoma
Keratin pearls
Can produce PTH related protein
Adenocarcinoma
Most common cancer in female non smokers
Important mediator of idiopathic pulmonary fibrosis
TGF-beta released from pneumocytes
ARDS hallmark and treatment
Hyline membranes
Ventilation with positive end-expiratory pressure
Paraneoplastic syndromes of small lung cell carcinoma
ADH
ACTH
Eaton-lambert - antibodies against calcium receptors
Squamous cell carcinoma can produce what?
PTHrP –> hypercalcemia
