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Path > Pulm Path > Flashcards

Pulm Path Flashcards

1
Q

MethHb

Etiology

A

Fe2+ ferrous to ferric 3+

  • drugs: Dapsone, Nitrites
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2
Q

CO poisoning

Etiology:
CF:
Tx:

A

Etiology: incomplete hydrocarbon combustion. caused by smoke inhalation

Pathogenesis: competitively bind iron present in heme proteins. The gas binds to heme iron with a much higher affinity than oxygen, forming carboxyhemoglobin

CF: nonspecific findings ranging from headache and dizziness to convulsions and respiratory arrest depending on concentration and exposure

Tx: high-flow or hyperbaric oxygen therapy

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3
Q

NADH methemoglobin reductase def

A

Cong methHbemia

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4
Q

Hb -bound- 2,3 DPG

A

N

Dec O2 affinity for Hb : more O2 release in peripheral

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5
Q

Hb w def binding to 2,3DPG

A

HbF

Inc O2 affinity than adults : more Ow extraction from mothers blood

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6
Q

Pancoast tumor

A

Causes thoracic outlet syndrome + Horner syndrome

Mets to : Brain, bone, adrenals

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7
Q

Absent breath sounds + hypotension + tachycardia + hypoxemia + hyperresonance seen in?

A

Tension pneumothorax

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8
Q

Where is thoracocentesis performed?

A

Bw 6th - 8th rib along midclavicular
8th - 10th rib along Midaxillary
10th - 12th along paravertebral

  • 9-10th rib: liver injury
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9
Q

Where is chest tube placed?

A

4th or 5th ICS in ant or midaxillary line

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10
Q

Excessive alveolar elastin degradation seen in?

A

Alpha 1 AT def

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11
Q

Deletion of phenylalanine @ AA position F508 seen in?

A

Causes improper folding of CFTR in CF

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12
Q

Lung transplant rejection-

Hyperacute:

Acute:

Chronic:

A

Hyperacute:

  • min to hours
  • preformed Abx to ABO or HLA
  • neutrophils, necrosis. White graft.

Acute:

  • within 6 m
  • CMI to HLA
  • lymphocytes

Chronic:

  • months to years
  • CMI aro HLA
  • inflammation w granulation tissue
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13
Q

Ranke complex

A

Calcified lower lobe + I/L hilar LN

Seen in Tb

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14
Q

Failure of dyenin arm seen in.

A

1° ciliary dyskinesia: Kartagener syndrome

Dyenin (f): contain ATPase to slide microtubules, producing ciliary movement

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15
Q

Acute CHERRY RED epiglottis in children?

A

H.inf

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16
Q

Epitheloid histiocytes + langhans giant cells seen in?

A

Active Tb

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17
Q

Pathogenesis of asthma

A
  1. Initial exp/ sensitization phase:
    - allergen - Th2 mediated IL5 release - eosinophils. IL4+13 - IgE production - mast cell priming
  2. Repeat exposure:
    Mast cells release histamine + leukotriene - vasodilation + bronchoconstriction + endoth damage — leaky eosinophils: major basic protein which activates neutrophils + alveolar macrophages — further inflammation
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18
Q

Phagolysosome maturation blocked in?

A

Tb

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19
Q

Central collection of epitheloid macrophages w abundant oink cytoplasm seen in?

A

Sarcoidosis

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20
Q

PFT changes in aging

A

Inc RV
Dec ERV, IRV, VC
N TLC, FRC

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21
Q

Alveolar capillary has exchange values

A

PAO2 : 150 - 105 - 40

PCO2 : 0 - 40 - 45

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22
Q

Inc in dead space ventilation seen w?

A

Pulm emboli

23
Q

Rapid shallow breathing index?

A

RSBI = RR / TV

  • used in the weaning of mechanical ventilation on ICU

Pts on mech ventilation - weak reso muscles: Low TV : Inc RR to maintain minute ventilation

Low RSBI - high TV - less recurrence of resp failure once off ventilator

24
Q

Intercellular bridges on Mx seen in?

A

Sq cell lung ca

+ keratin pearls

25
Q

Small blue cells w scant cytoplasm n granular chromatin on Mx seen in?

A

Small cell lung ca

  • salt n pepper pattern
26
Q

Vascular incpvasion + irreg glandular structures in Mx seen in?

A

Adenocarcinoma

27
Q

Epithelial histiocytes + necrotizing arthritis seen in?

A

Granulomatous w polyangitis

28
Q

Honeycomb pattern w cystic spaces lined by bronchial epith seen in?

A

Idiopathic Pulmonary Fibrosis

29
Q

BMPR2 gene mutation seen in?

A

Idiopathic pulmonary HTN

30
Q

Work of breathing in COPD vs RLD

A

COPD: inc air resistance , dec resp freq

RLD: inc elastic resistance, including resp freq

31
Q

PFT in COPD

A

Inc RV, FRC, TLC

Dec IRV, ERV, IC, VC

32
Q

Bitter almond breath seen w?

A

Cyanide poisoning

  • N O2 sat
33
Q

B/L globus pallidus lesion on MRI w Inhalation

A

Colourless, odourless Carbon Monoxide poisoning

L shift O2-Hb curve

34
Q

Microbe causing mediastinitis

A

Histoplasma

35
Q

Blunting of CVA on CXR seen in?

A

Pleural effusion

36
Q

Acid-base changes in emphysema

A

Chronic CO2 retention - Resp acidosis w metabolic compensation + hypoxemia

37
Q

Inc RV/TLC ratio seen in?

A

COPD

38
Q

MC complication of SVC syndrome

A

Inc intracranial P

39
Q

MCC large hilar mass w/ cavitation

A

Sq cell carcinoma

40
Q

Hypercalcemia seen s/ which lung ca?

A

Sq cell

PTHrP

41
Q

Hypercalcemia w inc ACE seen w ?

A

Sarcoidosis

42
Q

MC lung cancer

A

Adenocarcinoma

  • hazy pneumonia ~ infiltrates
  • hypertrophic osteoarthropathy (clubbing)
43
Q

MCC b/l wheezing w flushing and diarrhea?

A

Bronchial carcinoid syndrome

  • inc 5HIA
  • chromogranin, synaptoohysin +ve rosettes
  • TR, RHF, B3 def
  • Tx: Octreotide (SE: gall stones by CCK inhib)
44
Q

Dyspnea, wt loss, night sweats, joint pain seen w?

A

Coccidioides

  • immunocomromised
  • southwest US

Mx: sphere much larger than RBC

45
Q

Meds causing deactivation of Tb?

A

TNF inhibitors

Etanacerpt (Tx RA)

46
Q

Meds causing pulmonary fibrosis

A
  1. Bleomycin

2. Methotrexate

47
Q

2° Tb Mx

A

Caseating granulomatous w Langhans giant cells

  • 1° Tb: Ghon complex (mid/ lower lobes)
48
Q

How to diff bw transudative vs exudative fluid?

A

Light criteria

Pleural fluid/ serum protein and LDH

  • dec in transudative (HF, cirrhosis, nephrotic syndrome)
  • inc in exudative (inflamm.)
    — inflamm also has low Gluc since leukocytes metab gluc
49
Q

Lung cavity w inc air-fluid levels on CXR seen w?

A

Lung abscess

50
Q

Aspiration of gastric acid seen in?

A

Chemical pneumonitis

  • presents hours after
  • nonproductive cough
  • hypoxia
51
Q

Aspiration pneumonia vs aspiration pneumonitis

A

Asp pneumonia :

  • cavitation + air-fluid levels on CXR.
  • days after asp
  • productive, foul smelling sputum
  • lung abscess
  • Tx: Clindamycin + B-lactam and B-lactamase inhib

Asp pneumonitis:

  • chemical pneumonitis
  • presents hours after
  • nonproductive cough
  • hypoxia
52
Q

Dec in which lipung volume is seen in both COPD + RLD ?

A

Dec VC, dec IRV, dec TV

53
Q

air trapping and hyperinflation seen in?

A

COPD

  • inc LV & RV/TLC

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