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MHD Pulm Heme Block > Pulm Path II > Flashcards

Pulm Path II Flashcards

1
Q

Causes of Obstructive airway disease

A
  • Emphysema
  • Chronic bronchitis
  • Bronchiectasis
  • Asthma
  • Tumor
  • Foreign body
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2
Q

Causes of Restrictive airway disease

A
  • Neuromuscular
  • Interstitial/Infiltrative diseases
  • Chest wall disorders
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3
Q

How is asthma defined?

A

-Intermittent and reversible airway destruction

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4
Q

Other features of asthma

A
  • inc. responsiveness of tracheobronchial tree to various stimuli
  • chronic bronchial inflammation with eosinophils
  • bronchial smooth muscle hypertrophy hyper reactivity
  • inc. mucus production
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5
Q

Clinical presentation of asthma

A

-wheezing, breathlessness, chest tightness, cough

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6
Q

Factors for Atopic Asthma

A
  • Type 1 hypersensitivity reaction with IgE
  • begins in early childhood triggered by env. allergens
  • Tests: skin reaction to allergen
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7
Q

Factors for drug induced asthma

A
  • several drugs inc. aspirin
  • patients with recurrent rhinitis and nasal polyps
  • drugs might also induce skin reaction
  • chromosome 5q has several susceptibility genes (inc. IL 13 genetic polymorphisms)
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8
Q

Factors for occupational asthma

A
  • Asthma develops after repeated exposure to inciting agent
  • CD 14 abnormality
  • ADAM 33 20q is a member of metalloproteinase family with polymorphism accelerating bronchial smooth muscle proliferation
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9
Q

What is status asthmaticus?

A

Hyper inflated lungs

  • prolonged bout of asthma lasting for days responding poorly to treatment
  • worst outcome of asthma
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10
Q

Histology for asthma

A

-Curschmann spirals (mucus plugs)

Charcot-Leyden crystals (eosinophil derived crystals)

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11
Q

Clinical definition for Chronic Bronchitis

A

Persistent productive cough for at least three consecutive months in at least two consecutive years

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12
Q

Epidemiology for Chronic Bronchitis

A
  • smokers
  • urban dwellers, smog ridden cities
  • most common in middle aged men
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13
Q

Pathology of Chronic Bronchitis

A
  • Hypertrophy of mucus secreting glands
  • Goblet cell metaplasia
  • Inflammation
  • Fibrosis
  • May lead to atypical metaplasia/dysplasia of resp. epithelium
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14
Q

What is Reid Index for Chronic Bronchitis?

A

measures the gland to wall ratio (normally glands are 40% of wall thickness as measured from epithelial basement membrane to cartilage)

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15
Q

Complications for Chronic Bronchitis

A
  • Cor pulmonale
  • Infections
  • Bronchogenic carcinoma
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16
Q

What is emphysema?

A

Destruction of walls of airspaces distal to terminal bronchioles, leading to permanent abnormal enlargement of air spaces

17
Q

Types of emphysema

A
  • centriacinar (centrilobular)
  • panacinar (pan lobular)
  • Distal acinar (paraseptal)
  • Irregular
18
Q

Characteristics of centriacinar emphysema

A
  • resp. bronchioles
  • upper lobes
  • male smokers
  • coal workers pneumoconiosis
  • often associated with chronic bronchitis
19
Q

Characteristics of pan lobular emphysema

A
  • lower lobes
  • alpha 1 -antitrypsin deficiency
  • whole acinus
20
Q

Characteristics of Distal acinar emphysema

A
  • distal acinus
  • along pleura and lobular septa
  • adjacent to areas of fibrosis, scarring, atelectasis
  • can form bullae and lead to spontaneous pneumothorax in young adults
21
Q

Characteristics of irregular emphysema

A
  • acini irregularly involved
  • associated with scarring/healed inflammatory lesions
  • mostly asymptomatic
22
Q

Pathogenesis of Emphysema

A
  • mild chronic inflammation

- overproduction of protease in relation to antiprotease

23
Q

Alpha-1 Antitrypsin deficiency Characteristics

A

expressed codominantly on Pi locus of chromosome 14

  • normal is PiMM
  • worst form is PiZZ
24
Q

What is Bronchiectasis?

A

Permanent dilatation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue caused by chronic necrotizing inflammation

25
Q

Etiology of Bronchiectasis

A
  • Obstruction
  • Infection
  • Congenital/Hereditary (cystic fibrosis, kartagener’s syndrome, Immunodeficient states)
  • Other (Rheumatoid arthritis, lupus
26
Q

Cystic Fibrosis

A
  • severe bronchiectasis
  • defect in CFTR on chromosome 7 (delta F508) leading to accumulation of viscous secretions obstructing airways and infections
27
Q

Kartagener syndrome

A
  • Sinusitis, bronchiectasis, situs inversus, infertility
  • caused by primary ciliary dyskinesia
  • autosomal recessive with variable penetrance
  • absence or shortening of dynein arms
28
Q

Complications of Bronchiectasis

A
  • Resp. insufficiency
  • cor pulmonale
  • brain abscesses
  • amyloidosis

MHD Pulm Heme Block (11 decks)

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