pulmonary Flashcards
pleural effusion
bacterial translocation from alveoli into pleural space
empyema
accumulation of pus in pleural space
methemeglobin
Fe2+ to Fe3+, unable to bind O2, only ppO2 is normal, causes cyanosis, decreased O2 content of arterial blood, decreased O2 delivery to tissues
CO poisoning
- headache
-dizziness - competitively binds to heme with higher affinity than O2
-carboxyhemoglobin
tuberculosis
- fever, night sweats, maybe pericarditis but no heart murmur
Legionella
- pneumonia with diarrhea
- grows on cysteine and iron agar - buffered charcoal yeast
- confusion, headache
- treat with macrolide/fluoroquinolones
- oxidase positive
diaphragm innervation
C3-C5, phrenic nerve
most common lung cancer
adenocarcinoma
pancoast tumor
at the superior sulcus. Can cause Horner syndrome
Most commonly injured in thoracic procedures
Thoracic duct (lymph nodes are on it, could cause pleural effusion, ex lymph node removal)
markers for small cell lung cancer
- chromogramin, synaptophysin, NCAM
- sheets of small blue cells with scant cytoplasm
- associated with smoking
- centrally located
- neuroendocrine tumor secreting ADH
theophylline intoxication
watch for seizures and tachyarrythmias
transudative effusion
- can be caused be heart failure
- increased hydrostatic pressure causes leakage of fluid from pulmonary capillaries
- fluid shoes low protein, low lactate dehydrogenase
exudative effusion
- inflammatory disruption of vascular permeability in lungs
- fluid shows high protein, high lactate
asthma on histology
charchot leyden crystals and kershman spirals
cancer associated with Lambert eaton
associated with small cell lung cancer
Pulmonary embolism ____ physiologic dead space
Increases
Pulmonary actinimycosis usually caused by
Aspiration pneumonia
sarcoidosis
hypercalcemia, non caseating granulomas, activated macrophages, hilar lymphadenopathy, erythema nodosum
BMPR2 gene
Familial pulmonary hypertension - leads to vascular smooth mm hypertrophy
Damage to alveolar capillary interface causing leakage of fluid and hyaline membrane
ARDS
Neonatal respiratory distress syndrome
Decreased pulmonary surfactant
Lecithin
Higher than sphingoyelin, made of phosphotidle choline
Oxygen in neonatal respiratory distress syndrome
Causes free radical damage, can cause blindness
Most common cause of cancer mortality
Lung cancer
Keratin pearls with intracellular bridges
Squamous cell carcinoma
Most common lung tumor in non smokers
Adenocarcinoma
pleural effusion
increased hydrostatic pressure and increased rate of fluid flow to the pleural space
croup inflammation of the
trachea - causes barking cough
Traumatic pneumothorax
Has crepitus
mesothelioma stains positive for
cytokeratin
Asthma, bronchiectasis, eosinophilia, elevated IgE
Allergic bronchopulmonary aspergillosis
shift of trachea to the right
left pneuothorax
cilia ends where in the lungs
terminal bronchioles
positive end expiratory pressure
PEEP helps treat ARDS by opening collapsed alveoli to reduce intrapulmonary shunting and increase functional residual capacity
leukotrienes
vasoconstriction, increased vascular permeability and bronchospasm
stimulates broncodilation via blockade of binding of acetylcholine to muscarinic receptors
ipratropium, mostly used in COPD
5 lipoxygenase inhibitor that reduces production of leukotrienes
Ziluteon
ARDS affects which cell type?
type 1 pneumocytes
COPD
increase airway resistance and increased lung compliance
Most common mutation if A1AT deficiency
PiZ
A1AT deficiency also affects the
Liver - protein accumulation in endoplasmic reticulum
Emphysema does not have
Mucus
IL 5
Eosinophilia
Curshman and Charcot Leyden
Asthma
exudative effusion light criteria
bacterial of > 6.0
restrictive lung disease
everything is down except for ratio
used for long term asthma control
inhaled corticosteroid - fluticasone
harsh systolic ejection murmur that disappears with episodes of cyanosis
tetralogy of fallot
findings in tetralogy of fallot
- Right ventricular outflow obstruction
- ventricular septal defect
septic shock
widespread vasodilation leading to decreased SVR, increased cardiac index, decreased CVP (r sided preload)
cardiogenic shock
decreased cardiac index, increased PCWP, increased CVP(r sided preload), increased SVR, decreased SV02
brionchiolitis obliterans
progressive scarring of the small airways - can happen in chronic lung transplant rejection. Reduced FEV1, normal FVC
failure of primitive foregut to separate from airway
esophageal atresia and tracheoesophageal fistula, can present with polyhydrammios due to inability to swallow fluid; significant drooling, coughing, cyanosis with feeds due to reflux/aspiration of breastmilk into lungs; x ray shows a stomach bubble
