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Gen Path Test 2 > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Pneumonia

A

One of leading causes of death.

Bacterial, viral, fungal, parasitic etiology.

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2
Q

Bacterial Pneumonia Predisposing Factors:

A
  1. Loss of cough reflex
  2. Injury to cilia
  3. decreased phagocytosis
  4. pulmonary edema
  5. immunocompromised condition
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3
Q

Bacterial Pneumonia:
Cough, dyspnea, fever, chills, sputum production.
Two types =

A

Bronchopneumonia: patchy, begins around small bronchi in very young/old patients.

Lobar: entire lobe, 90% caused by S. pneumoniae in healthy adults

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4
Q

BP Stages of inflammation (lobar pneumonia?)

A
  1. Congestion
  2. Red hepatization
  3. Gray hepatization
  4. Resolution (organization)
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5
Q

Complications of BP

A

Empyema (purelent pleuritis), abscess, pericarditis, bacteremia

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6
Q

Atypical/interstitial Pneumonia:

highly variable, mild fever, headache, dry cough, myalgia

A

Etiology: Mycoplasma pneumoniae and viruses

Pathology: interstitial inflammation, mononuclear cells, congestion and hyalin membranes (diffuse alveolar damage)

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7
Q

Acute Respiratory distress Syndrome

Etiology: shock, infections, trauma, drugs overdose, irritants.

A

Fast serious condition with same histo features as IP.

Injury to endothelium and alveolar epi, leaky endothelials

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8
Q

Pulmonary Abscess:

cough, fever, purulent sputum

A

Pre Factors: bronchiectasis, aspiration, septic emboli, airway obstruction, dental sepsis

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9
Q

Pulmonary Abscess Course

A
  1. Scar
  2. Cavitate
  3. Progressively enlarges
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10
Q

TB Stats

A

Infects 1/3 of world population.
Most common infectious cause of death.
Cases been declining in US

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11
Q

TB Predisposing Factors

A

HIV, overcrowding, poor living conditions, immigrants

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12
Q

Myobacterium TB

Bacillus, aerobe, non motile, slow growing

A

Waxy coat = resists acid destaining (Acid Fast Bacillus)

Caseating granulomatous inflammation**

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13
Q

TB Pathogenesis

A

Acquired by inhalation.

Ghon lesion - site of early infection

Ghon complex - lung lesion + hilar lymph nodes

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14
Q

Cavity TB:

At _____ of lung.

May seed _____ airways, _____, or _____.

Direct extension to ______

What is typically seen?

A

Apex.

Large, lymph nodes, blood.

Pleura = effusion

Significant scarring

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15
Q

Latent TB:
________ of primary cases resolve.

May reactivate years later due to?

Reactivation induces?

What could it also do?

A

90-95%.

Immunosenescence, immunosuppression tx.

Type 4 hypersensitivity and tissue necrosis

May widely disseminate = Miliary TB (possible multi-organ involvement)

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16
Q

Miliary TB

May go to other lung, CNS, kidneys, adrenals, bones and marrow, liver, spleen

A

Spreading via lymphatics or blood = lymphohematogenous.

“Millet Seeds”

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17
Q

Granulomatous lung disease

A

TB is the classic.

Fungal infections like histoplasmosis.

Sarcoidosis

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18
Q

Lung Cancer

A

Leading Cause of cancer deaths.

RFs: cigarette smoking, asbestos, radon gas, nickle, chromates, pollutants, lung scar

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19
Q

Lung Cancer - Clinical

Cough, weight loss, chest pain, hemoptysis, dyspnea

A

Tumors may produce hormones = paraneoplastic.

ADH, ACTH, PTH, others

20
Q

Lung Cancer - Pathology

SCC = 
Adenocarcinoma =
Small Cell =
Large Cell = 
Bronchioloalveolar Carcinoma
Mesothelioma (asbestos, pleural malignancy)
Carcinoid
A

25-30%
30-35%
20-25%
10-15%

21
Q

Prognosis for Lung Cancer
5 year survival all types =
If localized when found =

A

16%

45%

22
Q

Pneumoconioses

A

Occupational/environmental causes.

Coal Workers = nodular/diffuse fibrosis with coal macules. Progressive.

Silicosis = most prevalent form

Asbestosis, bleomycin drugs

23
Q 
Hemoptysis:
Dyspnea:
Atelectasis:
Pneumothorax:
Empyeme:
A

Coughing up blood.
Difficulty breathing, perception of need breathe deeper/faster.
Collapse of lung volume.
Air in pleural space/cavity leads to collapse.
Suppuration in pleural cavity

24
Q

Pleural Effusion in pleural space

A

Transudate: low protein, caused by increased venous pressure.
Exudate: high protein fluid, w/ w/o inflammatory cells due to damage

25
Q

Pulmonary Edema

A

Accumulation of fluid first in interstitial tissue, then filling up distal air space.

Causes: increased CHF, hypoporteinemia, vascular damage

26
Q

Pulmonary Edema Complications

A

Inhibits normal oxygen exchange, predisposes to infection

27
Q

Pulmonary Thromboemboli

A

From deep veins of legs or pelvic, large emboli cause hemmorrhage/infarction.

Saddle embolus = very large emboli that lodge at the bifurcation of pulmonary arteries

28
Q

Pulmonary Thromboemboli Predisposing Factors

A

Chronic illness, prolonged bed rest, hypercoagulable state (Factor V Leiden), deep vein thromboses

29
Q

Obstructive Pulmonary Dz
Group of dz that results in _____ limitation or _____
Classic Disorders

A

airflow, obstruction.

Emphysema, chronic bronchitis, bronchiectasis, asthma.

Emphysema with chronic bronchitis = COPD

30
Q

Emphysema =
Chronic Bronchitis =
Asthma =

A

Alveolar wall destruction, overinflation.

Productive couch, airway inflammation.

Reversible obstruction (bronchial hyperresponsiveness) triggered by allergens, infections

31
Q

Emphysema:

Permanent _______ of the _____ small air spaces due to ______ of ________

A

Enlargement
distal small air spaces
destruction
alveolar septal walls

32
Q

Emphysema Clinical and pathogenesis

A

Dyspnea, cough, prolonged exhalation (pink puffers).

Imbalance between protease and anti-protease enzymes, smoking is major cause

33
Q

Centriacinar (emphysema)

A

Involves destruction of central portion of acini (Respiratory Bronchiole), usually upper lobes.

Most often related to smoking.

34
Q

Panacinar (emphysema)

A

Involves entire acinar unit from respiratory bronchioles to terminal alveoli, affects lower lobes usually.

Seen in patients with alpha1-antitrypsin deficiency

35
Q

Chronic Bronchitis:

Cough + Sputum production for _ consecutive months in _ consecutive years

May have:

A

3, 2.

Hypoxemia, cyanosis (blue bloaters)

36
Q

Chronic Bronchitis Pathogenesis and Pathology

A

Chronic irritation (smoking) and infections.

Increased mucus gland layer, chronic inflam, fibrosis and narrowing of airways, edema

37
Q

Predisposing factors for chronic bronchitis and emphysema

A

Cigarette Smoking!! = mucus gland hypertrophy, increase smooth muscle tone, inhibits cilia/phagocytosis, squamous metaplasia.

atmosphere pollutants, infections, genetic factors (CF, alpha1-AT deficiency)

38
Q

Bronchiecstasis

A

Chronic infection with permanent major airway dilation, secondary to obstruction, infection or both

39
Q

Bronchiecstasis clinical and complications

A

Severe cough, bloody mucoid expectoration, dyspnea.

Abscess, pneumonia, bronchopleural fistula, empyema

40
Q

Bronchiecstasis Predisposing factors

A

Obstructive tumors, foreign bodies, cystic fibrosis, other COPD, suppurative or necrotizing pneumonia

41
Q

Pathology of Bronchiecstasis

A

Dilated distal bronchi and bronchioles, chronic infection w/ inflammation and variable purulence

42
Q

Asthma:

Increased _____ and prominence of ________ in _______.

Affects ____ of adults and _____ of kids esp inner city

A

Irritability, smooth muscle, bronchi and bronchioles.

Leads to marked, reversible episodes of contraction and airway constriction.

5% of adults, 7-10% kids

43
Q

Asthma Clinically:

Atopic =

Non-atopic =

Either type can be triggered by emotional stress, exercise, cold Temps

A

Wheezing, long exhalation, hyperinflation of lungs

Allergic, extrinsive = Type I hypersensitivity (IgE), positive family history common.

Intrinsic = virus or air pollutants

44
Q

Asthma Pathology

A

Increased mucus glands, smooth muscle hypertrophy, inflammation with eosinophils!! and Th2 cells

45
Q

Asthma Pathogenesis

A

Antigen binds to surface of IgE on mast cells = histamine and leukotrienes

46
Q

Asthma Treatment

A

May subside spontaneously, inhaltion of bronchodilators (albuterol), controller medications (corticosteroids)

Gen Path Test 2 (4 decks)

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