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Pulmonary: Atelectasis + Obstructive Flashcards

1
Q

What is atelectasis

A

Collapse of airway spaces

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2
Q

What is resorption atelectasis

A

Occlusion of a bronchus

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3
Q

What is compression atelectasis

A

Due to a mass or bleeding

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4
Q

What is contraction atelectasis due to

A

Scarring in the lung like silicosis

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5
Q

What is obstructive lung disease?

A

Limitation of airflow due to partial or complete obstruction

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6
Q

Lung volumes in obstructive?

What is the problem?

A

Normal

Hard to get air out (FEV1 done)

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7
Q

What forms of obstructive are reversible?

A

Just asthma

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8
Q

What is asthma?

A

Episodic reversible bonrchospasm from stimuli with underlying chronic inflammatory state

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9
Q

Asthma on histo?

A

Inflammatory cells

Eosinophils

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10
Q

Symptoms of asthma?

A
  1. Episodic dyspena
  2. Chest tightnesss
  3. Cough
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11
Q

Extrinsic asthma initiated by what?

Timing in life

A

Type 1 hypersenstivity

Early in life (kids)

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12
Q

Asthma Ig?

Cells (2)

A

IgE

Mast and Eosinophils

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13
Q

Atopic asthma?

A

Kids with red rash from hay fever

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14
Q

Occupational asthma?

A

Something from work place

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15
Q

Allergic bronchopulmonary asthma is due to what?

A

Aspergillus growing in airways

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16
Q

Intrinsic asthma is triggered by what?

When in life?

A

Non-immune triggers like asthma, cold exposure, exercise

Later in life

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17
Q

Main cells in all asthmas? 2

A
  1. Eosinophils

2. Th2 lymphocytes

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18
Q

Substances involved in early phase of asthma? (5)

A
  1. Leukotrienes
  2. Prostglandings
  3. Platelet-activating factor
  4. Histamine
  5. Mast cell tryptase
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19
Q

Substances involved in late phase of asthma? (5)

A
  1. WBC chemotactic factors
  2. Leukotreine B
  3. IL-4 and IL-5
  4. Platelet activating factor
  5. Tumor necrosis factor
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20
Q

Morpho changes

A
  1. Mucus plugs (obstructive
  2. Edema
  3. Hyperemia
  4. Goblet cells increase
  5. Hypertrophy of bronchial muscle
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21
Q

What is hyperemia

A

Dilated vessels that give tissues a red color

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22
Q

COPD affects what % of US population

Reversible or irreversible?

A

10%

Irreversible

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23
Q

Two forms of COPD

Which is more common?

A

Emphysema
Chronic bronchitis

Combination of the two

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24
Q

Mechanism of emphysema

A

Alveolar sacs dilate and lose elastic recoil

25
What is the change in the lung in emphysema?
The walls are destroyed
26
How are chronic bronchitis and emphysema
1. Emphysema is defined by morphologic changes | 2. Emphysema Restricted to the acini
27
Emphysema is more common in which sex? | Which form especially?
Men Centriacinar
28
Emphysema has a clear association with what two factors?
1. Smoking | 2. Alpha-1-antitrypsin deficiency
29
Two imbalances in emphysema and their effect
1. Protease-antiprotease imbalance: ( Destruction of elastic fibers --> Permanent dilation of air sacs (Smoking & alpha-1-AT deficiency) 2. Oxidant-antioxidant imbalance: Oxidative damage --> Tissue destruction (Smoking)
30
First symptom of emphysema | Speed of disease
Dyspena | Slow
31
``` PFT's of emphysema show what? FEV1? FVC? FEV1-FVC ratio O2 levels ```
FEV1 down FVC normal FEV1/FVC down O2 normal
32
Pure emphysema individuals are described how? | Why?
Pink puffers Barrel chest Exhale against pursed lips (Back pressure against) Thin
33
Chronic bronchitis patients are described how? | Why?
Blue bloaters Overweight Hypoxic/Cyanosis
34
What do emphysema patients gradually acquire? (End-Stage) | Why?
Pulmonary hypertension Loss of capillary surface --> Increases resistance --> Pulmonary HTN
35
Centroacinar emphysema Locations spared? Upper or lower lobes Associated with what?
Distal parts of acini Upper lobes Cigarette smoke
36
Panacinar Location Upper or lower Associated with what?
All of the acini Lower lung Alpha-1-antitrypsin
37
Normal alpha-1-AT genotype? Bad one? What else happens with bad one?
MM ZZ Liver disease/Cirrhosis
38
Distal/paraceptal Location Location in lungs (2) Type of patient:
Distal portions of acini Pleural surface AND upper half Spontaneous pneumothorax in young adults
39
False emphysemas
1. Compensatory emphysema 2. Senile emphysema 3. Obstructive overinflation 4. Mediastinal emphysema
40
Compensatory emphysema cause
Dilatation due to loss of lung substance elsewhere
41
Senile emphysema definition
Overdistended lungs in elderly due to change in lung geometry (NO tissue destruction)
42
Obstructive overinflation definition? | Problem?
Lung expansion due to obstruction with air trapping | Serious lifethreatening if too much lung is compressed
43
Mediastinal emhysema definition | What is it secondary to?
Entrance of air into soft tissues of the lung, mediastinum and subcutis. High intra-alveolar pressures, ventilators, and chest wall trauma
44
Chronic bronchitis is diagnosed how?
Clinically: persistent productive cough for at least 3 consecutive months in at least 2 consecutive yeras
45
Define chronic bronchitis
Bronchial mucus hypersecretion secondary to inflammation, fibrosis, and narrowing of bronchioles
46
Simple chronic bronchitis is defined how?
Cough with mucoid sputum (no obstruction)
47
Chronic mucopurulent bronchitis is defined how?
Production of purulent sputum secondary to associated infections
48
Chronic asthmatic bronchitis is defined how? | Best treatment?
Hyperresponsive airways giving episodes of asthma Bronchodilator
49
Single most important cause of chronic bronchitis?
Cigarette smoke
50
Inflammation cells in chronic bronchitis?
1. CD8 T cells 2. Neutrophils 3. Macrophages
51
What is a secondary problem with chronic bronchitis?
Microbial infections
52
CB patients are described how? | Why?
Blue bloaters 1. Overweight 2. Cyanotic
53
Progression of chronic bronchitis (2)
1. Pulm HTN | 2. Cardiac failure
54
Bronchiectasis definition
Inflammatory destruction of bronchi walls --> Dilated and floppy with purulent secretions
55
Predisposing bronchiectasis hereditary conditions
1. Cystic fibrosis (pseudomonas) | 2. Kartagener syndrome (ciliary dysfunction)
56
Nonhereditary predisposing bronchiectasis conditions? 2
1. Necrotizing pneumoniae (Klebsiella, S. aureus) | 2. Suppurative pneumonias
57
How do cultures of bronchiectasis present?
Mixed: lots of bugs
58
Symptom of bronchiectasis
1. Persistent cough with sputum 2. Episodic and worsened by URI's 3. Clubbing of finger tips 4. Metastatic brain abscesses 5. Reactive amyloidosis

Pathology (36 decks)

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