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Pathology > Pulmonary: Atelectasis + Obstructive > Flashcards

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
Q

What is the change in the lung in emphysema?

A

The walls are destroyed

26
Q

How are chronic bronchitis and emphysema

A
  1. Emphysema is defined by morphologic changes

2. Emphysema Restricted to the acini

27
Q

Emphysema is more common in which sex?

Which form especially?

A

Men

Centriacinar

28
Q

Emphysema has a clear association with what two factors?

A
  1. Smoking

2. Alpha-1-antitrypsin deficiency

29
Q

Two imbalances in emphysema and their effect

A
  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
Q

First symptom of emphysema

Speed of disease

A

Dyspena

Slow

31
Q 
PFT's of emphysema show what? 
FEV1?
FVC?
FEV1-FVC ratio
O2 levels
A

FEV1 down
FVC normal
FEV1/FVC down
O2 normal

32
Q

Pure emphysema individuals are described how?

Why?

A

Pink puffers

Barrel chest
Exhale against pursed lips (Back pressure against)
Thin

33
Q

Chronic bronchitis patients are described how?

Why?

A

Blue bloaters

Overweight
Hypoxic/Cyanosis

34
Q

What do emphysema patients gradually acquire? (End-Stage)

Why?

A

Pulmonary hypertension

Loss of capillary surface –> Increases resistance –> Pulmonary HTN

35
Q

Centroacinar emphysema
Locations spared?
Upper or lower lobes
Associated with what?

A

Distal parts of acini
Upper lobes
Cigarette smoke

36
Q

Panacinar
Location
Upper or lower
Associated with what?

A

All of the acini
Lower lung
Alpha-1-antitrypsin

37
Q

Normal alpha-1-AT genotype?
Bad one?
What else happens with bad one?

A

MM
ZZ
Liver disease/Cirrhosis

38
Q

Distal/paraceptal
Location
Location in lungs (2)
Type of patient:

A

Distal portions of acini
Pleural surface AND upper half
Spontaneous pneumothorax in young adults

39
Q

False emphysemas

A
  1. Compensatory emphysema
  2. Senile emphysema
  3. Obstructive overinflation
  4. Mediastinal emphysema
40
Q

Compensatory emphysema cause

A

Dilatation due to loss of lung substance elsewhere

41
Q

Senile emphysema definition

A

Overdistended lungs in elderly due to change in lung geometry (NO tissue destruction)

42
Q

Obstructive overinflation definition?

Problem?

A

Lung expansion due to obstruction with air trapping

Serious lifethreatening if too much lung is compressed

43
Q

Mediastinal emhysema definition

What is it secondary to?

A

Entrance of air into soft tissues of the lung, mediastinum and subcutis.

High intra-alveolar pressures, ventilators, and chest wall trauma

44
Q

Chronic bronchitis is diagnosed how?

A

Clinically: persistent productive cough for at least 3 consecutive months in at least 2 consecutive yeras

45
Q

Define chronic bronchitis

A

Bronchial mucus hypersecretion secondary to inflammation, fibrosis, and narrowing of bronchioles

46
Q

Simple chronic bronchitis is defined how?

A

Cough with mucoid sputum (no obstruction)

47
Q

Chronic mucopurulent bronchitis is defined how?

A

Production of purulent sputum secondary to associated infections

48
Q

Chronic asthmatic bronchitis is defined how?

Best treatment?

A

Hyperresponsive airways giving episodes of asthma

Bronchodilator

49
Q

Single most important cause of chronic bronchitis?

A

Cigarette smoke

50
Q

Inflammation cells in chronic bronchitis?

A
  1. CD8 T cells
  2. Neutrophils
  3. Macrophages
51
Q

What is a secondary problem with chronic bronchitis?

A

Microbial infections

52
Q

CB patients are described how?

Why?

A

Blue bloaters

  1. Overweight
  2. Cyanotic
53
Q

Progression of chronic bronchitis (2)

A
  1. Pulm HTN

2. Cardiac failure

54
Q

Bronchiectasis definition

A

Inflammatory destruction of bronchi walls –> Dilated and floppy with purulent secretions

55
Q

Predisposing bronchiectasis hereditary conditions

A
  1. Cystic fibrosis (pseudomonas)

2. Kartagener syndrome (ciliary dysfunction)

56
Q

Nonhereditary predisposing bronchiectasis conditions? 2

A
  1. Necrotizing pneumoniae (Klebsiella, S. aureus)

2. Suppurative pneumonias

57
Q

How do cultures of bronchiectasis present?

A

Mixed: lots of bugs

58
Q

Symptom of bronchiectasis

A
  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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