Pulmonary Pathology Flashcards

1
Q

What are the requirements for normal fetal lung development?

A

Space in the thoracic cavity + ability to inhale (chest wall must be able to move and there needs to be enough material (amniotic fluid) present to inhale)

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2
Q

Larger airways conduct air to what?

A

terminal acinar units for proper gas exchange

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3
Q

What is normal bronchial histology?

A

Ciliated respiratory epithelium, smooth muscle glands and submucosal glands, cartilage

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4
Q

What is the predominant histology in lung tissue?

A

alveolar/lung parenchyma

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5
Q

What are the cellular constituents of the alveolar sac and septum?

A

type I and I alveolar cells, RBCs, macrophages, fibroblasts, capillaries, endothelial cells and surfactant

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6
Q

What is normal alveolar structure?

A

Capillaries associated with endothelium, baememnt membrane with interstitium, alveolar pores of Kohn, alveolar epithelium

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7
Q

What is the function of the alveolar pores of Kohn?

A

Allow for maximal aeration but also bacteria, cells or fluid to travel between alveoli

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8
Q

What are the components of alveolar epithelium?

A

Type 1 pneumocytes which facilitate gas exchange; Type 2 pneumocytes which produce surfactant and replace type 1 pneumocytes

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9
Q

What is atelectasis?

A

An acquired incomplete expansion of lung parenchyma; three types: resorption (obstructive), compression, contraction

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10
Q

What is resorption (obstructive) atelectasis?

A

Airway obstruction with gradual resorption of air reduces lung expansion

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11
Q

What is compression atelectasis?

A

accumulated material in pleural cavity compresses the lung parenchyma

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12
Q

What is contraction atelectasis?

A

Fibrotic or other innate restrictive process in the pleura or peripheral lung restricts lung expansion

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13
Q

What is pulmonary edema?

A

Interstitial fluid (pink proteinaceous material) in the alveolar spaces

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14
Q

What are three causes of pulmonary edema?

A

hemodynamic pressure gradient, injury to alveolar wall, or unsure mechanisms including neurogenic (brain injury) and high altitude pulmonary edema (HAPE)

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15
Q

What are examples of hemodynamic forces pushing out fluid that can lead to pulmonary edema?

A

LHF, volume overload, pulmonary vein obstruction

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16
Q

What are examples of hemodynamic gradients causing leaking out of fluid that can result in pulmonary edema?

A

hypoalbuminemia, nephrotic syndrome, liver disease

17
Q

What injuries to the alveolar wall can cause pulmonary edema?

A

Bacterial pneumonia, sepsis, smoke inhalation, aspiration

18
Q

Increased hydrostatic pressure causes what?

A

forces fluid out

19
Q

Decreased oncotic pressure results in what?

A

loses fluid through equilibrium across a semipermeable membrane

20
Q

Describe the appearance of pulmonary congestion

A

Apparent with dilated capillaries full of blood; micro hemorrhage occurs in these congested into alveolar spaces; as a result scattered hemosiderin laden macrophages accumulate within alveoli known as HF cells because of their association with pulmonary congestion with CHF

21
Q

What is acute lung injury?

A

A part of the ARDS spectrum; acute onset, hypoxemia, bilateral infiltrates, no evidence of cardiac failure; PaO2/FiO2 <300

22
Q

What are the features of RLD?

A

volume restriction/reduction, FEV1/FVC normal, FVC reduced, decreased TLC, interstitial lung disease

23
Q

What are the features of OLD?

A

Decreased flow, air trapping, low FEV1/FVC ratio, decreased FEV1, TLC increased

24
Q

What are the mediators for bronchoconstriction seen in asthma?

A

Leukotrienes C4-D4-E4, histamine, prostaglandin D2, acetylcholine

25
Q

What are the mediators for the mucus secretion seen in asthma?

A

leukotrienes C4-D4-E4

26
Q

What are the mediators for the increased vascular permeability seen in asthma?

A

leukotrienes C4-D4-E4

27
Q

What are the mediators for the recruitment of inflammatory cells seen in asthma?

A

Interleukins

28
Q

What role does genetics play in atopic asthma?

A

Atopic asthma is associated with seasonal allergies and eczema; may be linked to various alleles controlling like IgE, cytokines (IL-4), adrenergic receptors, etc

29
Q

What role does the environment play in atopic asthma?

A

Disease of industrialized societies (pollution, lack of allergen exposure at early age) + early infection

30
Q

What is aspirin sensitive asthma?

A

Associated with nasal polyps and recurrent rhinitis (Samter’s triad); unique sensitivity to aspirin; cross reacts with other NSAIDs

31
Q

What does lung transplant rejection show on biopsy?

A

Mononuclear infiltrates around vessels (acute rejection)