Pulmonary Pathology Flashcards
____________ is a respiratory disease that is one of the leading causes of death.
Pneumonia
T/F: Any organism can cause pneumonia.
True
What are some predisposing factors to bacterial pneumonia?
- Loss of cough reflex
- Injury to cilia
- Decreased phagocytosis
- Pulmonary edema
- Immunocompromised condition
What is often the cause of loss of cilia?
Smoking
Which type of pneumonia starts in the bronchi and is considered a patchy pneumonia?
Bronchopneumonia
Which type of pneumonia will affect the entire lobe?
Lobar pneumonia
T/F: Lobar pneumonia is seen more in adults, while bronchopneumonia is associated with young and older.
True
Which type of bacteria almost always causes lobar pneumonia?
Streptococcus pneumoniae
What are the stages of lobar pneumonia?
- Congestion
- Red Hepatization
- Gray hepatization
- Resolution
What are some complications of lobar pneumonia and bronchopneumonia?
- Empyema
- Abscess
- Pericarditis
- Bacteremia
What is fibrinous pleuritis?
Inflammation extending out to the pleura of the lung
What type of organism typically causes atypical (interstitial) pneumonia?
Viruses or mycoplasma
Which type of pneumonia typically causes a dry cough? Why?
Atypical pneumonia; viruses are taking up all of the WBCs
Hyaline membranes are produced in ______________ and can impair the ability to exchange oxygen.
Atypical pneumonia
What is acute respiratory distress syndrome (ARDS)?
Injury to endothelium and alveolar epithelium; causes them to be very permeable and not exchange gases well
How can interstitial pneumonia lead to ARDS?
Hyaline membranes causes damage to alveolar epithelium
The most likely cause of ARDS is _________ or ___________.
Burns; Infection
What are some predisposing factors to pulmonary abscesses?
Aspiration, bronchiectasis, septic emboli, airway obstruction, dental sepsis
What is the course of a pulmonary abscess?
It can scar, cavitate, or progressively get larger
Tuberculosis infects about ____ of the world population?
1/3
__________ is the most common infectious cause of death.
Tuberculosis
3 million deaths/year
What type of bacteria causes tuberculosis?
Mycobacterium
Caseating granulomatous inflammation is a classic tissue reaction for which bacteria?
Mycobacterium tuberculosis
How is tuberculosis acquired?
Inhalation
What is the difference between a Ghon lesion and Ghon complex?
Lesion: site of early infection
Complex: lesion + hilar lymph nodes
What can cavitary TB lead to?
Spread of infection into the mouth or pleura
Reactivation of tuberculosis induces type IV ______________ and tissue __________.
Hypersensitivity; necrosis
What is miliary TB?
Wide spread TB often caused by reactivation
If caseous necrosis is seen in organs other than the lungs, what is the most likely diagnosis?
Miliary TB
What is a common (in Ohio) fungal infection causing granulomatous lung disease?
Histoplasmosis
What are the risk factors for lung cancer?
- Cigarette smoking
- Asbestos
- Radon gas
- Nickel, chromates, pollutants, lung scar
T/F: Although lung cancer is not the most common cancer in men and women, it is the most fatal.
True
T/F: Lung cancers often do not produce clinical symptoms until they are highly advanced.
True
Which two types of lung cancer are most strongly associated with smoking?
Squamous cell carcinoma and small cell (oat cell) carcinoma
T/F: Lung tumors may produce hormones.
True
Mesothelioma is a malignancy associated with the __________ cavity and is at high risk from ___________ exposure.
Pleural; asbestos
What is pneumoconiosis?
Inhaled particles (dust) induce fibrosis in the lungs
T/F: Larger particles are the most dangerous in causing pneumoconiosis.
False
Particles 1-5 micrometers in diameter
Which lung disease is often considered an occupational and environmental disease?
Pneumoconiosis
What is the most prevalent form of occupational disease worldwide?
Silicosis
Which lung is slightly heavier?
Right lung
T/F: Lungs have dual blood supply.
True
Pulmonary and bronchial
Breathing requires _________ and _________ control.
Muscle; neural
_________ is the major defense of the upper respiratory tract. ____________ are the main defenses of the lower respiratory tract.
Filtering; mucociliary units
What is secreted by type II pneumocytes?
Surfactant
In the alveoli _____________ provide an immune defense.
Macrophages
What is hemoptysis?
Coughing up blood
What is dyspnea?
Difficulty breathing; shortness of breath
What is atelectasis?
Collapse of lung volume
What is a pneumothorax?
Air in the pleural space that can lead to collapse of the lung
What is an empyema?
Suppuration in pleural cavity
What is pleural effusion?
Fluid in the pleural space
What type of fluid is increased in a patient with pneumonia?
Exudate (high protein)
In pulmonary edema, accumulation will begin in the _____________ and eventually in the _________.
Interstitial tissue; lungs
What are three possible causes of pulmonary edema?
- Increased intravascular pressure (CHF)
- Hypoproteinemia (low protein)
- Vascular damage (infection, autoimmune diseases)
What are the two major problems with pulmonary edema?
- Stops O2 exchange
2. Risk for infection
What are four classic disorders that fall under obstructive pulmonary disease?
- Emphysema
- Chronic bronchitis
- Bronchiectasis
- Asthma
What is a term that normally encompasses both emphysema and chronic bronchitis?
Chronic Obstructive Pulmonary Disease (COPD)
What is the major cause of imbalance leading to Emphysema?
Smoking
What defines emphysema?
Permanent enlargement of the airways due to destruction of alveolar septal walls
The pathogenesis of emphysema involves an imbalance between ___________ and anti-__________ enzymes. (Same word)
Protease
What is the difference between centriacinar and panacinar emphysema?
Centriacinar - involves central portion of acini; often in upper lobe
Panacinar - involves entire acinar unit; usually in lower lobes
___________ emphysema is normally associated with smoking, while __________ emphysema is normally associated with genetic deficiency.
Centriacinar; panacinar
What is the definition of chronic bronchitis?
Cough and sputum production for 3 consecutive months in 2 consecutive years
Destruction of terminal airspaces is a major characteristic of _________.
Emphysema
Loss of elasticity is a major characteristic of __________.
Emphysema
T/F: Those with emphysema are often described as “pink puffers.”
True
T/F: Those with emphysema have trouble getting air in, but can exhale just fine.
FALSE
Struggle exhaling
T/F: Those with emphysema are often called “blue bloaters.”
FALSE
Chronic bronchitis
Do people with chronic bronchitis struggle inhaling or exhaling?
Inhaling
T/F: Chronic bronchitis involves narrowing of the airways and secretion into the lumen.
True
Mucus gland ____________ is a major factor in chronic bronchitis.
Hypertrophy
A deficiency in which gene can lead to chronic bronchitis and panacinar emphysema?
Alpha1-AT
What is the definition of bronchiectasis?
Chronic infection with permanent major airway dilation
Bronchiectasis can be secondary to ______________ or ______________ or both.
Obstruction; infection
T/F: Bronchiectasis presents clinically with bloody mucoid expectoration.
True
What are some predisposing factors to bronchiectasis?
- Obstructive tumors
- Foreign bodies
- Cystic fibrosis
- other COPD
- Pneumonia
What part of the bronchioles is affected by asthma?
Smooth muscle
What are the initiating factors of asthma?
Allergies, infections, exercise, drugs, emotions
Which children are at greater risk for asthma?
Inner city children
What is the difference between atopic and non-atopic asthma?
Atopic: allergic/extrinsic; Type 1 hypersensitivity
Non-atopic: intrinsic; initiated by viruses, air pollutants
What is the pathology for asthma?
- Increased mucus glands
- Smooth muscle hypertrophy
- Inflammation with EOSINOPHILS and type 2 helper cells
What antibody often mediates problems with asthma (esp in atopic)?
IgE on mast cells
What are the two treatment options for asthma?
- Inhalation bronchodilators for immediate relief (albuterol)
- Controller medications (corticosteroids)
Asthma will present with irritability and prominence of the _____________ in bronchi and bronchioles.
Smooth muscles