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Clin Med III > Pulmonary Pathology Part 3 > Flashcards

Pulmonary Pathology Part 3 Flashcards

1
Q

What occurs in a restrictive lung disease

A

Lungs cannot fully expand and there are decreased lung volumes and total lung capacities

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2
Q

What happens to residual volume in restrictive lung disease

A

Decrease or normal

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3
Q

What are signs and symptoms of restrictive lung disease initially

A

Chronic hyperventilation and exertional dyspnea

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4
Q

What are signs and symptoms of restrictive lung disease later on

A

Decreased alveolar ventilation, CO2 retention, hypoxemia, rapid shallow breathing, ineffective cough, dyspnea at rest

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5
Q

How do you treat restrictive lung disease

A

It is based on cause but promote oxygenation, maintain airway, maximize function, corticosteroids, and surgery

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6
Q

True or False:

Most restrictive lung diseases are not reversible

A

True

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7
Q

True or False:
With progressive restrictive lung diseases there is pulmonary artery hypertension that leads to cor pulmonale which causes severely decreased oxygenation and ventilatory failure

A

True

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8
Q

What is cor pulmonale

A

Right sided heart failure

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9
Q

What are the restrictive lung diseases (10)

A
  1. Pulmonary fibrosis
  2. Pneumoconiosis
  3. Hypersensitivity pneumonconiosis
  4. Noxious fumes
  5. Atelectasis
  6. Pulmonary edema
  7. ARDS
  8. Sarcoidosis
  9. Lung cancer
  10. Cystic fibrosis
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10
Q

What are the other names for pulmonary fibrosis

A

Interstitial lung/pulmonary disease

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11
Q

What is pulmonary fibrosis

A

Fibrotic changes at the level of the alveoli that occurs following chronic inflammation of lung tissue that leads to scarring (fibrosis)

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12
Q

What portion of pulmonary fibrosis cases are ideopathic and due to reactive airway diseases

A

Idiopathic: 2/3

Reactive airway diseases: 1/3

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13
Q

What happens with pulmonary fibrosis

A

Increased fibroblast activity distorts and shrinks lobe at the alveoli resulting in decreased lung compliance causing lungs to become stiff

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14
Q

What are signs and symptoms of pulmonary fibrosis (2)

A
  1. SOB

2. Dry cough initially

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15
Q

What are a persons TLC, RV, and FEV with pulmonary fibrosis

A

TLC decreased
RV decreased or normal
FEV decreased

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16
Q

How do you treat pulmonary fibrosis (3)

A
  1. Corticosteroids
  2. Education
  3. Monitoring especially during exercise
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17
Q

What are the goals with treating pulmonary fibrosis (2)

A
  1. Maintain current level of pulmonary function

2. Prevent further disease progression

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18
Q

What are the environmental and occupational pulmonary disorders (3)

A
  1. Pneumonconiosis
  2. Hypersensitivity pneumonitis
  3. Noxious gases,fumes, and smoke inhalation
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19
Q

What do environmental and occupational pulmonary disorders have involvement of

A

Pulmonary parenchyma

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20
Q

What is another name for pneumonconiosis

A

Dusty lungs or black lung disease

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21
Q

What causes pneumonconiosis

A

Inhalation of large amounts of industrial substances (iron ore, coal, asbestos, and agricultural dust)

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22
Q

What are risk factors for pneumonconiosis (5)

A
  1. Type of exposure
  2. Duration and intensity
  3. Underlying pulmonary conditions
  4. Smoking history
  5. Particle size and water solubility of the inhalant
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23
Q

What happens with pneumoconiosis

A

Particles that are not filtered out are inhaled or swallowed entering the lungs causing the cells to become pierced resulting in inflammation thickening and scarring around the particle

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24
Q

How long does it take symptoms of pneumoconiosis to occur

A

10-20 years

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25
Signs and symptoms of pneumoconiosis (4)
1. Differ based on exposure type 2. Progressive dyspnea 3. Chest pain 4. Productive cough
26
True or False: | It is important to do a lung biopsy to rule out cancer when diagnosing pneumoconiosis because it can develop into cancer
True
27
How do you treat pneumonconiosis (3)
1. Prevention 2. Relieve symptoms with corticosteroids 3. Treatment of neoplasms
28
What is another name for hypersensitivity pneumonitis
Extrinsic allergic alveolitis
29
What causes hypersensitivity pneumonitis
Exposure to organic dusts such as mold, fungus, plant fibers cork dust, and coffee beans
30
What does hypersensitivity pneumonitis affect
Alveoli and distal airways
31
What happens in hypersensitivity pneumonitis
Granulomas or mild fibrosis of the alveolar walls occur due to organic dust
32
Signs and symptoms of hypersensitivity pneumonitis (4)
1. Quick onset dyspnea 2. Fever 3. Chills 4. Nonproductive cough
33
When does hypersensitivity pneumonitis often resolve
24-48 hours
34
How do you treat hypersensitivity pneumonitis
Remove exposure and modify handling process
35
What is it called when O2 is replaced by other substances
Asphyxiation
36
What does exposure to noxious gases, fumes, and smoke inhalation cause (4)
1. Tissue anoxia 2. Tissue asphyxia 3. Airway edema 4. Airway obstructions
37
What are the lung parenchymal disorders (5)
1. Atelctasis 2. Pulmonary edema 3. ARDS 4. Sarcoidosis 5. Lung cancer
38
What is atelectasis
Collapse of a normally expanded lung at any level and can be all/part of the lung
39
What are the causes of atelectasis (4)
1. Bronchus obstructed (primary cause is a mucus plug) 2. Interference with lung expansion (post surgical) 3. Insufficient surfactant 4. Direct compression
40
What happens with atelectasis
Airway collapses or is obstructed and alveolar gas is absorbed into the blood and alveoli cannot stay open
41
What are the sign and symptoms of sudden atelectasis (6)
1. Dyspnea 2. Tachypnea 3. Cyanosis 4. Increased temp 5. Elevated BP 6. Shock
42
What are the signs and symptoms of chronic atelectasis (3)
1. Gradual onset 2. Dyspnea 3. Weakness
43
How do you treat atelectasis
Remove the cause with suction, deep breathing or chest PT
44
What is another name for pulmonary edema
Pulmonary cngestion
45
What is pulmonary edema
Excessive fluid in lungs
46
Where does the fluid accumulate in pulmonary edema
Interstitial tissue and/or alveoli
47
True or False: | Pulmonary edema risk increases with age in those with heart failure
True
48
What can cause pulmonary edema (6)
1. Left ventricle failure 2. Mitral valve disorder 3. Kidney/liver sidorders 4. Sepsis 5. Transfusion reactions 6. High altittude
49
How does left ventricle failure result in pulmonary edema
Left ventricle muscle wall hypertrophies resulting in not being able to put as much blood in the ventricles so there is a backup of blood and it backs up into the lungs
50
How does pulmonary edema occur
Fluid from the pulmonary vessels leaks into alveolar spaces decreasing the space for gas exchange
51
What leads to the excess fluid in pulmonary edema (4)
1. Fluid overload 2. Decreased serum albumin 3. Lymphatic obstruction 4. Tissue injury leading to fibrosis
52
What are the 4 stages of signs and symptoms of pulmonary edema
1. Asymptomatic or restless, anxious, cold symptoms, diaphoresis (sweating) 2. Worsened edema, increased RR, audible wheeing 3. Cough that produces frothy blood tinged sputum 4. Decreased responsiveness and consciousness
53
How do you treat pulmonary edema (9)
1. Prevention 2. Improve gas exchange 3. Reduce fluid overload 4. Strengthen and slow heart beat (beta blockers) 5. Fluid restriction 6. Diuretics 7. Diet 8. Relieve anxiety 9. O2 therapy
54
Is pulmonary edema reversible
Yes
55
What is acute respiratory distress syndrome (ARDS)
Acute respiratory failure
56
What are other names for ARDS
Respiratory distress syndrome, hyaline membrane disease, defuse alveolar damage
57
What could be causes of ARDS (7)
1. Trauma 2. Sepsis 3. Coronary artery bypass 4. Burns 5. Embolism 6. Near drowning 7. Shock
58
What happens in ARDS
Diffuse alveolar damage due to inflammatory response leads to inactivating surfactant and fluids, proteins, and blood cells leaking, which all results in collapsed alveoli and decreased lung compliance
59
True or False: | People with ARDS can have multiple organ failure
True
60
When do the symptoms of ARDS arise
12-48 hours after initial event
61
What are the signs and symptoms of ARDS (5)
1. Shallow rapid breaths 2. Dyspnea 3. Hyperventilation 4. Cyanosis 5. System failure
62
How do you treat ARDS
Treat underlying problems, prevent any further complications, provide supportive respiratory therapy and sedation
63
What is the mean survival of patients with ARDS
2 weeks
64
When do ARDS survivors get normal lung function back
1 year after onset
65
What percent of people with ARDS die
50-70%
66
What is sarcoidosis
Asystemic disease with diffuse granulomas and inflammation of lungs
67
True or False: | Sarcoidosis may regress or may progress to fibrosis
True
68
What are the signs and symptoms of sarcoidosis (3)
1. Lungs and thoracic lymph nodes are affected 2. Affects eyes, skin, liver, spleen, heart, small bones of hands/feet 3. Increased risk of osteoporosis
69
What are the signs and symptoms of pulmonary involvement of sarcoidosis (7)
1. Dyspnea 2. Dry cough 3. Fever 4. Malaise 5. Weight loss 6. Skin lesions 7. Fibrosis
70
True or False: | A patient with sarcoidosis may be asymptomatic
True
71
How long does it take for pulmonary symptoms to develop with sarcoidosis
Over weeks to months
72
How do you treat sarcoidosis (4)
1. Inhaled steroids 2. Corticosteroids 3. Manage/prevent osteoporosis 4. Lung transplant
73
When does complete resolution of symptoms usually occur with sarcoidosis
1-2 years
74
What is another name for lung cancer
Bronchogenic carcinoma
75
What are the 2 types of lung cancer
1. Small cell lung cancer (20%) | 2. Non-small cell lung cancer (80%)
76
True or False: | Lung cancer is the leading cause of cancer death in the US
True
77
What are the signs and symptoms of lung cancer (7)
1. Dyspnea 2. Systemic sympotms 3. Metastatic symptoms 4. Productive cough with hemoptysis 5. Wheezing 6. Chest pain 7. Hoarseness
78
How many stages of lung cancer
4
79
What is the first stage of lung cancer
Within lung no metastases
80
What is the second stage of lung cancer
Hilar/peribronchial lymph node involvement
81
What is the third stage of lung cancer
Mediastinal or cervical lymph node mets, extension to the chest wall, mediatinum, diaphragm, and carina
82
What is the fourth stage of lung cancer
Distant metastases
83
How do you treat lung cancer
Prevention and chemotherapy with or without radiation
84
How is lung cancer spread (3)
1. Direct extension view the chest wall or diaphragm 2. Lymphatic invasions (most frequent) 3. Blood born metastases
85
What are the areas that blood born metastases travel to (4)
1. Adrenal gland 2. Brain 3. Bone 4. Liver
86
What is small cell lung cancer
Lung cells compressed into a mass
87
Where is small cell lung cancer most often found
Bronchial submucosa centrally
88
What does the tumor of the small cell lung cancer do
Releases hormones that stimulate further growth causing obstruction, pneumonia, and lymphatic involvement
89
What are the signs and symptoms of small cell lung cancer (8)
1. Cough with hemoptysis 2. Dyspnea 3. Stridor 4. Wheezing 5. Chest pain 6. May cause broncopulmonary infections 7. Referred pain 8. Ectopic hormone production
90
How do you treat small cell lung cancer (3)
1. Chemotherapy 2. Radiation therapy 3. Surgical resection
91
What are the 3 types of non small cell lung cancer
1. Squamous cell 2. Adenocarcinoma 3. Large cell
92
Where is squamous cell lung cancer
Centralized in major bronchi
93
True or False: | Squamous cell lung cancer has rapid growth that is localized with cavitation
True
94
Where is adenocarcinoma lung cancer typically found
Peripheral in upper lobes
95
True or False: | Gland like structures form with adenocarcinoma lung cancer
True
96
True or False: | Large cell lung cancer has poor differentiation
True
97
True or False: | Non-small cell lung cancer is typically asymptomatic initially
True
98
What are the symptoms of non-small cell lung cancer (10)
1. Localized sharp severe pleural pain with inspiration 2. Limited lung expansion 3. Cough 4. Dyspnea 5. Clubbing 6. Skin changes 7. Joint swelling 8. Osteoarthropathy 9. Decreased/absent breath sounds 10. Pleural rub
99
How do you treat non-small cell lung cancer
Induction chemotherapy/chemoradiation and surgical resection
100
What is the treatment of non-small cell lung cancer for stage 1 and 4
Stage 1: Surgery no chemotherapy | Stage 4: Chemotherapy and palliative care

Clin Med III (9 decks)

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