Pulmonary System Pathology Flashcards

1
Q

What happens in an obstructive lugng disorder? What are the major examples of obstructive diseases?

A

expiratory airflow limitation:

asthma
COPD
chronic bronchitis
bronchiectasis
bronchiolitis
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2
Q

What happens in a restrictive lung disorder? What are the major examples of restrictive diseases

A

reduced total lung capcity/reduced ventilatory elasticity

diffuse parenchymal or interstitial lung disease like idiopathic pulmonary fibrosis and occupational lung diseases

chest wall/pleural diseases, massive obesity, neuromuscular diseases

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3
Q

What volumes/capacities will be low in obstructive and what will be low in restrictive?

A

obstructive = forced expiratory volume low

restrictive - total lung capacity low

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4
Q

What should you think of with sudden respiratory distress and unlateral leg swelling?

A

DVT/PE

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5
Q

What is a normal pulse ox?

A

equal or over 95%

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6
Q

WHen you do chest imaging, what can CXR tell you?

A

Use to look for pulmonary or pleural disease, cardiac enlargement and mediastinal pathology

note - larger airway disease and pulmonary vascular disease are usually NORMAL on CSR

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7
Q

When you do chest imaging, what can CT scan do for you?

A

It gives much better detail for chest contents like mass lesions, larger airways, lymph nodes, aorta pathology, esophagus issues and mediastinal masses/cysts

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8
Q

What is atelectasis?

A

collapse or loss of lung volume

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9
Q

What are the general classifications of secondary atelectasis?

A
  1. obstructive - resorption of alveolar gas distal to bronchial obstruction by mucus
  2. resorptive - alveolar collapse due to pneumonia or poor lung ventilation and POST GENERAL ANESTHESIA!
  3. Compression - pulmonary collapse due to mass effect
  4. conntraction - pulmonary shrinkage due to pleural fibrosis
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10
Q

What are the symptoms of asthma?

A

episodic wheezing, dyspnea, cough with or without tenadious mucus/sputum
kids may have cough-predominant symptoms

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11
Q

What does a diagnosis of pneumonia require?

A

pulmonary infiltrate on CXR or CT - lobar or whole lung ingiltrates or cavitation with or without effusion

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12
Q

What’s the basis for pulmonary edema?

In general, what’s the most common cause?

A

it’s movement of fluid into the alveolar spaces due to hemodynamically increased alveolar capillary pressure (cardiogenic) or alveolar microvascular injury (non-cardiogenic)

CHF is the most common cause

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13
Q

What’s the most common cause of cardiogenic pulmonary edema

A

left ventricular failure due to coronary disease (MI)

but also chronic HTN, cardiomyuopathy, aortic valve disease, new-onset arrhythmias and mitral stenosis

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14
Q

What lab findings will tell you if a pulmonary edema is from heart failure?

A

serum-B-natriuretic peptide

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15
Q

What imaging is best for assessing LV systolic/diastolic function, cardiac pressures, valvular disease or pericardial effusion/tamponade?

A

echocardiography

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16
Q

What is the major non-cardiogenic cause of acute pulmonary edema/

A

acute respiratory distress syndrome

or acute lung injury

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17
Q

slide 248 - How do the hypersensitivity pneumonidites present clinically?

A

acute attacks 4-6 hours post exposure to the inhaled antigen with fever, dyspnea, cough and leukocytosis

chronically with signs of restrictive lung disease

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18
Q

slide 275 - WHat are three highly important causes of acquired hypercoaculability resulting in predisposition to PE?

A

immobilization
post-surgery
cancer

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19
Q

276 - True or false: patients with DVT/PE will typically have either an inherited or an acquired hypercoagulability.

A

false - they can have both

20
Q

302 - What are the 5 most commn causes of pulmonary hemorrhage (hemoptysis) and which can cause massive hemoptysis?

A
bronchogenic carcinoma
bronchiectasis
tuberculosis
bronchitis
bacterial pneumoniae
(the top three can cause massive)
21
Q

358 - What is the commonest site of metastatic neoplasms?

A

the lungs

22
Q

Will mets to the lung typically be multiple or single? unilateral or bilateral?

A

multiple and bilateral

23
Q

366 - WHat is a pleural effusion?

A

usually there’s no more than 15 ml of clear serous fluid in each pleural cavity. In pleural effusion, you get an increase of that fluid.

24
Q

What are the symptoms of pleural effusion?

A
atelectasis (comrpession)
chest pain from pleuritis
dyspnea
cough
fever
25
Q

What is the msot common efflusion cause (in general terms)?

A

increased fluid production

can be from increased hydrostatic pressure (CHF)
decreased osmotic pressure 9nephrotic syndrome0
cirrhosis wih ascites (diaphragmatic transit)
peritoneal dialysis
urninothorax

26
Q

What are the three clinical factors for ARDS?

A

inciting event
bilateral pulmonary infiltrates
hypoxemia

27
Q

What are two most common causes of ARDS?

A

sepsis and general trauma (shock lung)

but also pulmonary infection, aspiration, inhaled irritants, drug overdose, drowning, transufsion

28
Q

For chronic pulmonary ilfiltrates of unknown type, what should you do first?

A

Get a pulmonary medicine consult!!!!!
they’ll rule out infection, check for cancer, look for interstitial lung disease causes and then determine whether it’s idiopathic or not.

29
Q

202 - ILD with a known cause is usually due to what? Aka, what’s the cause?

A

an inhalational exposure to an occupational/environmental particle (usually based on their employment - miners, farmers, etc.)

30
Q

203 - What are the 3 smoking-related causes of interstitial lung disease?

A
  1. pulmonary langerhans cell hstiocytosis
  2. desquamative interstitial pneumonia/respiratory bronchiolitis interstitial lung disease
  3. idiopathic pulmonary fibrosis
31
Q

What percentage of IPF cases are in smokers?

A

70%

32
Q

slide 204 - What are the two most common cause of interstitial lung disease in which we don’t really understand the pathogenesis

A

sarcoidosis

idiopathic interstitial lung disease

33
Q

Why is diagnosis for idiopathic interstitial lung disease so hard to make?

A

because there are tons of different entities that cause the same clinical picture.

34
Q

What is the most lethal cuase of ILD?

A

idiopathic pulmonary fibrosis - 70-80% mortlity at 5 years post diagnosis.

35
Q

Describe sarcoidosis

A

it’s idiopathic SYSTEMIC granulomatous disease with lung involvement in 90% of cases

36
Q

What is the main cause of pulmonary hypertension?

A

chronic hypoxemic vasoconstriction from chronic lung disease

37
Q

What is the most lethal cancer in the world? As in, what cancer kills the most people?

A

primary lung cancer

38
Q

99% of primary lung neoplasia are what type?

A

carcinoma (most common visceral cancer in the world)

39
Q

What are some risk factors for pimary lung cancer

A

smoking obviously
radiation exposure
asbestosis
pulmonary fibrosis

40
Q

What are the general two types of lung cancer?

A

non-small cell carcinoma

small-cell carcinoma

41
Q

What’s the most common non-small cell carcinoma (and most ccmmon primary lung cancer)? Who gets it?

A

adenocarcinoma

female dominant - can not be related to smoking

42
Q

What are the other two non-small cell carcinomas?

A

squamous cell carcinoma
large cell carcinoma (undifferentiated

then a few miscellanceous

43
Q

What lung cancer is the most likely to cause a paraneoplastic syndrome?

A

small cell carcinoma - neuroendocrine cells are factories for it

44
Q

If you have lung cancer, what type do you want?

A

carcinoid tumor - usually treatable with surgery alone.

45
Q

What is carcinoid tumor a tumor of?

A

well-differentiated neuroendocrine carcinoma

46
Q

Most common lung tumors?

A

metastases