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JL Respiratory > Pulmonary vascular disease and pleural disease > Flashcards

Pulmonary vascular disease and pleural disease Flashcards

1
Q

What is the pressure system of pulmonary circuation?

A

Low pressure

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2
Q

Due to the pulmonary circulation being a low pressure system, with thin walled vessels, what is there low incidence of at normal pressure?

A

Atherosclerosis

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3
Q

What is pulmonary oedema?

A

Accumulation of fluid in the lung - interstitium and alveolar spaces

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4
Q

What type of pattern of disease does pulmonary oedema cause?

A

Restrictive pattern

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5
Q

What are the 2 main pathological causes of pulmonary oedema?

A
  1. Haemodynamic (increase in hydrostatic pressure)

2. Due to cellular injury (alveolar lining cells/alveolar endothelium)

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6
Q

What condition causes localised pulmonary oedema?

A

Pneumonia

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7
Q

What condition causes generalised pulmonary oedema?

A

Adult respiratory distress syndrome (ARDS)

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8
Q

What is DADS?

A

Diffuse alveolar damage syndrome

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9
Q

What are 4 causes of shock lung?

A
  1. Sepsis
  2. Diffuse infection (virus, mycoplasma)
  3. Severe trauma
  4. Oxygen
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10
Q

What 4 things are involved in the pathogenesis of ARDS after injury (e.g. bacterial endotoxin)

A

Infliltration of inflamamtory cells
Cytokines
Oxygen free radicals
Injury to cell membranes

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11
Q

Name 3 things involved with the pathology of ARDS

A

Fibrinous exudate lining alveolar walls (hyaline membranes)
Cellular regeneration
Inflammation

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12
Q

What can be the outcome of ARDS?

A

Fibrosis (chronic restrictive lung disease)

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13
Q

Who does neonatal RDS occur in?

A

Premature infants

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14
Q

What causes neonatal RDS?

A

Deficiency in surfactant (type 2 alveolar lining cells)

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15
Q

How does neonatal RDS cause physical damage to cells?

A

Increased effort in expanding lungs

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16
Q

What is a detached intravascular mass carried by the blood to a site in the body distant from its point of origin?

A

Embolus

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17
Q

What is an important cause of sudden death and pulmonary hypertension?

A

PE

18
Q

What are 95% of emboli?

A

Thromboemboli

19
Q

Where is the source for most pulmonary emboli?

A

DVT of lower limbs

20
Q

What are these the effects of - sudden death, severe chest pain/dyspnoea/haemoptysis, pulmonary infarction and pulmonary hypertension?

A

PE

21
Q

What do the effects of PE depend on?

A

Size of embolus
Cardiac function
Respiratory function

22
Q

What do recurrent small emboli lead to?

A

Pulmonary hypertension

23
Q

In a pulmonary infarct (ischaemic necrosis), what artery supply is compromised?

A

Bronchial artery supply

24
Q

What are the two classes of pulmonary hypertension?

A

Primary (rare, young women)

Secondary

25
Q

What are 4 mechanisms of pulmonary hypertension?

A
  1. Hypoxia (vascular constriction)
  2. Increased flow through pulmonary circulation (congenital heart disease)
  3. Blockage (PE) or loss (emphysema) of pulmonary vascular bed
  4. Back pressure from left sided heart failure
26
Q

Give the steps in the morphology of pulmonary hypertension

A
  1. Medial hypertrophy of arteries
  2. Intimal thickening (fibrosis)
  3. Atheroma
  4. Right ventricular hypertrophy
  5. Extreme cases (congenital heart disease, primary pulmonary hypertension) - plexogenic change/necrosis
27
Q

What is a pulmonary hypertension complicating lung disease?

A

Cor Pulmonale

28
Q

What are three physiological features of Cor Pulmonale?

A

Right ventricular hypertrophy
Right ventircular dilatation
Right heart failure (swollen legs, congested liver)

29
Q

What might be seen on a CXR due to right ventricular dilatation?

A

Cardiomegaly

30
Q

What is the name for a mesothelial surface lining the lungs and medastinum?

A

Pleura

31
Q

What type of cells does the pleura have, that are designed for fluid absorption?

A

Mesothelial cells

32
Q

What two types of fluid can you get in a pleural effusion?

A

Transudate

Exudate

33
Q

What protein levels are transudate and exudate pleural effusions?

A

Transudate - low protein

Exudate - High protein

34
Q

What two conditions can lead to pleural effusion transudate?

A

Cardiac failure

Hypoproteinaemia

35
Q

What four conditions can lead to pleural effusion exudate?

A

Pneumonia
TB
Connective tissue disease
Maliganancy (primary or metastatic)

36
Q

What two factors can cause pneumothorax?

A

Trauma

Rupture of bulla

37
Q

What is a primary pleural neoplasia - malignant - called?

A

Maligannt mesothelioma

38
Q

What disease is closely related to mesothelioma?

A

Asbestosis

39
Q

What investigation can you do for malignant effusions?

A

Cytology, biopsy

40
Q

Where does the dual blood supply for the pulmonary circulation come from?

A

Pulmonary veins

Bronchial arteries

JL Respiratory (27 decks)

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