Pulmonology - Diseases Flashcards
Obstructive Sleep Apnea
Repeated cessation of breathing overnight lasting > 10 seconds; causes disrupted sleep pattern and daytime somnolence, also associated with systemic/pulmonary hypertension, cardiac arrhythmias, and sudden death
Findings: Elevated RBC/Hct due to increased erythropoiesis secondary to nocturnal hypoxia
Treatment: Weight loss, CPAP, surgery
Neonatal Respiratory Distress Syndrome
Commonly seen in premature infants born at <35 weeks gestation; characterized by deficient surfactant production by immature Type II pneumocytes causing increased alveolar surface tension and collapse (atelectasis)
Presents with tachypnea, dyspnea, and cyanosis shortly after birth
X-ray shows diffuse, bilateral consolidation
Treated with maternal glucocorticoids before birth, artificial surfactant for the neonate
Mesothelioma
Malignancy of the pleura, associated with asbestosis; commonly seen in ship-yard workers and plumbers
Presents with hemorrhagic pleural effusion, shortness of breath, chest pain
Findings: Ferruginous bodies - asbestosis fibers coated in hemosiderin; Psammoma bodies
Legionnaire’s Disease
Caused by gram negative rod Legionella pneumophila
Diagnosis: Organism grows on charcoal yeast extract + Cystine + iron; gram stains poorly but visualized with silver stain
Transmitted from aerosolized water from environmental sources (air conditioning, hot water heaters, etc.); no person-to-person transmission
Presents as severe pneumonia, fever, GI symptoms (diarrhea), and CNS symptoms
Treated with Macrolide or Fluoroquinolone
Pontiac Fever
Mild, flu-like illness caused by Legionella pneumophila
Pneumothorax
Air in the pleural space
Presents as unilateral chest pain, dyspnea, chest expansion, decreased tactile fremitus, hyperresonance, diminished breath sounds
May see deviation of trachea/mediastinum away from the affected lung in tension pneumothorax
Panacinar Emphysema
Associated with alpha-1 antitrypsin deficiency; uninhibited elastase activity in the lungs destroys elastin in alveolar walls leading to decreased DLCO, increased compliance, and decreased recoil
Presents as “pink puffer” phenotype (barrel-chested, exhalation through pursed lips); also associated with liver cirrhosis with PAS+ globules
Centriacinar Emphysema
Associated with smoking; destruction of alveolar walls leads to decreased DLCO, increased compliance, and decreased recoil
Presents as “pink puffer” phenotype (barrel-chested, exhalation through pursed lips)
Asbestosis
Associated with shipbuilding, roofing, and plumbing; associated with increased incidence of bronchogenic carcinoma and mesothelioma
Histology shows hemosiderin-laden “ferruginous bodies”
Chronic Bronchitis
Defined as productive cough > 3 months/year (not necessarily continuous) for > 2 years; caused by hyperplasia of mucus-secreting glands
Presents with wheezing, crackles, cyanosis, hypercapnia, secondary polycythemia
Findings: Reid index > 50%
Pancoast Syndrome
Caused by a tumor in the apex of the lung, where it compresses the superior cervical sympathetic ganglion
Presents as Horner syndrome (ptosis, miosis, anhidrosis of the ipsilateral face) + shoulder pain
