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Lungs First Aid USMLE 2013 > Resp Path > Flashcards

Resp Path Flashcards

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USMLE® Step 1 flashcards
1
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: Lodges in lower portion of right inferior lobe. Right lung more common because right main stem bronchus is wider and more vertical than the left. Treatment: *
A

Inhaled foreign body while sitting up

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2
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: Lodges in superior potion of right inferior lobe. Right lung more common because right main stem bronchus is wider and more vertical than the left. Treatment: *
A

Inhaled foreign body while supine

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3
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: ** Treatment: *Nitrates to cause methemglobinemia, then thiosulfate to bind cyanide.
A

Cyanide poisoning

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4
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: *Oxidized (ferric, Fe3+) form that has low O2 affinity, but high cyanide affinity. * Treatment: *Methylene blue.
A

Methemgoblinemia

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5
Q
  • Symptoms: ** Lab Values: Carboxyhemoglobinemia. Pathophysiology: Decreases hemoglobin’s oxygen bindign capacity (downward shift, lower Vmax) and decreases O2 unloading in tissues (left shift) Treatment: *
A

Carbon monoxide poisoning

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6
Q
  • Symptoms: * Results in cyanosis and right heart failure (cor pulmonale). Seen in young females.* Lab Values: > 25 mmHg pressure in the pulmonary artery. Smooth muscle hypertrophy. Pathophysiology: . Normally functions to inhibit vascular smooth muscle proliferation; poor prognosis. Treatment: *
A

Primary pulmonary hypertension

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7
Q
  • Symptoms: Athersclersois, medial hypertrophy, and intimial fibrosis. Results in cyanosis and right heart failure (cor pulmonale). Lab Values: > 25 mmHg pressure in the pulmonary artery. Pathophysiology: Due to COPD, mitral stenosis, recurrent thromboemboli, autoimmune disease (scleroderma), left-to-right shunting, sleep apenea, or living at high altitudes. Treatment: *
A

Secondary pulmonary hypertension

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8
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: Associated with long bone fractures and liposuction. Treatment: *
A

Fat embolus

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9
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: ** Treatment: *
A

Air embolus

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10
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: ** Treatment: *
A

Thrombus

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11
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: ** Treatment: *
A

Mycotic emboli

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12
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: Can lead to DIC, especially postpartum. Treatment: *
A

Amniotic fluid emboli

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13
Q
  • Symptoms: Chest pain, tachypnea, dyspnea. Respiratory alkalosis. Lab Values: Diagnose via helical CT. Pathophysiology: Approximately 95% of pulmonary emboli arise in the deep leg veins. Treatment: *
A

Pulmonary embolism

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14
Q
  • Symptoms: Can lead to pulmonary embolus. Lab Values: Hooman’s sign - tender calf muscle on dorsiflexion of the foot. Pathophysiology: Caused by stasis, hypercoagulability, or endothelial damage (Virchow’s triad). Treatment: *
A

Deep vein thrombosis

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15
Q
  • Symptoms: Airways close prematurely at high lung volumes. Lab Values: ↑RV, ↓FVC, ↓↓FEV1, {{↓FEV1/FVC ratio (hallmark).}} Pathophysiology: V/Q mismatch. Treatment: *
A

Obstructive lung disease (COPD)

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16
Q
  • Symptoms: “Blue bloater”. Wheezing, crackles, cyanosis (early-onset hypoxemia due to shunting), late-onset dyspnea. Productive cough for 3 months a year for 2 consecutive years. Lab Values: ↓FEV1/FVC ratio; Reid index > 50% (gland depth/total thickness of bronchial wall). Hypercapnia (high PaCO2, low PaO2). Pathophysiology: Typically an obese male smoker. Hypertrophy of mucus secreting glands in the bronchioles. Disease of the small airways. Tends to have squamous metaplasia (unlike asthma). Can lead to cor pulmonale. Treatment: *
A

Chronic bronchitis

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17
Q
  • Symptoms: “Pink puffer”. Exhalation through pursed lips to ↑airway pressure and prevent airway collapse during respiration. Progressive dyspnea and weight loss. Lab Values: ↓FEV1/FVC ratio; {{barrel-shaped chest; ↑compliance; ↑elastase activity or alpha-1 antitrypsin deficiency}}. Pathophysiology: Typically a thin smoker (or air pollution).{{ Enlargement of air spaces and ↓recoil resulting from destruction of alveolar walls. }}Compliance increased due to loss of elastic fibers. Worse in the apical segments of upper lobes. Treatment: *
A

Centriacinar (centrolobular) emphysema

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18
Q
  • Symptoms: Cough, wheezing, tachypnea, dyspnea, hypoxemia, pulsus paradoxus, mucus plugging (but no squamous metaplasia). Lab Values: ↓FEV1/FVC ratio; ↓I/E ratio (normal 1:2); {{dx with metacholine. Charcot-Leyden crystals}} (eosinophil membrane protein). {{Curschmann’s spirals}} (shed epilthelium from mucous plugs). Pathophysiology: {{Bronchial hyper-responsiveness}} causes reversible bronchoconstriction; smooth muscle hypertrophy. {{Type I hypersensitivity (pollen, dust, food, molds, animal dander).}} Treatment: *
A

Extrinsic asthma

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19
Q
  • Symptoms: something blocks or causes a Chronic necrotizing infection of bronchi which leads to {{permanently dilated airways distal to obstruction, purulent sputum, recurrent recurrent infections, and hemopytsis}}. Increased risk of aspergillosis. Foul smelling sputum (if anaerobe involvement). Lab Values: ↓FEV1/FVC ratio Pathophysiology: {{Associated with bronchial obstruction, poor ciliary motility (smoking), Kartagener’s syndrome.}} Treatment: *
A

Bronchiectasis

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20
Q
  • Symptoms: Lowered diffusing capacity due to pulmonary dysfunction. Lab Values: ↓FVC and TLC; {{↑ or normal FEV1/FVC ratio}} (> or = 80%). Pathophysiology: ARDS, neonatal respiratory distress syndrome, pneumoconioses (coal miner’s silicosis, abestosis), sarcoidosis, idiopathic pulmonary fibrosis, Goodpasture’s, Wegener’s, histiocytosis X, bleomycin/busulfan/amiodarone. Treatment: *
A

Restrictive lung disease due to interstital lung diseases

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21
Q
  • Symptoms: Peripheral hypoventilation due to extrapulmonary dysfunction. Lab Values: ↓FVC and TLC; ↑ or normal FEV1/FVC ratio (> or = 80%). ↓compliance. Pathophysiology: Poor muscular effort (poliomyelitis, myasthenia gravis); poor structural apparatus (scoliosis, morbid obesity). Treatment: *
A

Restrictive lung disease due to poor breathing mechanics

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22
Q
  • Symptoms: {{Involves upper lobes}}. Lab Values: * {{Restrictive}}↓FVC and TLC; ↑ or normal FEV1/FVC ratio (> or = 80%). {{“Eggshell” calcification of hilar lymph nodes. Birefringence on polarized light.}}* Pathophysiology: Restrictive lung disease. {{Associated with foundries, sandblasting, and mines. Macrophages response to silica and release fibrogenic factors, leading to fibrosis}}. Silica may distrupt phagolysosomes and increase susceptibilty to TB. Particles less than 10 microns in size (escape cilia). Treatment: *
A

Silicosis

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23
Q
  • Symptoms: {{Involves lower lobes}}. Increased incidence of bronchogenic carcinoma and mesothelioma. Family members at increased risk of bronchogenic carcinoma because it’s on their clothing. Lab Values: * {{Restrictive}}↓FVC and TLC; ↑ or normal FEV1/FVC ratio (> or = 80%). “Ivory white” calcified pleural plaques. Positive Prussian blue stain (asbestos bodies may be coated with iron).* Pathophysiology: Restrictive lung disease. Associated with ship-building, break-lining, roofing, and plumbing. Particles less than 10 microns in size (escape cilia). Treatment: *
A

Asbestosis

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24
Q
  • Symptoms: Acute exposure results in pneumonitis. Chronic exposure results in pulmonary noncaseating granulomas, fibrosis, hilar lymph node granulomas, and systemic noncaseating granulomas. Lab Values: {{Restrictive}}↓FVC and TLC; ↑ or normal FEV1/FVC ratio (> or = 80%). Pathophysiology: {{Associated with aerospace industry and nuclear reactors. Type IV hypersensitivity}}. Granuloma formations. Treatment: *
A

Berylliosis

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25
Q
  • Symptoms: Involves uper lobes. Carbon pigment (athracotic) accumulates in macrophages of the lympahtics and interstitium. Can result in cor pulmonale Lab Values: ↓FVC and TLC; ↑ or normal FEV1/FVC ratio (> or = 80%). Pathophysiology: Restrictive lung disease. Associated with coal mines. Particles less than 10 microns in size (escape cilia). Treatment: *
A

Coal miner’s pneumoconiosis

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26
Q
  • Symptoms: {{Risk factors are prematurity, maternal diabetes (due to elevated insulin), cesarean delivery}} (decrease release of fetal glucocortiocids); risk of PDA due to low O2 tension and hemorrhage at germinal matrix. Atelectasis. Complications lead to nectrotizing enterocolitis, bronchopulmonary dysplasia, and retinal neovascularization (due to O2 treatment). Lab Values: * or = 80%).* Pathophysiology: {{Surfactant deficiency leading to incrased surface tension, resulting in alveolar collapse}}. Usually pre-35th week of gestation. Fibrin. Treatment: *Maternal steroids before birth, artifical surfactant for infant; thyroxine.
A

Neonatal respiratory distress syndrome

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27
Q
  • Symptoms: Dyspnea, tachypnea, hypoxemia, cyanosis, and use of accessory respiratory muscles. Secondary to trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, or amniotic fluid embolism. Lab Values: {{“White out” on CXR (bilateral lung opacity).}} Protein-rich exudate in alveoli.↓FVC and TLC; {{Restrictive{{↑ or normal FEV1/FVC ratio (> or = 80%). Pathophysiology: Diffuse alveolar damage leads to increase alveolar capillary permeability.{{ Results in formation of intra-alveolar hyaline (FIBRIN) membrane. Initial damage due to release of PMN substances toxic to alveolar wall, activation of coagulation cascade, and oxygen derived free radicals.}} Treatment: *100% O2, PEEP, mechanical ventilation.
A

Acute respiratory distress syndrome

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28
Q
  • Symptoms: Associated with obesity, loud snoring, systemic or pulmonary HTN, arrhythmias, and sudden death. Patient is chronically tired. Lab Values: {{Erythrocytosis (hypoxia induced EPO release)}}. Pathophysiology: Respiratory effort against airway obstruction. Person stops breathing for at least 10 seconds repeatedly during sleep. Treatment: *Weight loss, CPAP, surgery.
A

Obstructive sleep apnea

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29
Q
  • Symptoms: ** Lab Values: {{Erythrocytosis (hypoxia induced EPO release).}} Pathophysiology: {{No respiratory effort. Person stops breathing for at least 10 seconds repeatedly during sleep}}. Treatment: *
A

Central sleep apnea

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30
Q
  • Symptoms: ** Lab Values: {{Absent/↓ breath sounds over affected area, ↓ resonance, ↓fremitus, tracheal deviation toward side of lesion}}. Pathophysiology: ** Treatment: *
A

Bronchial obstruction

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31
Q
  • Symptoms: ** Lab Values: {{Bronchial breath sounds, dull resonance,↑fremitus…think solid lung}}. Pathophysiology: ** Treatment: *
A

Lobar pneumonia

32
Q
  • Symptoms: Unilateral chest pain and unilateral chest expansion. Lab Values: ↓ breath sounds, hyperresonant, absent fremitus,{{ tracheal deviation away from side of lesion.}} Pathophysiology: Secondary to trauma or lung infection. {{Air enters pleural space but can’t escape. and pushes tracheaa to the other side}} Treatment: *
A

Tension pneumothorax

33
Q
  • Symptoms: Unilateral chest pain and unilateral chest expansion. Lab Values: ↓ breath sounds, hyperresonant, ↓ fremitus, tracheal deviation toward side of lesion. Pathophysiology: {{Most frequently occurs in tall, thin, young males due to rupture of apical blebs.}} Accumulation of air in the pleural space. Treatment: *
A

Spontaneous pneumothorax

34
Q
  • Symptoms: Affects central lung. PTHrP paraneoplastic syndrome {{(hypercalcemia, hypophosphatemia)}}. Cough, hemoptysis, bronchial obstruction, wheezing, {{pneumonic “coin” lesions on x-ray }}or noncalcified nodule on CT. Lab Values: {{Keratin pearls and intracellular bridges}} (desmosomes). Pathophysiology: Most common cause of death due to cancer; {{male SMOKERS}}. Hilar mass arising from bronchus; cavitation. Requires metaplasia columnar epithelium to squamous; then dysplasia => carcinoma in situ => invasive carcinoma. Treatment: *Surgery.
A

Squamous cell carcinoma of the lung

35
Q
  • Symptoms: Affects peripheral lung. Cough, hemoptysis, bronchial obstruction, wheezing, pneumonic “coin” lesions on x-ray or noncalcified nodule on CT. Lab Values: Multiple densities on chest X-ray. Pathophysiology: {{Most common lung cancer in nonsmokers and females}}. Develops in site of prior pulmonary inflammation or injury. {{Neoplasm of clara cells and type II pneumocytes. K-ras mutation}}. May spread via pleura. Treatment: *Surgery.
A

Bronchial adenocarcinoma

36
Q
  • Symptoms: Affects peripheral lung. Can present like interstitial pneumonia; result in {{hypertrophic osteoarthropathy (paraneoplastic; clubbing of the fingers and arthritis)}}. Cough, hemoptysis, bronchial obstruction, wheezing. Lab Values: ** Pathophysiology: {{Not linked to smoking.}} Grows along airways. {{K-ras mutation. May spread via pleura. Arises from Clara cells}}. Treatment: *Surgery.
A

Bronchioloalveolar adenocarcinoma

37
Q
  • Symptoms: Affects central lung. Often associated with {{ACTH (Cushingoid), ADH (SIADH), or Lambert-Eaton paraneoplastic syndromes}}. Cough, hemoptysis, bronchial obstruction, wheezing, pneumonic “coin” lesions on x-ray or noncalcified nodule on CT. Lab Values: {{Small dark blue cells}}. Pathophysiology: {{Associated with smoking (M>F)}}. Neoplasm of neuroendocrine Kulchitsky cells. Undifferentiated and very aggressive. {{L-myc mutation.}} Treatment: *Inoperable; response to chemotherapy.
A

Small cell (oat cell) carcinoma

38
Q
  • Symptoms: Affects peripheral lung. Cough, hemoptysis, bronchial obstruction, wheezing, pneumonic “coin” lesions on x-ray or noncalcified nodule on CT. Lab Values: {{Pleomorphic giant cells with leukocyte fragments in cytoplasm.{{ Pathophysiology: {{Highly anaplastic undifferentiated tumor; poor prognosis}}. Treatment: *{{Less responsive to chemotherapy; remove surgically}}.
A

Large cell carcinoma of the lung

39
Q
  • Symptoms: Tends to form obstructive polyp-like mass in the bronchus. Lab Values: {{5-hydroxyindoleatic acid (5-HIAA) in urine.}} Chromogranin positive. Pathophysiology: ** Treatment: *
A

Carcinoid tumor of the lung

40
Q
  • Symptoms: Hemorrhagic pleural effusions and pleural thickening. Dyspnea. Lab Values: {{Psammoma bodies. Long, thin microvilli on EM (vs short, blunted for adenocarcinoma)}}. Tumor encases and compresses the lung. Pathophysiology: *{{Malignancy of the pleura associated with asbestosis}}. * Treatment: *
A

Mesothelioma

41
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: {{Travels to adrenals (50% of the time, associated with adrenocortical insufficiency), brain (epilepsy), bone (pathologic fractures})}, liver (jaundice, hepatomegaly). Treatment: *
A

Metastasis from the lung

42
Q
  • Symptoms: {{Multiple lesions, likely bilateral will be seen (versus a single focus in a primary tumor).}} Lab Values: ** Pathophysiology: Most common lung cancer. Often from breast, colon, prostate, stomach, and bladder cancer. Treatment: *
A

Metastasis to the lung

43
Q
  • Symptoms: {{Horner’s syndrome (ptosis, miosis, anhidrosis)}}. Lab Values: ** Pathophysiology: {{Carcinoma that occurs in apex of lung and may compress cervical sympathetic plexus}}. Treatment: *
A

Pancoast’s tumor

44
Q
  • Symptoms: Upper limb and head edema, headaches, dizziness; risk of aneurysm and rupture of cranial arteries. Lab Values: Increased ICP (if severe), elevated JVP. Pathophysiology: *{{Obstruction of SVC that impairs blood drainage from the head, neck, and upper extremeties. Due to thoracic neoplasms and thromboses}}. * Treatment: *
A

Superior vena cava syndrome

45
Q
  • Symptoms: Fever/chills, {{productive cough}}, tachypnea, pleuritic chest pain, decreased breath sounds, rales, dullness to percussion. Lab Values: {{Lobar or segmental consolidation (opacification)}}. Pathophysiology: {{Most commonly due to S. pneumonia (95%; rusty sputum)}}; also {{Klebsiella (if alcoholic, Enteric Aspiration; mucoid sputum, currant jelly).}} Intra-alveolar exudate consolidation; may involve entire lung. Congestion (hyperemia, edema) followed by {{red hepatiziation (PMN, hemorhage), grey hepatzation (degradation of RBCs)}}, resolution (healing). Treatment: *
A

Lobar pneumonia (Bacterial)

46
Q
  • Symptoms: Fever/chills, {{productive cough,}} tachypnea, pleuritic chest pain, decreased breath sounds, rales, dullness to percussion. Affects the old, young, and terminally ill. May have foul smelling sputum of abscess becomes dominated by anaerobes. Lab Values: {{Patchy opacification centered around bronchioles}}. Pathophysiology: {{Due to S. aureus, H. influenzae, Klebsiella, S. pyogenes.}} {{Acute inflammatory infiltrates from bronchioles into adjacent alveol}}i; patchy distribution involving greater than 1 lobe. Treatment: *
A

Bronchopneumonia (lobular pneumonia, bacterial)

47
Q
  • Symptoms: Fever, {{NON-PRODUCTIVE COUGH}}. Generally follows a more indolent course than bronchopneumonia. Lab Values: {{Fluffy, light, diffuse interstitial infiltrates}}. No consolidations. Pathophysiology: {{Atypical. Due to viruses (RSV, adenovrius, CMV), Mycoplasma (most common), Legionella, Chlamydia}}. Diffuse patchy inflammation localized to interstitial areas at alveolar walls; distribution involving greater than 1 lobe. Can be complicated by superimposed bacterial infections. Treatment: *
A

Interstitial pneumonia (viral)

48
Q
  • Symptoms: Localized collection of pus within lung parenchyma. Foul smelling sputum (if anaerobes present). Lab Values: {{Air-fluid level seen on CXR.}} Pathophysiology: {{Due to S. aureus or anaerobes (Bacteroides, Fusobacterium, Peptostreptococcus}}). {{Caused by bronchial obstruction (e.g. cancer), aspiration of oropharyngeal contents}} (those predisposed to loss of consciousness like alcoholics or epileptics). Treatment: *
A

Lung abscess

49
Q
  • Symptoms: Dyspnea, cough, chest tightness, headache. Lab Values: Low CD4:CD8 T-cell ratio. Pathophysiology: *{{Mixed type III/IV hypersensitivity reaction to environmental antigen. Often seen in farmers and those exposed to birds.}}
  • Granulomatous Rxn w/Eosinophils
  • Chronic Exposure can lead to interstitial fibrosis.
A

Hypersensitivity pneumonitis

50
Q
  • Symptoms: ** Lab Values: *↓ breath sounds over effusion, dull resonance, ↓fremitus. {{Low protein content (
A

Pleural transudate

51
Q
  • Symptoms: ** Lab Values: ↓ breath sounds over effusion, dull resonance, ↓fremitus. {{High protein content (>1.012 specific gravity); cloudy}}. Pathophysiology: {{Secondary to malignancy, pneumonia}}, collagen vascular disease, trauma. Occurs in tate of increased vascular permeability. Must be drained in light of risk of infection. Treatment: *
A

Pleural exudate

52
Q
  • Symptoms: ** Lab Values: ↓ breath sounds over effusion, dull resonance, ↓fremitus. {{Milky fluid, ↑triglycerides.}} Pathophysiology: {{Alternatively known as chylothorax. Due to damage to the thoracic duct}}, usually by a aggressive non-Hodgkin’s lymphoma. Treatment: *
A

Lymphatic effusion

53
Q
  • Symptoms: Area of collapsed or nonexpanded lung. Lab Values: {{Mediastinum shifts towards the collapse}}. Pathophysiology: Due to an obstruction/resportion or compression (due to fluid, air, blood, or tumor in pleural space). Predisposed to infection due to decrease mucociliary clearance. Treatment: *
A

Atelectasis

54
Q
  • Symptoms: {{Fever and night sweats, weight loss, cough, hemoptysis. }} Lab Values: {{Caseating granulomas with acid-fast bacilli}}. {{Positive PPD. Ziehl-Neelson stain}}. Pathophysiology: {{Initial exposure. Ghon focus}}(subpleural; upper portion of lower lobe, or lower portion of the upper lobe). Draining hilar lymph nodes (granuloma). Treatment: *
A

Primary tuberculosis

55
Q
  • Symptoms: Fever and night sweats, weight loss, cough, hemoptysis. Lab Values: {{Caseating granulomas with acid-fast bacilli. Positive PPD. Ziehl-Neelson stain.}} Pathophysiology: Reactivation or reinfection. {{CAVITARY lesion in the apex (Simon focus)}}. Treatment: *
A

Secondary tuberculosis

56
Q
  • Symptoms: Untreated, progressive infection. Lab Values: ** Pathophysiology: {{TB disseminating in from the lungs via the lymphatics and blood.}} Can cause meningitis (invades base of skull), gonads, GI tract, lumbar vertebrae bone marrow (Pott disease). Treatment: *
A

Miliary tuberculosis

57
Q
  • Symptoms: Causes obstruction of the bronchus, leading to atelectasis and bronchiectasis. Lab Values: Polypoid intrabronchial mass on gross. Small, round, {{uniform cells growing in nests (organoid pattern) on microscopy. Dense neurosecretory granules on EM.}} Pathophysiology: *Young age (
A

Bronchial carcinoids

58
Q
  • Symptoms: Hoarseness, difficulty swallowing, pain, hemoptysis. At risk of infections. Lab Values: ** Pathophysiology: {{Associated with smoking, alcohol, and frequent cord irritation.}} May spread by direct extension, metastasis. Treatment: *
A

Laryngeal squamous cell carcinoma

59
Q
  • Symptoms: {{Emphysema plus liver cirrhosis (due to accumulation of alpha-1-antitrypsin in liver)}}. {{“Pink puffer”. Exhalation through pursed lips to ↑airway pressure and prevent airway collapse during respiration.}} Progressive dyspnea and weight loss. Lab Values: {{Obstructive}}↓FEV1/FVC ratio; barrel-shaped chest; ↑compliance. Pathophysiology: {{Alpha-1-antitrypsin deficiency in lung }}(chromosome 14; PiZZ gene; example of codominance); can’t break down elastase. {{Not due to smoking}}. Worse in the bases of lower lobes. Treatment: *
A

Panacinar emphysema

60
Q
  • Symptoms: *Pneumonconiosis plus rheumatoid arthritis.
A

Caplan’s syndrome

61
Q
  • Symptoms: Cough, wheezing, tachypnea, dyspnea, hypoxemia, pulsus paradoxus, mucus plugging (but no squamous metaplasia). Lab Values: ↓FEV1/FVC ratio; ↓I/E ratio (normal 1:2); dx with metacholine. Charcot-Leyden crystals (eosinophil membrane protein). Curschmann’s spirals (shed epilthelium from mucous plugs). Pathophysiology: Bronchial hyper-responsiveness causes reversible bronchoconstriction; smooth muscle hypertrophy. {{Mechanism unknown (not type I hypersensitivity). Due to infections, stress, exercise, cold temperatures, drug induced (aspirin).}} Treatment: *
A

Intrinsic asthma

62
Q
  • Symptoms: Progressive exertional dyspnea, {{restrictive profile on spirometry}}, biospy showing paraseptal and subpleural cystic airspace enlargement {{(honeycomb lung).}} Lab Values: ** Pathophysiology: ** Treatment: *
A

Idiopathic pulmonary fibrosis

63
Q
  • Symptoms: Very gradual worsening of dyspnea and {{productive cough}}. Lab Values: {{Bilateral patchy pulmonary opacification due to intraalveolar accumulation of amporhous protein and phospholipid material (constituents of surfactant).}} Pathophysiology: {{Congenital mutation of GM-CSF. Autoantibodies against GM-CSF. Imparied surfactant clearance by alveolar macrophages}}; lamellar bodies in alveoli. Treatment: *
A

Pulmonary alveolar proteinosis

64
Q
  • Symptoms: Solitary lung nodule “coin lesion”; benign. {{Excess growth of tissue native to the lung such as hyaline cartilage, fat, or smooth muscle lined by respiratory epithelium.}} Lab Values: ** Pathophysiology: ** Treatment: *
A

Pulmonary hamartoma

65
Q
  • Symptoms: *{{Squamous metaplasia; vitamin A is required for differentiation of respiratory epithelium.}}
A

Vitamin A deficiency pulmonary symptom

66
Q
  • Symptoms: {{Preformed antibodies to graft HLA or ABO groups}}; massive thrombosis and ischemia of graft; {{“white graft” rejection.}} Lab Values: {{Within hours.}} Pathophysiology: ** Treatment: *
A

Hyperacute lung transplant rejection

67
Q
  • Symptoms: Lymphocytic perivascular and peribronchial {{infiltration of vasculature due to graft HLA incompatibility}}. Lab Values: {{Within weeks.}} Pathophysiology: ** Treatment: *
A

Acute lung transplant rejection

68
Q
  • Symptoms: Bronchiolitis obliterans (inflammation of small airways); Lab Values: {{Within years}}. Pathophysiology: ** Treatment: *
A

Chronic lung transplant rejection

69
Q
  • Symptoms: Breathing difficulties, chest tightness, wheezing, cough. Leads to scarring and respiratory failure. {{“Brown lung disease.”}} Lab Values: ** Pathophysiology: *{{Caused by cotton dust at yarn or fabric factories}}. * Treatment: *
A

Byssinosis

70
Q
  • Symptoms: ** Lab Values: ** Pathophysiology: S. aureus, S. pneumonia, H. influenzae caused pneumonia secondary to a primary influenza A infection. Treatment: *
A

Secondary bacterial pneumonia

71
Q
  • Symptoms: Asthmatic or cystic fibrosis patient with bronchietasis, dyspnea, foul smell sputum. Lab Values: ** Pathophysiology: ** Treatment: *
A

Allergic broncopulmonary aspergillosis

72
Q

Why does supplemental O2 result in retinopathy of prematurity and bronchopulmonary dysplasia?

A

Increased risk of free radicals leads to retinopic destruction and bronchopulmonary dysplasia.

73
Q

Pt presents with increasing resp effort after birth, tachypnea with use of accessory muscles and grunting.
- Findings include hypoxemia w/cyanosis and diffuse granularity of lung on CXR.

A

Neonatal Respiratory Distress Syndrome

74
Q
  • Accumulation of air in the pleural space.

- Tall, thin, young males because of rupture of apical blebs with trachea deviated toward the affected lung.

A

Spontaneous Pneumothorax

75
Q

Unilateral Chest Pain and dyspnea, unilateral chest expansion, decreased tactile fremitus, hyperresonance, and diminished breath sounds.

A

Pneumothorax

76
Q
  • Air is capable of entering the pleural space but not exiting with trachea deviated away from the affected lung.
  • Usually presents with trauma or lung infection.
A

Tension Pneumothorax

Lungs First Aid USMLE 2013 (3 decks)

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