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Resp Path > Resp Path Gomez structural > Flashcards

Resp Path Gomez structural Flashcards

1
Q

Bronchopulmonary sequestrations (2)

A

No normal airway connection, no pulmonary circulation,
Extra lobar - outside lung tissue (other cong defect)
Intralobar - Recurrent Inf, Bronchiectasis, acquired

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2
Q

RDS (newborn) (definition, causes, and intrauterine induction) Risk with O2

A

Lack of surfactant. Mom anesthesia, DM, C section, cord wrapped around neck. To induce give move steroids.
Risk - retinopathy with O2 administration

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3
Q

L/S ratio

A

Lecithin/ sphingomyelin ratio, Used to tell maturity of lungs through amniocentesis.
2 both lungs are mature

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4
Q

Bronchopulmonary dysplasia. Time frame, Dx req, factors involved

A

Req 28 days of O2 therapy and age >36 weeks.
Alveolar hypoplasia
Decreased VEGF
Increased TNF, iL-8

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5
Q

Cystic Fibrosis (genes, Signs, Dx, clinical presentation)

A

CFTR Gene absent or missing,
508 heterozygosity (70%)
DX - Sibling w/ CF, ^ sweat Cl on 2 occasions, Nasal Ion transport, ID of mutations.
Immunoreactive trypsinogen-pancreatic protein elevated

Clinically - recurrent infections and salty sweat
Pancreatic insufficiency, Decreased ADK vitamins

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6
Q

Atelectasis - 3 types

A

Compression - Fluid pneumo, Mediastinum away

Resorption - Obstruction, air past obstruction will get absorbed by blood, lung will shrink and mediastinum toward

Contraction - Fibosis/scarring

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7
Q

Acute lung injury (4 criteria)

A

Acute dyspnea, Hypoxemia, Bilateral infiltrates, No Hx of heart failure

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8
Q

Adult ARDS (describe, cells, hemodynamic state, Conditions associated with(4))

A

Alveolar/capillary wall dmg w/ neutrophils. 2º loss of surfactant, (d/t loss of type 2 pneumocyte)
Prothrombotic
Sepsis, Gastric Aspiration, Head injury, diffuse pulmonary infection

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9
Q

Acute interstitial pneumonia

A

Similar presentation to ARDs but no causative disorder identified (basically idiopathic)

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10
Q

Chronic Diffuse Lung Disease (2 types)

A

Obstructive - Low FEV/FVC (COPD, emphysema, bronchiectasis, astham, chronic bronchitis)

Restrictive - normal FEV/FVC (Obesity, ard, fibrosis)

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11
Q

Emphysema (3 of 4 types and associations)

A

Centriacinar/centrilobular (95%) - SMOKING Upper Lobar (bronchi)

Panacinar/Panlobar - SMOKING, Alpha-1 antitryptase deficiency, Lower Lobes (Bronchi to Alveoli)

Distal Acinar - Pneumothorax (alveloi)

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12
Q

Emphysema MOA and inhibitor, Clinical presentation

A

Neutrophils release elastase to degrade tissues in lungs, (inhibited by alpha 1 antitryptase

Clinical - Low FEV/FVC, Barrel chest, Punk Puffers, High TLC

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13
Q

Random increased air conditions

A

Compensatory - Removal of one lung

Obstructive overinflation - Water heater thing

Interstital emphysema - sounds like rice crispies

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14
Q

Chronic Bronchitis (Dx time frame, histological findings, physiological findings, Leads to ?)

A

3 months/year for 2 consecutive years
Hyperplasia of goblet cells, Bronchiectasis, Increased Reid index (Ratio of glands to total thickness >.4 = hyperplasia) , Bronchiolitis obliterans

Leads to cor pulmonal

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15
Q

Asthma (definition, inducers)

A

Partially reversible - bronchiodilaters,
Aggravations - Cold, exercise, allergens
Can lead to fibrosis

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16
Q

Type 1 asthma ( factors to know)

A

Hypersensitivity - IgE, increased TH2, Eosinophils

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17
Q

Drug induced asthma

A

Primarily aspirin, leukotriens can produce bronchoconstriction

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18
Q

Curschmann Spiral

A

Asthma - shed epithelium

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19
Q

Bronchiectasis

A

Permenant dilation, recurrent infections, Cystic fibrosis

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20
Q

Kartageners

A

Cystic fibrosis, situs inversus, ciliary retardation, Male infertility

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21
Q

Categories of chronic interstital lung disease

A

Usual interstital pneumonia, Nonspecific interstital pneumonia, Cryptogenic (unsure of cause), Pneumoconiosis, Sarcoidosis, Eosinophilic pneumonia,

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22
Q

Idiopathic pulmonary fibrosis/ Usual interstital (cells, inhibited factor, Clinical)

A

Hyperplasia of Type 2 - increased mucous, Inhibition of caveolin allows deposition of collagen

Clinical - Digital clubbing (bone enlargement d/t hypoxemia and nonspecific ), honeycomb lung

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23
Q

Nonspecific interstital pneumonia (clinical)

A

SOB and cough for several moths
No honeycombing/fibrosis
Milder than IPF/UIP

24
Q

Cryptogenic Organizing Pneumonia

A

Alveolar disease w/ well circumscribed lesions. No fibrosis

25
Q

Collagen vascular disorder-related insterstital lung disease (caplan syndrome)

A

Usually Rheumtoid arthritis, When combined with pneumoconiosis is caplan syndrome

26
Q

Coal workers pneumoconiosis (2 types)

A

Simple - asymptomatic, some nodules

Complex - SOB, symptomatic, >2 cm lesions, Can lead to pulmonary massive fibrosis, Pulm HTN, Cor Pulmonale

27
Q

Silicosis(frequency, Increased risk, appearance)

A

Mos prevalent environemtnal pneumoconiosis in the world, increased incidence of TB, Birefringent in polarization, Carcinogenic

28
Q

Asbestos (associated health problems, buzz words, xray)

A

Mesothelioma(ampiboles) = asbestos, but lung cancer is more common (laryngeal carcinoma) Fibrous pleural plaques
xray - peripheral plaques(meso) by ribs.

29
Q

Sarcoidosis ( xray, histological buzzword, diagnostic test)

A

Granulomas, anergy to PPD/candida, Increased ACE, Asteroid bodies - inside cell, Schaumann body - calcified body inside macrophage

30
Q

Hypersensitivity pneumonitis (location and types 3)

A

Alveolar, Farmers - Actinomyces in hay , Brid fancier - serum in feces, Humdfier lung - thermophillic actinomyces

31
Q

Intersitial diseases related to smoking (3)

A

Desquamative Interstitial pneumonia - Smokers macrophages, steroids and not smoking cures

Respiratory bronchiolitis-associated interstital lung disease - Pigmented macrophages in Bronchioles w/ peribronchiolar fibrosis

Pulmonary Langerhans Cell Hitiocytosis ** - Eosinophilic granuloma, CD1a associated

32
Q

Pulmonary alveolar proteinosis (clinical presentation + 3 classes

A

Build up of surfactant - shiny gelatinous phlegm.

Autoimmune(90%) Ab to GM-CSF ( defecting phagocytosis of surfactant)

Secondary - Rare - pneumocoiosis associated

Hereditary - Rare- fatal w/o transplant

33
Q

Pulmonary embolism (location, COD, 2º major effect, types)

A

Lower lobe, Death d/t arrythmia from strain on R ventricle d/t emboli,
acute cor pulmonale
Fat, marrow, aminotic fluid, talc (gloves)

34
Q

Primary pulmonary HTN (gene and demographic)

A

Lack of BMPR2 - smooth muscle hypertrophy

Females 20-40 yrs

35
Q

Goodpasture (ab, Clinical signs)

A

Ab to collagen 4. Renal failure, ^ creatinine, SOB, Hemoptysis.

36
Q

Idiopathic pulmonary hemosiderosis (demographics, location, tmnt)

A

Children, deposits in alveolar walls, Immunosupression works

37
Q

Polyangitis w/ Granulomatosis (wegners) (triad, antibody)

A

Upper resp lesions, Granulomatous vascular lesions, Masses in lungs, problems in kidneys
PR3/c-anca

38
Q

Pneumonia Syndromes (community, 4 alveolar w/ associations, Atypical pneumonias (4), Aspiration (4), Immunocompromised (5)

A

(alveolar)
Strept pneumoniae - MOST COMMON increased risk of splenectomy

Haemophilus influenza - COPD

Staph Aureus - Common post viral pneumonia

Pseudomonas aeruginosa - cystic fibrosis

Atypical interstitial
Myco pneumoniae (cold agglutins)
Chlamydia
Coxiella burnetti
Viruses

Aspiration (lead to necrotizing pneumonia/lung abscess)
Bacteroides, Fusobacterium, Peptostrept, Prevotella

Immunocompro
Myco avium-intracellular, Cytomegalovirus, Pneumocystis jirovecii, Aspergillosis, Candidiasis

39
Q

Viral pneumonias

A

Usually a chest cold but can be fatal

40
Q

Pulmonary abscess (Organisms 4, presentation, Sources)

A

Staph aureus, Bacteroides, fusobacterium, Peptococcus

Present - foul smelling/bloody sputum, non specific, empyema, hemorrhage, brain abscess

Sources - Aspiration, septic embolism, neoplasm

41
Q

Respiratory Syncytial Virus (demographic/associated symptoms)

A

Most common cause of Bronchiolitis/pneumonia in kinds <12 months.
Otitis Media associated

42
Q

TB Pneumonia

A

Chronic,
Primary - Ghon Complex (Lymph node and lesion)
Secondary - Reactivation of old lesion
Milliary - shotgun appearance, vessel invasion

43
Q

Fungal Pneumonias (Species, Size, Location)

A

Histoplasma capsulatum - smaller than RBC, ohio, michigan, carribean (Dumbbell, granuloma

Blastomyces dermatidis - about RBC size, Central/SE US, india, africa,

Cocciodes immitis - bigger than RBC, Cali, Mexico, Far West

44
Q

Immunocompromised pneumonies (5)

A

Pneumocystis Jirovecii, Cytomegalovirus, Myco Avium cellulair, Aspergillus, Candida

45
Q

Indications for lung transplant (4)

A

Emphysema, Idiopathic pulmonary fibrosis, Cystic fibrosis, Idiopahic/Familial pulmonary HTN

46
Q

Immunocompromised organism Buzz words

A

Pneumocystis jirovecii -Frothy/Cotton candy exudate, Cup and Saucer cells

Cytomegalo virus - Owl eye

Candida - spaghetti and meatball

Cryptococcus - mucous capsule - will have a surrounding area on mucin stain

Aspergillus - 45º hyphae

47
Q

Pulmonary Hamartoma

A

Same/right tissue in an abberant place, “popcorn calcifications”

48
Q

Pancoast tumor (location and associated syndrome)

A

Apical lung tumor, Ulnar nerve pain,

Horner - Enopthalmos, Ptosis, Miosis, Anhidrosis

49
Q

Paraneoplastic syndromes

A

PTHrp - Squamous cell carcinoma

ADH, ACTH, Calcitonin

50
Q

Squamous cell Carcinoma (location, associated hormone)

A

98% of smokers - D/T dmg of epithelium,
Central - bronchioles
PTHrp - Parathyroid hormone related protein (hypercalcemia)

51
Q

Adenocarcinoma (demographic, location, Gene)

A

Female non-smokers
Peripheral
Mucin production
TTF1 positive (Thyroid transcription factor 1)

52
Q

Bronchioloalveolar Carcinoma in Situ

A

Alveolar, aerogenous spread, Non invasive vs Micronvasive which has <5mm spread

53
Q

Large Cell Carcinoma (location/defining characteristic)

A

Undifferentiated and Central or peripheral

54
Q

Small Cell Carcinoma (location, cell type, hormone/ion)

A

Central w/ some peripheral growth

Neuroendocrine, ^ADH, ^ Ca

55
Q

Pleural Neoplasms (Most common type, buzz words)

A

MEtastatic are most common
Primary - more rare, MEsothelioma
Calretenin, Mesothelin, WT-1

56
Q

Mesothelioma (appearance & histological)

A

Can look like adenocarcinoma
Thick band encasing lungs
Long packed microvili

Resp Path (3 decks)

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