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PT342 > Respa > Flashcards

Respa Flashcards

1
Q

Front

A

Back

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2
Q

What are the lesions of the upper respiratory tract associated with acute infections?

A
  1. Acute rhinitis 2. Acute sinusitis 3. Acute tonsillitis 4. Acute pharyngitis 5. Acute epiglottitis 6. Acute laryngitis
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3
Q

What are the chronic forms of inflammation in the upper respiratory tract?

A

Chronic forms of inflammation occur due to repeated attacks of acute infections.

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4
Q

Define acute rhinitis.

A

Acute rhinitis is the inflammation of the nasal mucosa.

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5
Q

What are the two types of acute rhinitis?

A
  1. Common cold 2. Allergic rhinitis
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6
Q

What is the common cold?

A

The common cold also known as coryza is a disease caused by pathogens such as influenza viruses rhinoviruses and RSV.

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7
Q

What symptoms are associated with the common cold?

A

Symptoms include fever nasal congestion watery discharge and sore throat.

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8
Q

What are the two phases of inflammation in acute rhinitis?

A
  1. Viral phase: The virus adheres to cell surface proteins enters the cell replicates causing edema and congestion with no neutrophil exudation. 2. Bacterial phase: Bacteria invade the damaged tissue causing features of acute inflammation.
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9
Q

What characterizes allergic rhinitis (hay fever)?

A

Allergic rhinitis is an atopic disease characterized by edema and eosinophil infiltrate with symptoms such as itching sneezing and watery discharge.

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10
Q

What is acute sinusitis?

A

Acute sinusitis is the inflammation of the mucosa lining the sinuses particularly the maxillary sinus often occurring as a complication of rhinitis or dental sepsis.

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11
Q

What pathogens are commonly associated with acute sinusitis?

A

Common pathogens include S. pneumoniae and S. aureus.

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12
Q

What are the complications of acute tonsillitis?

A

Complications include quinsy (peritonsillar abscess) direct spread of infection acute rheumatic fever and post-streptococcal glomerulonephritis.

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13
Q

What causes acute tonsillitis?

A

Acute tonsillitis is commonly caused by streptococcus hemolyticus.

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14
Q

What are the three types of acute tonsillitis?

A
  1. Catarrhal: Enlarged hyperemic tonsils 2. Follicular: Purulent exudate over lymph follicles 3. Membranous: Purulent exudate forms a membrane covering the tonsils.
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15
Q

What is acute pharyngitis and what are its common causes?

A

Acute pharyngitis is inflammation of the pharynx often caused by Ebstein-Barr virus (EBV) adenovirus or β-hemolytic streptococci.

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16
Q

What are complications of acute pharyngitis?

A

Complications include retropharyngeal abscess and adenoid hyperplasia.

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17
Q

What causes acute epiglottitis?

A

Acute epiglottitis is caused by H. influenza. Vaccination against H. influenza has reduced its incidence.

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18
Q

What are the complications of acute laryngitis?

A

Complications include sloughing aspiration of the pseudomembrane causing major airway obstruction toxic myocarditis and peripheral neuropathy.

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19
Q

What are nasal polyps?

A

Nasal polyps are recurrent infections of the nose leading to polypoid thickening of the mucosa appearing as bilateral rounded masses in the middle turbinate.

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20
Q

What is nasopharyngeal carcinoma and its associated risk factors?

A

Nasopharyngeal carcinoma is caused by EBV particularly in the Chinese population associated with genetic susceptibility and is more common in children and the elderly.

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21
Q

What are the three types of nasopharyngeal carcinoma?

A
  1. Undifferentiated carcinoma: Large neoplastic cells with reactive lymphocytes 2. Keratinizing squamous cell carcinoma 3. Non-keratinizing squamous cell carcinoma.
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22
Q

What is the prognosis for nasopharyngeal carcinoma?

A

It is a radiosensitive tumor with a 5-year survival rate of 50%.

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23
Q

What are laryngeal tumors and their types?

A

Laryngeal tumors include vocal cord polyps squamous papilloma and carcinoma of the larynx.

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24
Q

What are vocal cord polyps?

A

Vocal cord polyps are non-malignant lesions occurring in heavy smokers or singers characterized by smooth round masses composed of fibrous tissue.

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25
Q

What is squamous papilloma and its characteristics?

A

Squamous papilloma is a benign tumor caused by human papilloma virus (types 6 11) characterized by soft finger-like projections.

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26
Q

What is the most common type of lung cancer?

A

The most common type of lung cancer is squamous cell carcinoma.

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27
Q

What are the causes of epistaxis?

A

Causes of epistaxis include local trauma hypertension tumors leukemia nasal polyps hemorrhagic blood diseases and vitamin K deficiency.

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28
Q

What is the function of the normal lung?

A

The normal lung is supplied by pulmonary and bronchial arteries of aortic origin and is responsible for gas exchange between inspired air and blood.

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29
Q

What is the anatomical difference between the right and left bronchus?

A

The right bronchus is more vertical and aligned with the trachea making it more likely for aspirated foreign bodies to enter the right lung.

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30
Q

What structures are involved in gas exchange in the lungs?

A

Gas exchange occurs in the acinus composed of respiratory bronchioles and several alveoli.

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31
Q

What types of cells are found in the alveolar wall?

A
  1. Capillary endothelium 2. Type 1 pneumocytes (flattened cells covering 95% of the surface) 3. Type 2 pneumocytes (rounded granular cells that secrete surfactant) 4. Alveolar macrophages.
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32
Q

What is atelectasis and its causes?

A

Atelectasis is a collapse or loss of lung volume due to inadequate expansion of air spaces which can be caused by obstruction compression or contraction.

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33
Q

What are the categories of atelectasis?

A
  1. Resorption atelectasis (obstruction) 2. Compression atelectasis (passive or relaxation) 3. Contraction atelectasis (cicatrization) 4. Microatelectasis.
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34
Q

What is obstructive lung disease characterized by?

A

Obstructive lung disease is characterized by an increase in resistance to airflow due to partial or complete obstruction at any level.

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35
Q

What are examples of obstructive lung diseases?

A

Examples include asthma emphysema chronic bronchitis bronchiolitis and bronchiectasis.

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36
Q

What is chronic obstructive pulmonary disease (COPD)?

A

COPD is a term used to describe chronic bronchitis and emphysema due to persistent and irreversible airflow obstruction.

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37
Q

What are restrictive lung diseases characterized by?

A

Restrictive lung diseases are characterized by reduced expansion of lung parenchyma and decreased total lung capacity.

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38
Q

What are the two conditions that can lead to restrictive lung diseases?

A
  1. Extra pulmonary disorders affecting chest wall function (e.g. severe obesity kyphoscoliosis) 2. Acute or chronic interstitial lung diseases (e.g. ARDS sarcoidosis).
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39
Q

What is bronchial asthma?

A

Bronchial asthma is an episodic reversible bronchospasm resulting from increased bronchioconstrictor response to various stimuli.

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40
Q

What are the two categories of asthma?

A
  1. Extrinsic asthma 2. Intrinsic asthma.
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41
Q

What triggers extrinsic asthma?

A

Extrinsic asthma is initiated by a type 1 hypersensitivity reaction to an extrinsic antigen.

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42
Q

What are the types of extrinsic asthma?

A
  1. Atopic asthma 2. Occupational asthma 3. Allergic bronchopulmonary aspergillosis.
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43
Q

What characterizes intrinsic asthma?

A

Intrinsic asthma is triggered by non-immune mechanisms and IgE levels are typically normal.

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44
Q

What are the effects of early phase mediators in asthma?

A

Early phase mediators cause bronchospasm increased vascular permeability and mucin secretion.

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45
Q

What are Curschmann spirals?

A

Curschmann spirals are mucus plugs containing whorls of shed epithelium found in sputum examination of asthma.

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46
Q

What are Charcot-Leyden crystals?

A

Charcot-Leyden crystals are crystalloid structures made of eosinophil membrane protein found in asthma patients.

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47
Q

What cells are infiltrated in bronchial asthma?

A

Eosinophils and mast cells.

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48
Q

What are the features of bronchial asthma?

A

Dyspnea wheezing and chest tightness that last from 1 to several hours which relieve spontaneously or with treatment.

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49
Q

What is status asthmaticus?

A

A severe condition that persists for days and can result in severe cyanosis and death.

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50
Q

How is bronchial asthma diagnosed?

A

By high eosinophil count in the blood and the presence of Curschmann spirals and Charcot Leyden crystals in the sputum.

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51
Q

Define emphysema.

A

Permanent enlargement of the air spaces distal to terminal bronchioles with destruction of their walls.

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52
Q

What percentage of emphysema cases are asymptomatic and when are most diagnosed?

A

50% of cases are asymptomatic and are diagnosed only at autopsy.

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53
Q

List the types of emphysema.

A
  1. Centriacinar (Centrilobular) 2. Distal acinar (Paraseptal) 3. Panacinar (Pan lobular) 4. Irregular emphysema.
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54
Q

What is centriacinar emphysema and its prevalence?

A

Centriacinar emphysema occurs in 95% of cases in heavy smokers severe in the upper lobe and involves the proximal or central part of the acini.

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55
Q

What is panacinar emphysema associated with?

A

Panacinar emphysema occurs in patients with alpha-1 antitrypsin deficiency and involves the lower zone affecting the entire acini including respiratory bronchiole alveolar duct and alveoli.

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56
Q

What is distal acinar emphysema?

A

It involves the distal part of the acinus adjacent to the pleura and can form cyst-like structures called bullae that range from 0.5 to 2 cm.

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57
Q

What is irregular emphysema?

A

A common form related to scarring that is asymptomatic and involves irregular acinus involvement.

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58
Q

What is the pathogenesis of emphysema?

A

It involves protease-antiprotease imbalance and oxidant-antioxidant imbalance.

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59
Q

What is the role of alpha-1 antitrypsin in emphysema?

A

Alpha-1 antitrypsin is a major inhibitor of elastase secreted by neutrophils during inflammation.

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60
Q

How does smoking contribute to emphysema?

A

Nicotine attracts neutrophils in the alveoli which release elastase proteinase resulting in tissue damage.

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61
Q

What morphological differences exist between centriacinar and panacinar emphysema?

A

Centriacinar affects the central portion with sparing of distal airways and is caused by smoking while panacinar affects both central and distal airways and is caused by alpha-1 antitrypsin deficiency.

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62
Q

What are the clinical features of emphysema?

A

Dyspnea cough wheezing weight loss; patients may be barrel-chested with prolonged expiration.

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63
Q

Differentiate between ‘pink puffers’ and ‘blue bloaters’.

A

Pink puffers (do not tolerate hypoxia severe breathlessness hyperventilation) vs. blue bloaters (tolerate hypoxia severe hypoxemia hypercapnia right ventricular hypertrophy).

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64
Q

What are the conditions related to emphysema?

A
  1. Compensatory emphysema after surgical removal of a diseased lobe. 2. Senile emphysema related to aging. 3. Obstructive overinflation. 4. Mediastinal emphysema.
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65
Q

Define chronic bronchitis.

A

Inflammation of the large to medium bronchi characterized by a persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.

66
Q

What are the types of chronic bronchitis?

A
  1. Simple chronic bronchitis 2. Chronic mucopurulent bronchitis 3. Chronic asthmatic bronchitis 4. Chronic obstructive bronchitis.
67
Q

What are the causes of chronic bronchitis?

A
  1. Cigarette smoking 2. Air pollutants such as sulfur dioxide and nitrogen dioxide.
68
Q

What is the pathogenesis of chronic bronchitis?

A

Hypersecretion and hypertrophy of bronchial mucus glands inflammation with infiltration of CD8 T cells macrophages and neutrophils.

69
Q

What is the Reid index and its significance?

A

The Reid index is the ratio of submucosal gland thickness to bronchial wall thickness with a value greater than 12 indicating significant changes.

70
Q

What is bronchiectasis?

A

Permanent dilation of bronchi and bronchioles due to muscle and elastic tissue destruction.

71
Q

What causes bronchiectasis?

A
  1. Bronchial obstruction (tumors foreign bodies) 2. Necrotizing pneumonia (e.g. Klebsiella S. aureus) 3. Congenital conditions (e.g. cystic fibrosis Ig deficiencies Kartagener syndrome).
72
Q

What is the clinical course of bronchiectasis?

A

Productive cough of mucopurulent sputum hemoptysis finger clubbing hypoxemia pulmonary hypertension and cor pulmonale in severe cases.

73
Q

Define restrictive lung diseases.

A

Diseases requiring more pressure to expand the lung due to stiffness from chest wall abnormalities or parenchymal causes.

74
Q

What are acute restrictive lung diseases (ARLD)?

A
  1. Acute lung injury (ALI) 2. Acute respiratory distress syndrome (ARDS).
75
Q

What is the morphology of ARDS during the exudative phase?

A

Capillary congestion with neutrophil collection necrosis of alveolar epithelial cells collapsed alveoli and dilated alveolar ducts lined with hyaline membrane.

76
Q

What is idiopathic pulmonary fibrosis (IPF)?

A

A chronic restrictive lung disease characterized by the inflammatory response to injury that heals by fibrosis with dense collagen and cystic spaces.

77
Q

What is hypersensitivity pneumonitis?

A

An immunologically mediated inflammatory disease that affects alveoli due to sensitivity to inhaled antigens.

78
Q

What is the clinical course of hypersensitivity pneumonitis?

A

4-8 hours after exposure the patient develops fever cough dyspnea with chronic cases leading to malaise and weight loss.

79
Q

What is Goodpasture syndrome?

A

An immune-mediated disease presenting as a triad of hemoptysis anemia and diffuse pulmonary infiltrate caused by antibodies to a common antigen in glomerular and pulmonary basement membranes.

80
Q

What is the common demographic affected by sarcoidosis?

A

Adults younger than 40 years especially non-smokers with a higher incidence in Danish Swedish and U.S. black populations.

81
Q

What are the clinical findings in sarcoidosis?

A

Non-caseating granulomas and associated respiratory symptoms.

82
Q

What treatment is required for severe Goodpasture syndrome?

A

Renal transplant is required in severe cases.

83
Q

What are the three primary factors that contribute to genetically predisposed persons exposed to certain environmental agents?

A
  1. Immunological factors 2. Genetic factors 3. Environmental factors
84
Q

What are the immunological factors related to cell mediated response to an unidentified antigen?

A
  1. Intraalveolar interstitial accumulation of CD4 T cells. 2. Increase in IL-2 and IFN- causing macrophage activation. 3. Increase in IL-8 TNF and MIP-1 that recruit T cells and macrophages to induce granuloma formation.
85
Q

What genetic factors are associated with certain predisposed individuals?

A

Familial racial factor and association with certain HLA genotypes specifically HLA-A1 and HLA-B8.

86
Q

What environmental factors are identified as causing sarcoidosis?

A

Several antigens such as viruses mycobacteria and pollen have been implicated although there is no evidence of infectious agents.

87
Q

What is the morphology associated with sarcoidosis?

A

Mononuclear phagocytes rimmed by CD4 helper T cells epithelioid histiocytes with eosinophilic cytoplasm vesicular nuclei and multinucleated giant cells.

88
Q

What are the two microscopic features of sarcoidosis?

A
  1. Schaumann bodies: laminated concretions of calcium and proteins. 2. Asteroid bodies: stellate inclusions enclosed within giant cells.
89
Q

What percentage of sarcoidosis cases involve the lungs and how does it affect connective tissue?

A

90% of cases involve the lungs affecting the interstitium and connective tissue around bronchioles and pleura.

90
Q

How does sarcoidosis affect the skin and eyes?

A

25% of cases involve the skin resulting in erythema nodosum; 50% involve the eyes causing conditions like iritis iridocyclitis glaucoma and retinitis.

91
Q

What is the clinical course of sarcoidosis?

A

Asymptomatic cases may show enlarged hilar and paratracheal lymph nodes on X-ray which appear painless and firm with a rubbery texture. Respiratory symptoms and fever may occur. 70% of patients recover; 20% experience lung dysfunction or visual impairment and 10% develop pulmonary fibrosis or cor pulmonale.

92
Q

What are the three common forms of pneumoconioses?

A
  1. Coal dust (Coal workers pneumoconiosis) 2. Silica (Silicosis) 3. Asbestos (Asbestosis)
93
Q

What factors influence the pathogenesis of pneumoconioses?

A
  1. Size of particles (1-5 micrometers) 2. Solubility 3. Duration of exposure 4. Concentration 5. Host response.
94
Q

What is the role of alveolar macrophages in lung injury and fibrosis?

A

Alveolar macrophages are key in initiating lung injury and fibrosis by releasing toxic mediators that trigger inflammatory responses and fibroblast proliferation.

95
Q

How is Coal Workers Pneumoconiosis (CWP) classified?

A

CWP is classified into four categories: 1. Anthracosis 2. Simple CWP 3. Complicated CWP 4. Caplan syndrome.

96
Q

What are the characteristics of Anthracosis?

A

Anthracosis is characterized by carbon particles engulfed by macrophages that drain through lymphatics resulting in black streaks in lymph nodes.

97
Q

What defines Simple Coal Workers Pneumoconiosis (CWP)?

A

Simple CWP is defined by focal aggregates of dust-laden macrophages around respiratory bronchioles known as coal nodules.

98
Q

What is Complicated Coal Workers Pneumoconiosis (CWP)?

A

Complicated CWP is characterized by large black fibrotic scars ranging from 2-10 cm commonly referred to as ‘black lung’.

99
Q

What is Caplan syndrome?

A

Caplan syndrome is a combination of rheumatoid arthritis with pneumoconiosis.

100
Q

What clinical course do patients with complicated CWP typically experience?

A

Patients may develop pulmonary dysfunction and pulmonary hypertension but CWP does not progress to bronchiogenic carcinoma unlike asbestosis or silicosis.

101
Q

What is Silicosis?

A

Silicosis results from exposure to silicates which are inorganic minerals present in stone and sand leading to nodule formation and tissue destruction.

102
Q

What are the types of Silicosis?

A
  1. Acute silicosis: results from high levels of silica exposure causing interstitial inflammation. 2. Chronic silicosis: characterized by nodules in the upper lobes (2 cm). 3. Complicated silicosis: defined by the expansion of nodules beyond 2 cm with lung destruction.
103
Q

What are the macroscopic and microscopic features of Silicosis?

A

Macroscopic features include pale nodules in the upper lobe (silicotic nodules). Microscopic features include whorled collagen fibers surrounding an amorphous center.

104
Q

What are the clinical consequences of Silicosis?

A

Respiratory symptoms pulmonary hypertension and cor pulmonale appear in complicated silicosis cases with chronic cases detectable by X-ray as fine nodules in the upper lobe.

105
Q

What is Asbestosis and its related risks?

A

Asbestosis is associated with asbestos exposure leading to a precancerous lesion with risks for bronchogenic carcinoma and malignant mesothelioma.

106
Q

What are the morphologic characteristics of Asbestosis?

A

Asbestosis affects the lower lobe and presents with pleural plaques which are dense collagen with calcium and causes either nodular fibrosis or diffuse interstitial fibrosis.

107
Q

What clinical symptoms develop after exposure to asbestos?

A

Respiratory symptoms typically appear 10-20 years after exposure and can lead to cor pulmonale and death. Lung or pleural cancer associated with asbestosis has a poor prognosis.

108
Q

What are the common causes of pulmonary thromboembolism?

A

Common causes include embolization of thrombi from the right side of the heart to the lung with 95% arising from thrombi in the deep veins of the legs.

109
Q

What are the risk factors for pulmonary embolism?

A
  1. Leg surgery 2. Severe trauma 3. Prolonged bed rest 4. Contraceptive pills 5. Congestive heart failure 6. Disseminated cancer.
110
Q

What are the morphological features of pulmonary embolism?

A

Emboli may occur in the main pulmonary artery or its branches referred to as saddle embolus with smaller emboli preserving parenchyma vitality.

111
Q

What is the clinical course for patients with pulmonary embolism?

A

80% are silent and removed by fibrinolysis 10% cause pulmonary infarction 5% cause acute cor pulmonale or sudden death and 3% of recurrent emboli cause chronic cor pulmonale.

112
Q

What is the prophylactic therapy for preventing pulmonary embolism?

A
  1. Early ambulation 2. Leg exercises 3. Elastic stockings. Patients with pulmonary embolism may require thrombolytic or anticoagulant therapy.
113
Q

What are the non-thrombotic forms of pulmonary embolism?

A
  1. Air embolism 2. Fat embolism 3. Amniotic fluid embolism 4. Foreign body embolism.
114
Q

What are the characteristics of primary pulmonary hypertension?

A

Primary pulmonary hypertension is idiopathic and affects young women causing chest pain and dyspnea potentially leading to right-sided heart failure.

115
Q

What is secondary pulmonary hypertension and its causes?

A

Secondary pulmonary hypertension can occur at any age due to underlying conditions such as COPD recurrent pulmonary emboli heart disease or inflammatory vascular diseases.

116
Q

What are the clinical features and treatment options for pulmonary hypertension?

A

Primary pulmonary hypertension can be treated with vasodilators; lung transplantation may be necessary in advanced cases.

117
Q

What is pneumonia and its classification based on acquisition?

A

Pneumonia is an inflammation of the lung parenchyma and is classified as community-acquired acute pneumonia community-acquired atypical pneumonia nosocomial pneumonia aspiration pneumonia chronic pneumonia lung abscess and immunocompromised pneumonia.

118
Q

What are common pathogens causing community-acquired acute pneumonia?

A

Streptococcus pneumoniae is the most common pathogen often associated with aspiration of pharyngeal flora.

119
Q

What are the four stages of lobar pneumonia?

A
  1. Congestion 2. Red hepatization 3. Gray hepatization 4. Resolution.
120
Q

What defines bronchopneumonia in terms of inflammation distribution?

A

Bronchopneumonia is characterized by inflammatory consolidation distributed through one or more lobes which can appear confluent resembling lobar pneumonia.

121
Q

What are the clinical symptoms of pneumonia?

A

Fever chills chest pain and mucopurulent cough are common symptoms with sputum often showing gram-negative organisms.

122
Q

What complications can arise from pneumonia?

A

Complications include tissue destruction (necrosis abscess) empyema organization of alveolar exudate and bacterial dissemination to other sites.

123
Q

What organisms other than Streptococcus pneumoniae can cause pneumonia?

A
  1. Haemophilus influenzae 2. Staphylococcus aureus 3. Klebsiella pneumoniae 4. Pseudomonas aeruginosa 5. Legionella pneumophila 6. Moraxella catarrhalis.
124
Q

What characterizes community-acquired atypical pneumonia?

A

Community-acquired atypical pneumonia is caused by Mycoplasma pneumoniae and Chlamydia pneumoniae often resulting in pharyngitis laryngitis tracheobronchitis and pneumonia.

125
Q

What is the clinical course of community-acquired atypical pneumonia?

A

The condition presents with acute onset fever headache malaise and later develops a dry cough with X-ray patches in the lower lobe.

126
Q

What are the causes of chronic pneumonia?

A

Chronic pneumonia often occurs in chronic granulomatous diseases like Tuberculosis or Actinomycosis.

127
Q

What defines primary tuberculosis?

A

Primary tuberculosis occurs in non-immunized individuals characterized by Ghon focus and Ghon complex which may undergo fibrosis and calcification.

128
Q

What distinguishes secondary tuberculosis from primary tuberculosis?

A

Secondary tuberculosis often leads to cavitation primarily affecting the apical lobes and can occur due to reactivation or reinfection.

129
Q

What are the clinical symptoms of tuberculosis?

A

Mucopurulent sputum fever night sweats weight loss and consolidation or cavitation in lung apices on X-ray with potential drug resistance.

130
Q

What causes a lung abscess and its common morphology?

A

A lung abscess can result from aspiration of infective material or gastric content commonly located on the right side due to the vertical airway.

131
Q

What is the microscopic appearance of infection described in the text?

A

Suppuration surrounded by fibrous scarring with mononuclear infiltrate including lymphocytes plasma cells and macrophages.

132
Q

What symptoms characterize the clinical course of the described respiratory condition?

A

Cough with a large amount of foul-smelling purulent sanguineous sputum; fever; weight loss; anemia; and finger clubbing.

133
Q

What radiological finding is mentioned in the text?

A

Air-fluid level in x-ray.

134
Q

What is the mortality rate associated with the condition described?

A

10% mortality rate.

135
Q

What is cellulitis characterized by according to the text?

A

Lack of localization.

136
Q

What are some complications of the infection described?

A
  1. Abscess rupture into airways to be drained. 2. Rupture into pleural cavity causing bronchopleural fistula resulting in empyema. 3. Embolization through blood to the brain causing meningitis or brain abscess. 4. Secondary amyloidosis AA in chronic cases.
137
Q

What are some types of pneumonia mentioned in the text?

A

Immunocompromised pneumonia Cytomegalovirus infections Pneumocystis pneumonia.

138
Q

What is Cytomegalovirus (CMV) classified as?

A

A member of the herpes virus family.

139
Q

In which population is CMV infection particularly common?

A

Immunosuppressed adults such as AIDS patients and recipients of bone marrow or organ transplants.

140
Q

What are the modes of transmission for CMV?

A
  1. Transplacentally (congenital CMV) 2. Cervical or vaginal secretions at birth breast milk (perinatal) 3. Saliva in preschool years 4. Venereal route after 15 years 5. Respiratory secretions 6. Fecal-oral route 7. Iatrogenic through organ transplant or blood transfusion.
141
Q

What are the clinical manifestations of congenital CMV?

A

95% asymptomatic or classic cytomegalic inclusion disease causing intrauterine growth retardation jaundice bleeding and anemia.

142
Q

What are the symptoms of perinatal CMV?

A

Failure to thrive interstitial pneumonitis hepatitis and excretion of the virus in urine or saliva for months to years.

143
Q

What is the morphology observed in CMV infection?

A

Any organ can be affected with interstitial mononuclear infiltrate and foci of necrosis in the lung. Infected cells show gigantism of both the entire cell and nucleus with enlarged basophilic inclusion surrounded by a clear halo within the nucleus (owl’s eye).

144
Q

What diagnostic methods are used for CMV detection?

A

Viral culture rising antiviral antibody titer and PCR detection of CMV DNA.

145
Q

What is Pneumocystis pneumonia caused by?

A

P. jiroveci formerly known as P. carinii.

146
Q

What is the clinical presentation of Pneumocystis pneumonia?

A

Fever cough dyspnea with X-ray showing bilateral hilar basal infiltrate.

147
Q

What is the common histological feature of Pneumocystis pneumonia?

A

Intra-alveolar foamy pink exudate referred to as ‘cotton candy exudate’.

148
Q

What is the treatment for Pneumocystis pneumonia?

A

Antiviral drugs; recovery is common with early treatment but relapses are common.

149
Q

What are the types of lung tumors mentioned?

A
  1. Benign (Fibroma leiomyoma hamartoma) 2. Malignant (Bronchogenic carcinoma bronchial carcinoid).
150
Q

What is the most common cause of cancer death according to the text?

A

Bronchogenic carcinoma.

151
Q

What is the 5-year survival rate for lung cancer mentioned?

A

0.15

152
Q

What histological classification is provided for non-small cell lung carcinoma (NSCLC)?

A
  1. Adenocarcinoma (40%) 2. Squamous cell carcinoma (20%) 3. Large cell carcinoma (10%).
153
Q

What genetic factors are associated with lung cancer development?

A

Inactivation of tumor suppressor gene on chromosome 3p and later TP53 mutation.

154
Q

What is the typical morphology of adenocarcinomas?

A

Common in non-smokers and women arising as a small mucosal mass may develop central necrosis.

155
Q

What is adenocarcinoma in situ also known as?

A

Bronchioloalveolar carcinomas (BAC).

156
Q

What is the clinical course for small cell lung carcinoma (SCLC)?

A

It spreads early and is treated with chemotherapy with or without radiation.

157
Q

What are paraneoplastic syndromes associated with lung cancer?

A
  1. Hypercalcemia in squamous cell carcinoma 2. Cushing syndrome (ACTH) 3. Hyponatremia (ADH) 4. Neuromuscular syndrome 5. Finger clubbing 6. Hematological manifestations such as DIC in adenocarcinoma.
158
Q

What is the survival rate for bronchial carcinoid tumors?

A

50-90% survival rate over 5-10 years.

159
Q

What differentiates malignant mesothelioma from other pleural conditions?

A

Malignant mesothelioma occurs due to asbestos exposure and has a poor prognosis with few surviving more than 2 years.

160
Q

What is the appearance of pleural effusion described in the text?

A

Presence of fluids in the pleural space which can be transudate or exudate.

161
Q

What is pneumothorax?

A

Presence of air in the pleural sac which can occur spontaneously or secondary to other conditions.

162
Q

What is the characteristic appearance of lung secondary tumors?

A

Multiple nodules in all lobes reaching a few cm in diameter with a cannonball appearance from renal carcinomas and sarcomas.

PT342 (1 decks)

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