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BHP Exam 3 > Respiratory 2 (Use this LATEST edition!) > Flashcards

Respiratory 2 (Use this LATEST edition!) Flashcards

1
Q

what causes right heart failure?

A

pulmonary hypertension

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2
Q

left heart failure causes

A

pulmonary edema

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3
Q

restrictive pulmonary disease

A

restrics lung expansion, decreases lung volume, increases work of breathing, inadequate ventilation/oxygen

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4
Q

restrictive pulmonary disease results in

A

hypoxia + diffusional defect when there’s edema + fibrosis of alveolar walls

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5
Q

restrictive pulmonary disease has 3 phases to damage alveolar walls

A

hyaline membrane in alveolar sacs
edema + inflammation of interstitium
fibrosis

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6
Q

Acute respiratory distress syndrome (ARDS)

A

produced by diffuse alveolar damage (DAD) leading to systemic metabolic derangements

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7
Q

ARDS increases alveolar capillary permeability causing

A

leakage of fibrin rich edema fluid into alveoli

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8
Q

Phase 1 of ARDS : Acute exude

A

forms hyaline membranes in alveolar spaces; exudation of fibrin rich edema fluid mixed with cytoplasmic + lipid remnants of necrotic epithelial cells

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9
Q

Phase 2 of ARDS: Late organization

A

cell proliferation and fibrosis; congested, impaired ventilation; regeneration of type II alveolar lining cells and organization of hyaline membrane with pulmonary fibrosis

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10
Q

When does interstitial fibrosis with thickening of alveolar walls or fibrous obliteration of alveolar spaces occur?

A

phase 2 of ARDS

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11
Q

ARDS treatment

A

mortality reduced to 40%

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12
Q

AdULT respiratory distress syndrome interstitial fibrosis leads to

A

honeycomb lung

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13
Q

2 causes of chronic interstitial lung disease (inhaled)

A
  1. extrinsic allergic alveolitis (immune rxn to inhaled organic dusts),
  2. pneumoconiosis- inhaling industrial (mineral) dusts
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14
Q

intrinsic diseases that cause chronic interstitial lung disease

A
  1. idiopathic interstitial pneumonitis (inflammation of alveoli)
  2. non-organ specific autoimmune CT diseases
  3. sarcoidosis
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15
Q

immune reaction in lung to inhaled antigens causes extrinsic allergic alveolitis (hypersensitivity pneuonitis)

A
  1. proteins in bird droppings
  2. contaminated vegetable derived material
  3. actinomyces + fungi in rotting crops

Farmer’s lung- moldy hay
Bird Fancier’s lung- Pigeon feces
Bagassosis- moldy sugarcane

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16
Q

4 types of pneumoconiosis

A
  1. antracosis
  2. coal worker’s pneumoconiosis
  3. silicosis
  4. asbestosis
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17
Q

what causes coal worker’s pneumoconiosis?

A

inhalation of coal dust with carbon and silica

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18
Q

progressive massive fibrosis (restrictive pulmonary disease) in Coal Worker’s is usually surrounded by

A

emphysema

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19
Q

Silicosis

A

silica particles within nodules under polarized light; silica in macrophages cause TB

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20
Q

Asbestosis long latent period often seen of up to

A

50 years b/w exposure and onset of clinical disease

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21
Q

asbestosis

A

a lung disease resulting from the inhalation of asbestos particles, marked by severe fibrosis and a high risk of mesothelioma (cancer of the pleura)

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22
Q

Ferruginous bodies

A

asbestosis bodies within macrophages; long thin fibers coated w/ hemosiderin and protein to form yellow brown filaments w/ a beaded or drumstick pattern

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23
Q

sarcoidosis

A

granulomatous lung disease, non-caseating histiocytic granulomas in lung interstitum

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24
Q

histiocytic and giant cell inflammation in

A

sarcoidosis

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25
Q

other granulomatous lung diseases

A 
(TGIF)
TB
Granulomatous Vasculitis
Inhaled Foreign bodies (e.g. pneumoconiosis)
Fungal infections (e.g. histoplasmosis)
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26
Q

sarcoidosis prognosis

A

70% recover via steroid tx

27
Q

What affects interstitium of lungs, causing fibrosis

A

restrictive pulmonary disease

28
Q

restrictive pulmonary disease

A

diffuse alveolar damage (DAD) is initial response

29
Q

ARDS is an acute form of

A

diffuse alveolar damage caused by sepsis and shock

30
Q

progressive pulmonary interstitial fibrosis leads to

A

honey comb lung

31
Q

idiopathic interstitial pneumonitis leads to

A

idiopathic progressive fibrosis of lung interstitium

32
Q

Farmers Lung is an example of

A

an extrinsic allergic alveolitis due to hypersensitivity to inhaled allergens

33
Q

pneumoconiosis exhibits fibrosis caused by

A

reactions to inhaled mineral dusts

34
Q

coalworker’s pneuoconiosis has what two forms

A

simple and progressive massive fibrosis

35
Q

asbestos predisposes

A

interstitial fibrosis, lung cancer, and mesothelioma

36
Q

sarcoidosis + autoimmune CT diseases cause

A

interstitial fibrosis

37
Q

lung cancer histopathological types

A
  1. adenocarcinoma 38%
  2. squamous cell carcinoma 20%
  3. small cell anaplastic carcinoma 14%
  4. large cell anaplastic carcinoma 3%
  5. mixed 25%
38
Q

most common form of lung cancer in females

A

adenocarcinoma

39
Q

lung cancer spreads in 4 ways

A

local, lymphatic, transcoelomic, hematogenous

40
Q

main sites of hematogenous spread

A

brain, bone, liver, adrenal glands

41
Q

bone sites of hematogenous spread

A

rib, vertebrae, humeri + femora with pain or pathological fracture

42
Q

squamous cell carcinoma

A

usually in males; central and close to carina w/ features related to bronchial obstruction

43
Q

4 histopathological patterns of adenocarcinoma

A 
(MAPS)
mucinous
acinar
papillary
solid
44
Q

most malignant lung cancer

A

small cell anaplastic carcinoma of the lung

45
Q

small cell anaplastic carcinoma of the lung

A

bronchial epithelium but differentiates into neuroendocrine cells

46
Q

Ectopic hormone like ACTH (from small cell anaplastic carcinoma of the lung) leads to

A

paraneoplastic syndrome

47
Q

lung cancer symptom

A

cough (80%) ; infection distal to airway is blocked

48
Q

lung cancer metastasis

A

frequent sign present in 70%;

49
Q

hematogenous spread of lung cancer

A 
(LPCH)
leukoerythroblastic anemia
pathological fracture
CNS symptoms
Hepatomegaly and jaundice
50
Q

Pancoast tumor

A

superior sulcus tumor at apex of lung; w/ invasion of sympathetic chain

51
Q

What leads to Horner syndrome

A

pancoast tumor

52
Q

Horner Syndrome

A

ptosis, enopthalmos, small pupils (miosis), lack of sweat (anhydrosis)

53
Q

lung cancer

A

very sensitive to radiotherapy and chemotherapy but survival is poor
complete local response in 30%
median survival= 11 mos.
one year survival= 45%

54
Q

coin lesions

A

rounded, solitary radiopaque lesion on chest radiograph; 1/3 of cases (>50 yrs) caused by lung carcinoma

55
Q

common causes of coin lesions

A

primary bronchiole or lung carcinoma
metastatic tumor
granulomatous inflammation like TB
lung abscess

56
Q

uncommon causes of coin lesions

A

fungal mycetoma

57
Q

lung cancer survival

A

5 yrs; 5-30% depending on type and stage; median approximately 15%

58
Q

Pleural Fluid Types

A

Cool PB FEAT!
Chylothorax (lymphatic fluid) - leak from lymphatic duct
Pus-empyema due to infection
Blood- hemothorax; due to trauma or surgery
Fluid effusion
Exudate-high protein
Air- pneumothorax
Transudate-low protein fluid due to movement of excess fluid through normal vessels

59
Q

Malignant Mesothelioma latent period of

A

25 to 45 years

60
Q

pediatric lung disease

A
  • due to deficiency of surfactant in lungs

- hyaline membrane disease caused by a deficiency of surfactant as a result of immaturity + damaged type II pneumocytes

61
Q

50% mortality if

A
62
Q

Cystic Fibrosis

A

Defective fxn in a membrane cl channel of epithelial cells; decreased release of Na+ and H20 to liquify mucus; bronchi and bronchioles become obstructed

63
Q

Problem with cystic fibrosis

A

bronchiectasis and hemoptysis

64
Q

median survival age of people with cystic fibrosis

A

30 years old

BHP Exam 3 (7 decks)

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