Respiratory Flashcards
The trachea and bronchi are lined by
pseudostratified columnar mucin producing ciliated epithelium
The bronchioles are lined by
cuboidal epithelium w/ neuroendocrine cells dispersed throughout (NO mucus glands)
The alveoli are lined by
epithelium composed of type I and type II pneumocytes
Type ___ alveolar pneumocytes have the ability to proliferate
II; Type II pneumocytes replace Type I if the need arises
Defense Mechanism: Nasal clearance filters contaminants of what size
> 10μm - particulate matter, dust, allergens, bacteria, pollens and fungi
Defense Mechanism: Mucociliary escalator filters contaminants of what size
3-10μm - important in polluted environments
Defense Mechanism: Alveolar clearance/Macrophages filter contaminants of what size
1-5μm (carbon pigments)
parenchymal subpleural lesion + enlarged caseating lymph nodes
Primary TB
Septic shock predisposes a pt to
ARDS
Which lung cancer commonly produced ACTH?
Small cell carcinoma
Invasion of blood or lymph vessels by TB and spread
Miliary TB
Enlarged, barrel chest, pursed lips
Emphysema
Resolving lobar pneumonia may be characterized by
Grey Hepatization
Congenital A1AT deficiency is associated with
Panacinar emphysema
Diffusely circumscribed tumor, Arise in periphery of lung, beneath the pleura, Glandular differentiation
Adenocarcinoma
ARDS is associated with respiratory or metabolic acidosis or alkalosis?
respiratory acidosis
Lungs of ARDS appear
heavy, red, boggy
Microscopy of lungs w/ ARDS would show
hyaline membrane formation, inflammation and hyperplasia of Type II pneumocytes
Emphysema is related to a deficiency of
A1AT
A complication of emphysema
cor pulmonale
Most common agent of lobar pneumonia
S. pneumo
Hemorrhage into alveolar spaces w/ neutrophils, bacteria, and fibrin accumulation describes
Red hepatization
cavitary lesion w/ hilar LAD
TB
Caseation necrosis + hilar lymph nodes
Ghon Complex
What happens to most primary TB lesions?
walled off and remain dormant
If TB was found in the kidney what could you assume?
TB invaded the pulmonary vein
Asbestos exposure is most likely to result in
bronchogenic carcinoma
Irregular mass, near hilum, cells produce keratin
SCC
Which tumor has the highest association with smoking?
SCC
Tumors secreting hormone or hormone-like proteins is called
Paraneoplastic syndrome
Normal EKG but no palpable pulses
PE
young female with atherosclerosis, medial hypertrophy of pulmonary a. branches
idiopathic pHTN
The cause of idiopathic pHTN is believed to be
Neurohormonal
What condition is typically seen with centrilobular emphysema
chronic bronchitis
Fever, SOB, rusty sputum, S. pneumo
Lobar pneumonia consolidation
Microscopy of Lobar pneumonia would show
intra-alveolar segmented neutrophils w/ bacteria and blood
Hilar LAD, asteroid bodies, non-caseating granuloma
Sarcoidosis
Subpleural caseating granuloma + hilar LAD
Ghon complex
Order of which bronchogenic carcinomas are associated w/ smoking
SCC, Small cell, Adenocarcinoma
Microscopy of interstitial lung disease would show
extensive fibrosis of pulmonary parenchyma
Mucus gland hyperplasia, goblet cell hypertrophy, squamous metaplasia
Chronic bronchitis
Emphysema is characterized by
overinflation and alveolar wall destruction
Rapid development of intra-alveolar hyaline membrane formation
ARDS
Obstruction -> lung collapse is an example of
absorptive atelectasis
Bronchogenic carcinoma least associated w/ smoking
adenocarcinoma
Marked dilation of airways + foul sputum
bronchiectasis
Electromechanical dissociation on EKG
PE
necrotizing infection, irreversible airway dilation, foul sputum
bronchiectasis
Mucus plugs, BM thickening, SM hypertrophy, eosinophil infiltrate
Allergic asthma
ARDS may result from
pancreatitis, burns, septic shock, toxic drug reaction
Which pulmonary feature distinguishes allergic vs non-allergic asthma
eosinophilic infiltrate
Systemic miliary TB is related to
invasion of the pulmonary venous system
Type II pneumocyte hyperplasia occurs in
ARDS
Liver
dual blood supply
Caroli’s Disease
Commonly associated with congenital hepatic fibrosis
von Meyenburg complex
Rarely malignant
Gilbert’s Disease
Not fatal
Dubin-Johnson Syndrome
Not fatal
alpha-1-antitrypsin
common cause of neonatal cholestasis
Cystic Fibrosis
Mutation deltaF508 regulates Chloride ion channel transport on Chromosome 7
Hemochromatosis
Autosomal recessive disorder
Wilson’s Disease
Autosomal recessive disorder
Alcoholic Liver Disease
20% of alcoholics develop cirrhosis
autoimmune hepatitis
70% women
Neonatal hepatitis
prognosis with surgery
Nonalcoholic Steatohepatitis
is not easily distinguished from alcoholic hepatitis
Echinococcal cyst
Common cause of hepatic cysts worldwide
Hepatitis A
NOT associated with massive hepatic necrosis and acute liver failure
Hepatitis B
Lifetime risk for hepatocellular carcinoma is low for men and women
hepatitis testing
HBsAG IgM is the FIRST marker to go up in the window period
Autoimmune Cholangitis
associated with IgG4
Primary Biliary Cirrhosis
Rapid/Severe course
Primary Sclerosing Cholangitis
NOT AN Indolent course managed effectively with medication
Budd-Chiari Syndrome
HIGH mortality for acute disease
T1
solitary tumor without vascular invasion
T2
solitary tumor with vascular invasion or multiple tumors, none > 5cm
T3
multiple tumors > 5cm, or tumor(s) of any size involving a major branch of the hepatic or portal vein
T4
tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneum
