Respiratory Flashcards

1
Q

most common cause of inflammation of nasal mucosa

A

adenovirus

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2
Q

which pulmonary function test is decreased in obstruction

A

FEV1

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3
Q

which pulmonary function test is from full inspiration to full expiration

A

vital capacity

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4
Q

which pulmonary function test is from end of normal expiration + residual volume?

A

functional residual capacity

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5
Q

which part of respiratory tract has clara cells?

A

bronchioles

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6
Q

kid inhaled a peanut, what lung changes in lung?

A

resorption atelectasis

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7
Q

large tumor on chest wall compresses pleura, what changes you see in lung?

A

compression atelectasis

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8
Q

lung injury leads to scarring, what lung changes?

A

contraction atelectasis

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9
Q

complete whiteout, rapid onset and severe hypoxemia, septicemia, what histo changes after 2 weeks? obstructive or restrictive?

A

proliferation of type II cells, alveolar septal thickening

restrictive

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10
Q

complete whiteout, rapid onset and severe hypoxemia, septicemia, what histo changes after 2 days? obstructive or restrictive?

A

hyaline membranes

restrictive

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11
Q

TLC: increased
FVC: normal
FEV1: decreased lots
FEV1:FVC - reduced

A

COPD

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12
Q

only reversible COPD

A

asthma

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13
Q

permanent airspace enlargement distal to terminal bronchiole, no fibrosis, imbalance of antiproteases and antioxidants. disease? obstructive or restrictive?

A

emphysema, obstructive

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14
Q

chronic liver disease, polymorphism in TGFB increases severity, PiZZ. Disease? why liver disease?

A

alpha-1-antitrypsin -> emphysema

A1-AT made in liver, misfolded, accumulates -> disease

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15
Q

“moth eaten” upper lung, free floating alveolar septa. disease? subtype? what causes it?

A

emphysema, centrilobular (centriacinar), smoking

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16
Q

panlobular (panacinar) form of emphysema caused by what?

A

A1-AT deficiency

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17
Q

4 obstructive lung diseases

A

emphysema
chronic bronchitis
asthma
bronchiectasis

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18
Q

patient with dyspnea, sits down in a forward hunched position, skinny, hyperventilation. Disease? what would you see on xray (2 things)?

A

barrel chest

flat domes of diaphragm

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19
Q

patient presents complaining of persistent, productive cough for over 3 months over the past couple years, see no eosinophils. disease? 1 cause, 2 histo findings

A

chronic bronchitis
smoking/city dwelling
increased goblet cells
hypertrophy of seromucinous glands

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20
Q

hypersecretion of mucus

A

chronic bronchitis

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21
Q

increased Reid index

A

thickening of glandular layer in large airways (hypertrophy of seromucinous glands) - chronic bronchitis

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22
Q

hypoxia, hypercapnea, cyanosis, obese, cor pulmonale. disease?

A

chronic bronchitis “blue bloaters”

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23
Q

episodic cough, wheezing, (+) wheal and flare test. Disease? name the cytokines involved

A

asthma (obstructive)
IL-4: class switching to IGE
IL-5: eosinophils!!!!
IL-13: IgE production by B cells

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24
Q

wheezing post viral infection, serum IgE normal disease?

A

non-atopic asthma

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25
Q

runny nose, nasal polyp, bronchospasm, urticaria (hives), history of headache with aspirin treatment

A

drug induced asthma

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26
Q

curshmann spirals

A

asthma

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27
Q

charcot leyden crystals (what are they made of and what disease)

A

major basic protein from eosinophils

asthma

28
Q

rare, lots of eosinophils, cardiac involvement, asthma, allergic rhinitis, lung infiltrates. what do you see on neutrophilic staining?

A

p-ANCA

churg-strauss syndrome

29
Q

cell inclusions seen with langerhans histiocytosis

A

berbick granules, tennis racket shaped

30
Q

patient with apex beat on the right, presents with cough and foul-smelling sputum. disease and 1 complication

A

bronchiectasis - permanent dilation of bronchioles and bonchi

secondary (AA) amyloidosis

31
Q

V-P mismatch, decreased lung compliance, fibroblasts (general)

A

restrictive lung disease

32
Q

FVC: decreased
FEV1: decreased
FEV1:FVC - normal

A

restrictive lung disease

33
Q

cobblestoned pleural surface, honeycomb change, lower lobe only, no asbestosis exposure, temporal and geographic heterogeneity, dry cough, crackles on inspiration

Disease and prognosis

A

Idiopathic Pulmonary Fibrosis (IPF) / Usual interstitial pneumonia (UIP)

poor prognosis, relentless progression

34
Q

young people, responds to steroid treatment, no honeycomb change, upper and lower lungs

disease and prognosis

A

Nonspecific interstitial Pneumonia (NSIP)

decent prognosis, responds to treatment

35
Q

chicken wire fibrosis

A

Nonspecific interstitial Pneumonia (NSIP)

36
Q

ground glass appearance, masson body, architecture intact. disease and prognosis

A

Cryptogenic organizing penumonia aka
Bronchiolitis obliterans organizing pneumonia (BOOP)

recover spontaneously

37
Q

masson body disease and what is it

A

COP/BOOP

central core of inflammatory cells (not in fibroblast foci)

38
Q

young runner cant walk anymore, what other disease might he have?

A

collagen vascular disease is seen with lupus, rheumatoid, systemic sclerosis

39
Q

sudden onset dyspnea, must be put on ventilator immediately, hyaline membranes

A

acute interstitial pneumonia (AIP)

ideopathic ARDS basically

40
Q

HIV+ pt shows expansion of interstitium by sheets of lymphoid cells, what can it progress to?

A

lymphoid interstitial pneumonia (LIP)

lymphoma

41
Q

35 year old nonsmoking Swedish woman presents with bilateral hilar lymphadenopathy. On histology of biopsy you find schaumann and asteroid bodies. Disease? What type of hypersensitivity is involved? What would a PPD skin test reveal, why?

A

sarcoid
type IV - CD4+ T cell mediated
negative skin tests for PPD and candida due to anergy

42
Q

laminated concretion of calcium and protein. what and disease?

A

schaumann body

sarcoid

43
Q

alcoholic found in vomit, develops pneumonia. What might you find in the lungs and where?

A

abcess right lower lobe - less acute angle

44
Q

mass at apex of lung

A

secondary TB

silicosis (usually many)

45
Q

blue bloaters and pink puffers

type of lung disease and individual diseases with risk factors

A

obstructive

blue: chronic bronchitis - smoking
pink: emphysema - smoking

46
Q

PAS+ globules in hepatocytes, what are they made of and disease

A

A1AT accumulations in emphysema

47
Q

noncaseating granulmomas, bilateral lymph adenopathy, astronaut

A

berylliosis

48
Q

cough, hypercalcemia, elevated ACE

disease and treatment

A

sarcoid

treat with steroids

49
Q

pulmonary pressures are 1/4 of systemic is that normal? what is normal?

A

no its high

1/8th of systemic is normal

50
Q

BMPR2 inactivation in young adult females

A

proliferation of smooth muscle

primary pulmonary hypertension

51
Q

3 things that can reduce surfactant production in newborn

A

prematurity
caesarian section
maternal diabetes (insulin decreases surfactant)

52
Q

baby born with tachypnea with use of accessory muscles, grunting, cyanosis and ground glass apearance on xray, should you give them oxygen? why?

A

no, suffering from neonatal respiratory distress syndrome - supplemental oxygen increases the risk for free radical injury

53
Q

person clearing out their basement with a dirt floor, spend years doing work down there. person develops lung carcinoma, what caused it? what else could cause the same disease?

A

radon - 2nd most frequent cause of lung carcinoma in US

uranium

54
Q

person living in midwest presents with coin lesion, what is it what disease?

A

granuloma from Histoplasma

55
Q

tumor of neuroendocrine Kulchitsky cells. disease, assoc. location

A

small cell lung carcinoma, male smokers, central

56
Q

intercellular bridges in lung

disease, assoc. location

A

squamous cell carcinoma
male smokers (most common tumor)
central

57
Q

peripheral tumor in nonsmoking female

A

adenocarcinoma

58
Q

poorly differentiated big cells

disease, assoc. location, prognosis

A

large cell
smoking
central or peripheral
poor prognosis

59
Q

tumor arising from clara cells, looks like pneumonia on xray

disease, assoc. location, prognosis

A

bronchioloalveolar carcinoma
not related to smoking
peripheral
excellent prognosis

60
Q

neuroendocrine cell tumor, chromogranin positive

disease, assoc. location

A

carcinoid tumor
not related to smoking/can cause carcinoid syndrome
polyp-like mass in bronchus

61
Q

cannon ball nodules, 2 most common causes

A

metastasis from breast and colon carcinoma

62
Q

rupture of emphysematous bleb in young adults -> collapse of portion of lung
problem and where does trachea shift?

A

spontaneous pneumothorax

trachea shifts to the side of collapse

63
Q

person suffers penetrating chest wall injury, person cant breathe
problem and where does trachea shift?

A

tension pneumothorax: air enters pleural space, cannot escape
trachea pushed to opposite side of the injury

64
Q

tumor follows shape of lungs in U around bottom lobe, what exposure is common?

A

asbestos

65
Q

most common site for lung cancer to metastasize to?

A

adrenal gland

66
Q

when do you see clubbing of fingernail?

A

lung cancer, lung abscess, bronchiectasis