Respiratory pathology Flashcards

1
Q

For any disease think ‘In a surgeon’s gown physicians may make some more progress’

A

(Epidemiology) Incidence, age, sex, geography. Pathology: macroscopic microscopic. Signs (symptoms and complications). management. prognosis

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2
Q

Common neoplastic lung diseases

A

lung cancer and mesothelioma

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3
Q

Asthma causes

A

allergens and atopy, pollution, drugs - NSAIDs, occupational, diet, physical exertion, intrinsic

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4
Q

Pathogenesis of asthma

A

sensitisation to allergen -> immediate phase -> late phase

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5
Q

Histology of asthma

A

hyperaemia, hypertrophic ….

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6
Q

COPD defined as

A

chronic cough productive of sputum, most days for at least 3 months over at least 2 consectuvie years

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7
Q

What does COPD look like

A

hypertrophy mucous glands, dilation of airways, goblet cell hyperplasia

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8
Q

Complications of chronic bronchitis

A

repeated infections, chronic hypoxia and reduced exercise tolerance, chronic hypoxia reslts in pulmonary hypertension and right sided heart failure (cor pulmonale), increased risk of lung cancer independent of smoking

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9
Q

Bronchiectasis defintion

A

permanent abnormal dilatation of bronchi

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10
Q

Commmon causes of bronchiectasis

A

Congenital or inflammatory, i.e. post infectious (CF children), ciliary dyskinesia, obstruction, post-inflammtory (aspiration), secondary to bronchiolar disease, systemic disease, asthma

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11
Q

Complications of bronchiectasis

A

recurrent infections, haemoptysis, pulmonary hypertension and right sided heart failure, …

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12
Q

Cystic fibrosis affects?

A

1 in 2500 live births… 1 in 20 of population are heterzygous carriers

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13
Q

Which gene CF

A

Chr 7q3 = CFTR gene

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14
Q

CF effects on systems

A

Lungs - airway obstruction, repiratory failure, recurrent infection, GI tract - meconium ileus, malabsorption, pancreas - pancreatitis, secondary malabsorption, liver - cirrhosis, male reproductive system - infertility

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15
Q

Common parenchymal diseases (non-neoplastic lung diseases)

A

pulmonary oedema…

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16
Q

Definition of pulmonary oedema

A

accumulation of fluid in alveolar spaces as consequence of ‘leaky capillaries’ or ‘backpressure’ from failing left ventricle

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17
Q

Common causes of pulmonary oedema

A

hospital admission and of respiratory failure. LEFT HEART FAILURE. alveolar injury, neurogenic, high altitude.

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18
Q

Diffuse alveolar damage in adults:

A

acute respiratory distress syndrome “shock lung”

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19
Q

Diffuse alveolar damage in children:

A

Hyaline membrane disease of newborn

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20
Q

Diffuse alveolar damage pathogenesis

A

….

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21
Q

What does alveolar damage look like?

A

Post-mortem, heavy lung.

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22
Q

Diffuse alveolar damage

A

Capillary congestion -> exudative phase -> hyaline membranes -> organising phase

23
Q

Clinical outcome of DAD

A

Death, …

24
Q

Common parenchymal diseases which are infections ?

A

Pulmonary infections …

25
Q

Pulmonary infections infective agents

A

Bacterial,…

26
Q

What is bacterial pneumonia

A

Variety of patterns of lung involvement depending upon organism and other co-factors

27
Q

Who does bronchopneumonia happen to?

A

Compromised host defense - elderly

28
Q

Bronchopneumonia organisms

A

29
Q

What does bronchopneumonia look like?

A

30
Q

Lobar pneumonia organism

A

Hgh virulence organism: 90-95% pneumococci…

31
Q

Lobar pneumonia steps

A
  1. Congestion, 2. red hepatization, 3. …
32
Q

Complicaitons of infection

A

33
Q

Defintion of emphysema - COPD

A

Emphysema is the permanent loss…

34
Q

Pathogenesis of emphysema

A

Rare causes , cigarette smoke … neutrophil and macrophage activation … inhibit alpha 1 antitrypsin…

35
Q

Complications of emphysema

A

large air spaces (bullae), resp failure, pulmonary hypertension and cor pulomonale

36
Q

What is a granuloma?

A

Collection of histocytes/macrophages +/- ultinucleate ggiant cells, necrotising or non necrotising

37
Q

Caues of granuloma

A

38
Q

Types of fibrosing lung disease

A

idiopathic pulmonary fibrosis ….

39
Q

idiopathic pulmonary fibrosis what does it look like?

A

??

40
Q

Common pulmonary vascular disease ??

A

41
Q

Thrombus formation: Virchow’s triad

A

stasus, damage to endothelium, increased coagulation

42
Q

What is pulmonary thromboembolism ….

A

43
Q

Small emboli?

A

small peripheral pulmonary arterial occlusion

44
Q

What happens in small emboli?

A

haemorrhagic …

45
Q

large emboli?

A

can occlude the main pulmonary trunk

46
Q

non-thrombotic emboli?

A

bone marrow, amniotic…

47
Q

PHBP =

A

mean pulmonary arterial pressure > 25mmHg at rest

48
Q

Pulmonary circulation normall low pressure

A

PAP = 12 mmHg

49
Q

Benign lung tumour example

A

chondroma

50
Q

Malignant tumours - non small cell carcinomas?

A

squamous cell carcinoma (30%), adenocarcinoma (30%), large cell carcinoma

51
Q

lung cancer casues in non-smokers

A

asbestos, radiation, air pollution, other, genetic

52
Q

Markers in lung cancer adenocarcinoma

A

EGFR, ALK, Ros1, pdl1…

53
Q

markers in SCC lung tumours

A

pd1, pdl1?

54
Q

What percentage of lung cancers in the UK develop in non-smokers?

A

10-20%