Respiratory Pathology Flashcards
What is rhinosinusitis? Symptoms? Causes? What can it lead to?
obstrution of sinus drainage into nasal cavity leading to inflammation and pain over affected area
Viral URI
May lead to superimposed bact infeciton such as S. pneumo, H. influenzae, M. catarrhalis
What is nasopharyngeal CA? Association? Epid? Biopsy? Presentation?
malignant tumor of nasopharyngeal epithelium
EBV: african children and chinese adults
Pleomorphic keratin-positive epithelial cells in backgrond of lymphocytes
Involvement of cervical nodes
What is epistaxis? Where does it most commonly occur (which vessels)? Where can life threatening hemorrhages occur? Which vessels?
Nose bleed
Anterior segment of nostril (kiessebach plexus)
Posterior segment (sphenopalatine artery of maxillary artery)
What is a vocal cord nodule? What causes it? Location? What is it composed of? Presentation? Treatment?
Singer’s nodule
Excessive use of vocal cords
Bilateral nodule on true vocal cords
Degenerative (myxoid) CT
Hoarseness
Resting of voice
What is a laryngeal papilloma? What causes it? Presentation?
Benign papillary tumor of the vocal cord
HPV 6 and 11; single in adults, multiple in children
hoarseness
What is laryngeal CA? What does it arise from? Risk factors? Presentation?
squam. cell CA arising from vocal cord epithelial lining
Alcohol and tobacco
hoarseness; also cough and stridor
What are the symptoms of a DVT? What puts people at risk? What do 95% of PE arise from? What is Homan sign? What is the treatment?
Swelling, redness, warmth, pain
Virchow triad
proximal deep veins of LE
Dorsiflexion of foot–>calf pain
Heparin or LMWH for acute management
Warfarin for treatment (long term)
What is the pathophys of pulmonary emboli? Symptoms? Diagnosis?
V/Q mismatch leasd to hypoxemia leads to respiratry alkalosis (incr. breathing).
Sudden onset dyspnea, chest pain, tachypnea, and tachycardia
Sudden death
CT pulmonary angiography
What is the pathophys of obstructive lung diseases? What happens to the PFTs? What happens to vasculature?
Obstruction of air flow resulting in air trapping in lungs. Airways close prematurely at high lung volumes.
Incr. RV and decr. FVC
Very Decr. FEV1
Decr. FEV1/FVC ratio (hallmark)
V/Q mismatch
Chronic hypoxic pulmonary vasoconstriction can lead to cor pulmonale
What is the pathology of chronic bronchitis? How is the diagnosis made? What are the findings?
Blue bloater
Hyperplasia of mucus secreting glands in bronchi leads to reid index (ratio of glands to wall thickness) >50%
Productive cough for >3 months per year for at least 2 yeras
Wheezing, crackles, cyanosis (early onset hypoxemia due to shunting), late onset dyspnea, CO2 retention, Secondary polycythemia
What is the pathology of emphysema? What are the two types are what are they associated with? Pathophys? CXR finding? How do they breath? Symptoms?
Enlargement of air spaces, decreased recoil, incr compliance, decr. diffusing capacity for CO resulting from destruction of alveolar walls.
Centriacinar: smoking
Panacinar: alpha 1 antitrypsin
Incr. elastase activity leads to loss of elastic fibers leading to incr. lung compliance
Pursed lip breathing
Barrel shaped Chest
Severe dyspnea
What is the pathology of asthma? What are some speficic histological findings and what causes them? What triggers it? Diagnosis? Findings?
Bronchial hyperresponsiveness cuases reversible bronchoconstriction.
Smooth muscle hypertrophy Curschmann spirals (shed epithelium forms whorled mucus plugs) Charcot-Leyden crystals (eosinophilic, hexagonal, double pointed, needle like crystals formed from breakdown of eosinophils in sputum)
Viral URIs, allergens, stress
Methacholine challenge
Cough, wheezing, tachypnea, dyspnea, hypoxemia, decr. insp/exp ratio, pulsus paradoxus, mucus plugging
What is the pathology of bronchiectasis? Symptoms? Associations/causes?
chronic necrotizing infection of bronchi leading to permanently dilated airways.
Purulent sputum, cough, dyspnea, recurrent infections, hemoptysis
Bronchial obstruction, poor ciliary function (smoking, kartageners), CF, allergic bronchopulmonary aspergillosis)
What is the pathology of restrictive lung disease? PFTs? What are the two main types/etiologies and how do their findings differ?
Restricted lung expansion causes decr. lung volumes.
Decr. FVC and TLC
FEV1/FVC ratio is greater than or equal to 80%
Poor breathing mechanics: extrapulmonary, peripheral hypoventilation, normal A-a gradient
Interstitial lung diseases: decr. pulm. diffusing capacity, incr. A-a gradient
What are some examples of poor breathing mechanics that lead to RLD? What are some interstitial lung diseases?
Poor muscular effort: Polio, myasthenia gravis
Poor structural apparatus: scoliosis, morbid obesity
ARDS, NRDS, Pneumoconioses (coal workers, silicosis, berylliosis, asbestosis), sarcoidosis, idiopathic pulmonary fibrosis, goodpasture syndrome, Wegener, eosinophilic granuloma, hypersensitivity pneumonitis, drug toxicity
What is the pathophys of idiopathic pulmonary fibrosis? Histology? Symptoms? Treatment?
Repeated cycles of lung injury leadin to TGF-beta release leading to fibrosis
Progressive dyspnea and cough
Honeycomb lung
Transplant