Respiratory Pathology (REYNOLDS) Flashcards
Normal breathing is referred to as _______.
A. Hypoxia
B. Eupnea
C. Dyspnea
D. Apnea
B. Eupnea
Hypoxia = a deprivation of oxygen
Eypnea = normal breathing
Dyspnea = difficult or labored breathing
Apnea = temporary cessation of respiration
Temporary cessation of respiration is known as _______.
A. Hypoxia
B. Eupnea
C. Dyspnea
D. Apnea
D. Apnea
Hypoxia = a deprivation of oxygen
Eypnea = normal breathing
Dyspnea = difficult or labored breathing
Apnea = temporary cessation of respiration
A deprivation of oxygen is referred to as ________.
A. Hypoxia
B. Eupnea
C. Dyspnea
D. Apnea
A. Hypoxia
Hypoxia = a deprivation of oxygen
Eypnea = normal breathing
Dyspnea = difficult or labored breathing
Apnea = temporary cessation of respiration
Difficult or labored breathing is referred to as ________.
A. Hypoxia
B. Eupnea
C. Dyspnea
D. Apnea
C. Dyspnea
Hypoxia = a deprivation of oxygen
Eypnea = normal breathing
Dyspnea = difficult or labored breathing
Apnea = temporary cessation of respiration
All of the following are true regarding Bronchoconstriction EXCEPT:
A. causes a decrease in the radius
B. causes a decrease in resistance to airflow
C. can be caused by an allergy
D. associated w/ parasympathetic stimulation
E. All of the above are true
B. causes a decrease in resistance to airflow
Bronchoconstriction:
- decrease in radius and increased resistance to airflow
- allergy
- Parasympathetic
Bronchodilation:
- increase in radius and decreased resistance to airflow
- Sympathetic system
All of the following are true regarding Bronchodilation EXCEPT:
A. Increased radius
B. Decrease in resistance to airflow
C. Parasympathetic stimulation
D. All of the above are true
E. None of the above are true
C. Parasympathetic stimulation
Bronchoconstriction:
- decrease in radius and increased resistance to airflow
- allergy
- Parasympathetic
Bronchodilation:
- increase in radius and decreased resistance to airflow
- Sympathetic system
Collapse of smaller airways and a breakdown of alveolar walls (septum) is referred to as _________.
A. Asthma
B. Pneumonia
C. Chronic bronchitis
D. Emphysema
D. Emphysema
Asthma: recurrent attacks of dyspnea (usually an allergic response)
Pneumonia: acute infection and inflammation of the lungs (usually with fluid in the lungs)
Chronic bronchitis: long term inflammatory condition of the lower respiratory airways (irritating cigerette smoke, polluted air, or allergens)
Emphysema: collapse of smaller airways and a breakdown of alveolar walls (septum)
Acute infection and inflammation of the lungs - usually with fluid in the lungs is referred to as _________.
A. Asthma
B. Pneumonia
C. Chronic bronchitis
D. Emphysema
B. Pneumonia
Asthma: recurrent attacks of dyspnea (usually an allergic response)
Pneumonia: acute infection and inflammation of the lungs (usually with fluid in the lungs)
Chronic bronchitis: long term inflammatory condition of the lower respiratory airways (irritating cigerette smoke, polluted air, or allergens)
Emphysema: collapse of smaller airways and a breakdown of alveolar walls (septum)
Long term inflammatory condition of the lower respiratory airways (irritating cigarette smoke, polluted air, or allergens) is referred to as ________.
A. Asthma
B. Pneumonia
C. Chronic bronchitis
D. Emphysema
C. Chronic bronchitis
Asthma: recurrent attacks of dyspnea (usually an allergic response)
Pneumonia: acute infection and inflammation of the lungs (usually with fluid in the lungs)
Chronic bronchitis: long term inflammatory condition of the lower respiratory airways (irritating cigerette smoke, polluted air, or allergens)
Emphysema: collapse of smaller airways and a breakdown of alveolar walls (septum)
Recurrent attacks of dyspnea, usually an allergic response:
A. Asthma
B. Pneumonia
C. Chronic bronchitis
D. Emphysema
A. Asthma
Asthma: recurrent attacks of dyspnea (usually an allergic response)
Pneumonia: acute infection and inflammation of the lungs (usually with fluid in the lungs)
Chronic bronchitis: long term inflammatory condition of the lower respiratory airways (irritating cigerette smoke, polluted air, or allergens)
Emphysema: collapse of smaller airways and a breakdown of alveolar walls (septum)
Discuss Obstructive and Restrictive in regards to lung disease characterization:
- Which of the following makes it hard to get air out?
- A. Obstructive
- B. Restrictive
- Which of the following makes it hard to get air in?
- A. Obstructive
- B. Restrictive
- Which of the folloiwng is an airway related disease?
- A. Obstructive
- B. Restrictive
- Which of the following results in reduced expansion of parenchyma?
- A. Obstructive
- B. Restrictive
- Which of the following makes it hard to get air out?
- A. Obstructive
- B. Restrictive
- Which of the following makes it hard to get air in?
- A. Obstructive
- B. Restrictive
- Which of the folloiwng is an airway related disease?
- A. Obstructive
- B. Restrictive
- Which of the following results in reduced expansion of parenchyma?
- A. Obstructive
- B. Restrictive
Obstructive: hard to get air OUT
- airway related disease
- limitation of airflow, increased resistance
Restrictive: hard to get air IN
- reduced expansion of parenchyme, decreased lung capacity
All of the following are characterized as Obstructive lung diseases EXCEPT:
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. ARDS
E. Asthma
D. ARDS
Obstructive:
- Emphysema
- Chronic bronchitis
- Bronchiesctasis
- Asthma
Restrictive:
- ARDS
- Pneumoconoises
- Interstitial fibrosis
- Sarcoidosis
All of the following are characterized as Restrictive lung diseases EXCEPT:
A. ARDS
B. Pneumoconoises
C. Bronchiectasis
D. Interstitial fibrosis
E. Sarcoidosis
C. Bronchiectasis
Obstructive:
- Emphysema
- Chronic bronchitis
- Bronchiesctasis
- Asthma
Restrictive:
- ARDS
- Pneumoconoises
- Interstitial fibrosis
- Sarcoidosis
Collapse or incomplete expansion (unable to expand) of part or all of the lung is referred to as _______.
A. Chronic bronchitis
B. ARBS
C. Atelectasis
D. COPD
E. RDS
C. Atelectasis
Note: Atelectasis is very similar to pneumothorax (collapsed lung)
Occurs in newborns who are born premature or contain a low birth weight and is characterized by an inability to synthesize surfactant:
A. Chronic bronchitis
B. ARBS
C. Atelectasis
D. COPD
E. RDS
E. RDS
RDS
- Respiratory Distress Syndrome
- Occurs in newborns
-
Prematurity, low birth weight
- mothers w/ diabetes
- second premature twins
- aspiration of amniotic fluid or blood
-
Inability to synthesize surfactant-deflated lung
- alveolar colapse
- corticosteroids given to synthesize surfactant
Which of the following occurs in adults and is characterized by an Exudative and Proliferative stage?
A. Chronic bronchitis
B. ARBS
C. Atelectasis
D. Emphysema
E. RDS
B. ARBS
Acute Respiratory Disease Syndrome (ARDS):
- Occurs in adults
- Respiratory failure and arterial hypoxemia resistant to O2 therapy
- Injury to pneumocytes and endothelial cells by:
- oxygen-derived free radicals
- activated neutrophils and macrophages
- loss of surfactant
-
Etiology:
- Infections (viral)
- Gas inhalation or liquid aspiration
- Drugs, chemicals, radiation
- Hypotension, sepsis, trauma
- Pathology:
- Acute (exudative) stage
- Proliferative or organized stage
What are the three types of Atelectasis?
- Contraction: scarring
- Resorption: obstruction of airway
- Compressive: pleural edema or pneumothorax
(T/F)
The lung is primarily a gas exchange organ that is now being better understood as a mediator of host defense mechanisms.
True
note: The lungs are more of a host defense mediator than the skin bc it is directly exposed to the environment through respiration
Discuss the lungs in regards to inflammation:
- Resolution
- Repair
Resolution: rapid restoration of tissue integrity and function
Repair: complex interplay between humoral (B cells), cellular (T cells), and EM (extracellular matrix) networks
note: the body does this very fast when damage is done to the lungs. There is no time to wait so they start putting down collagen as soon as possible.
e. g. If damage is done to the respiratory membrane, the body doesn’t try to replace the old respiratory membrane w/ a new one (that would take too long). It begins repairing the broken respiratory membrane immediately resulting in a not as good respiratory membrane.
Discuss each of the following:
- Bronchial asthma
- which type of bronchial asthma occurs due to allergens?
- Atopic asthma
- Non-Atopic asthma
Bronchial asthma:
- Chronic inflammatory disorder of the airways resulting in contraction of bronchial muscle and smooth muscle proliferation (growth factors by mast cells)
- Types:
- Extrinsic (atopic, allergic): food pollen, dust
- Intrinsic (non-atopic): initiated by infections, drugs, pollutants and chemical irritants
Atopic asthma (Allergies):
- recurrent episodes of wheezing, breathlessness, chest tightness and cough
- Pathogenesis: type I hypersensitivity via T helper cells (Th2) activation of eosinophils and IgE by cytokines
- Steps:
- vascular edema and permeability
- recruitment of pro-inflammatory cells
- increased mucus production
- irreversible airway remodeling
- eosinophils release mediators
- more cells recruited
- epithelial cell death
- collagen depostion
- globlet cell hyperplasia
Non-Atopic asthma:
- Etiology: viral infections of respiratory tract and inhaled pollutants
- Elicit inflammatory response mediated by eosinophils and IgE
- Drug-induced asthma (aspirin) and occupational asthma from toxic fumes and wood dust
note: asthma is inflammatory that recruits lots of cells
(T/F)
COPD is the 3rd leading cause of death in the world.
True
What are the two components of irreversible airflow of COPD?
- Emphysema (destruction of acinus, alveoli)
- Chronic bronchitis and chronic bronchiolitis
note: these two components can occur independently of each other but USUALLY occur simultaneously
Discuss Emphysema in regards to COPD:
Emphysema
- Destruction of alveolar tissue resulting in larger but fewer alveoli
- Decreased area for gas exchange
- Collapse of bronchioles
- Smoking is the major cause
- Destructive enlargement of airspaces distal to terminal bronchioles
- Two types:
- Centriacinar: destruction of central portion with sparing of distal airspaces (caused by smoking)
- Panacinar: caused by alpha-1-antitrypsin deficiency
- Smoking enhances elastase activity
- Dyspnea, weight loss, cough and wheezing
- FEV is lowered (due to expiration limits or expelling air)
Which of the following types of Emphysema is caused by alpha-1-antitrypsin deficiency?
A. Centriacinar
B. Panacinar
B. Panacinar
All of the following are true regarding Centriacinar Emphysema EXCEPT:
A. Destruction of central portion w/ sparing of distal airspaces
B. Lower lobes > Upper
C. Caused by smoking
D. All of the above are true
E. None of the above are true
B. Lower lobes > Upper
Centriacinar:
- destruction of central portion w/ sparing of distal airspaces
- upper lobes > lower
- Cause: smoking
Panacinar:
- uniform injury
- lower lobes > upper
- Cause: alpha-1-antitrypsin deficiency
All of the following are true regarding Panacinar Emphysema EXCEPT:
A. Caused by alpha-1-antitrypsin deficiency
B. Lower lobes > Upper
C. Destruction of central portion with sparing of distal airspaces
D. Uniform injury
E. All of the above are true
C. Destruction of central portion with sparing of distal airspaces
Centriacinar:
- destruction of central portion w/ sparing of distal airspaces
- upper lobes > lower
- Cause: smoking
Panacinar:
- uniform injury
- lower lobes > upper
- Cause: alpha-1-antitrypsin deficiency
All of the following are true regarding Emphysema EXCEPT:
A. Defined as destruction of alveolar tissue
B. Results in smaller alveoli but increase in number
C. Decreased area for gas exchange
D. Collapse of bronchioles
E. Smoking is the major cause
B. Results in smaller alveoli but increase in number
note: emphysema results in larger alveoli (but fewer)
Which of the following is defined as dilation of bronchi and bronchioles secondary to chronic inflammation and obstruction?
A. Emphysema
B. Chronic bronchitis
C. Atopic asthma
D. Idiopathic pulmonary fibrosis (IPF)
E. None of the above
E. None of the above
Bronchiectasis: dilation of bronchi and bronchioles secondary to chronic inflammation and obstruction
Which of the following is characterized by large dilation of airways?
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Idiopathic pulmonary fibrosis (IPF)
E. None of the above
C. Bronchiectasis
Bronchiectasis: dilation of bronchi and bronchioles secondary to chronic inflammation and obstructions
***Possible EXAM Q***
Globlet cell hyperplasia is characteristic of which of the following?
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Idiopathic pulmonary fibrosis (IPF)
E. None of the above
B. Chronic bronchitis
note: in chronic bronchitis ppl cough up a lot of phlem
Persistent cough with sputum production for at least 3 months in at least 2 consecutive years:
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Idiopathic pulmonary fibrosis (IPF)
E. None of the above
B. Chronic bronchitis
note: in chronic bronchitis, globlet cell hyperplasia is responsible for coughs w/ sputum
Hypoxia and cyanosis are clincial signs of _______. (pts usually have less than 3 years to live if diagnosed w/ this condition)
A. Emphysema
B. Chronic bronchitis
C. Bronchiectasis
D. Idiopathic pulmonary fibrosis (IPF)
E. None of the above
D. Idiopathic pulmonary fibrosis (IPF)
Idiopathic pulmonary fibrosis (IPF):
- diffuse interstitial fibrosis of unknown etiology
- hypoxia and cyanosis are clinical signs
- 3 yrs or less is life expectancy
- interstitial pneumonia
- respiratory and heart failure (cor pulmonale)
note: cor pulmonale = interaction between respiratory system and the heart
Which of the following occurs in newborns?
A. ARDS
B. RDS
B. RDS
ARDS = Adult
_______ are disorders caused by inhalation of inorganic elements, primarily metals.
A. Bronchiectasis
B. Idiopathic Pulmonary Fibrosis (IPF)
C. Pneumoconioses
D. Hypersensitivity pneumonitis
E. Bronchopneumonia
C. Pneumoconioses
***POSSIBLE EXAM Q***
Inhalation of Carbon dust (Coal Woker’s), silicone (Silicosis) or asbestos result in which of the following disorders?
A. Bronchiectasis
B. Idiopathic Pulmonary Fibrosis (IPF)
C. Pneumoconioses
D. Hypersensitivity pneumonitis
E. Bronchopneumonia
C. Pneumoconioses
***POSSIBLE EXAM Q***
Discuss Pulmonary Edema:
Pulmonary Edema (inflammation)
- Severe infection
- Upper airway obstruction
- Ascent to high altitude occasionally causes high altitude pulmonary edema (HAPE)
- Aspitation, e.g. gastric fluid or in case of drowning
- Multiple blood transfusions
- Inhalation of toxic gases
- Pulomary contusion i.e. high-energy trauma
- Multitrauma as in a severe car accident
***REYNOLDS did not really talk about this slide much so I doubt it’ll show up on exam. Just incase***
Discuss Pulmonary Embolism:
Pulmonary Embolism
- clot or thrombosis
- Large emboli (10%) are a cause of sudden death (acute cor pulmonale)
- Medium sized emboli generally cause infarctions (hemorrhagic infarcts)
- Smaller emboli (70%) are clinically silent; cause infarctions in pts w/ heart failure, cause hemoptysis
Medium sized emboli:
- prolonged bed rest
- orthopedic surgery of knee or hip
- severe trauma especially burns
- congestive heart failure
Which of the following is referred to as “patchy”?
A. Bronchopneumonia
B. Lobar pneumonia
A. Bronchopneumonia
Bronchopneumonia = patchy
Lobar = complete lobe
Discuss the pathology of Pneumonia:
- Alveolar (bronchopneumonia and Lobar)
- Interstitial
Pneumonia Pathology
Alveolar: (caused by S. pneumonia)
- Bronchopneumonia (patchy)
- Lobar (complete lobe)
Interstitial: viral -influenza
***Make sure you know the bacteria S. pneumonia***
________ is the most common microorganism to cause Bronchopneumonia.
A. Influenza virus
B. Klebsiella pneumoniae
C. Streptococcus pneumoniae
D. Legionella pneumophila
E. Staphylococcus aureus
C. Streptococcus pneumoniae
***POSSIBLE EXAM Q***
Abrupt, with high fever, shaking chills pleuritic chest pain and productive, mucopurulent cough:
A. Lobar pneumonia
B. Bronchopnneumonia
C. Opportunistic pneumonia
D. Interstitial pneumonia
B. Bronchopnneumonia
REMEMBER: the main organism associated w/ bronchopneumonia is S. pneumonia
Opportunistic pneumonias are associated with each of the following EXCEPT:
A. AIDS
B. Cancer patients
C. Transplant recipients
D. Smokers
E. all of the above are associated with opportunistic pneumonias
D. Smokers
Opportunistic pneumonia: infections that affect immunosuppressed patients
All of the following are true regarding secondary pulmonary hypertension EXCEPT:
A. Chronic obstructive pulmonary disease
B. Chronic interstitial pulmonary disorders
C. Chronic heart failure
D. Less common than primary pulmonary hypertension
E. Recurrent pulmonary emboli
D. Less common than primary pulmonary hypertension
note: secondary pulmonary hypertension is the most common form
note: primary pulmonary hypertension is idiopathic (unknown cause)
_______ is an immunologically mediated disorder affecting airways and interstitium.
A. Bronchopneumonia
B. Pulmonary hypertension
C. Hypersensitivity pneumonitis
D. Pulmonary embolism
C. Hypersensitivity pneumonitis
Hypersensitivity pneumonitis:
- Farmer’s lung
- Pigeon breeder’s
- Air-condition lung
All of the following are associated with Hypersensitivity pneumonitis EXCEPT:
A. Coal workers
B. Farmer’s lung
C. Pigeon breeder’s
D. Air-condition lung
E. All of the above are associated w/ hypersensitivity pneumonitis
A. Coal workers
What are the 3 main things associated w/ Hypersensitivity Pneumonitis?
Farmer’s lung, Pigeon breeder’s and Air-condition lung
(T/F)
Out of all cancers, Lung cancer is the #1 cause of death in male and females.
True
Lung cancer deaths are increasing in ______.
A. Males
B. Females
C. Both
B. Females
note: more men die from lung cancer (29%) than women (26%) but research is showing that female death rates are increasing while male deaths from lung cancer are on the decline
Which of the following account for the most deaths?
A. Lung cancer
B. Colon-rectum cancer
C. Breast cancer
D. Prostate cancer
A. Lung cancer
note: there 228,820 new cases of lung cancer, 135,720 of them die. More than half the ppl diagnosed w/ lung cancer die
Which of the following is the main cause of lung cancer?
A. Genetics
B. Gender
C. Smoking
D. Drinking
C. Smoking
Which of the following is the most common Lung cancer?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Small cell carcinoma
D. Large cell carcinoma
A. Adenocarcinoma
_***POSSIBLE EXAM Q***_
Which of the following is the LEAST common Lung cancer?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Small cell carcinoma
D. Large cell carcinoma
D. Large cell carcinoma
Adenocarcinoma = 35%
Squamous cell carcinoma = 30%
Small cell carcinoma = 25%
Large cell carcinoma = 10%
***POSSIBLE EXAM Q***
List each of the following from most common to least:
- Small cell carcinoma
- Large cell carcinoma
- Squamous cell carcinom
- Adenocarcinoma
“ASS L”
- Adenocarcinoma (most common- 35%)
- Squamous cell carcinoma (30%)
- Small cell carcinoma (25%)
- Large cell carcinoma (least common- 10%)
note: he said you don’t need to memorize the percentages, just know what is most/least prevalent
“that ASS is pretty LARGE”
Which of the following lung cancers is more prevalent in females?
A. Adenocarcinoma
B. Small cell carcinoma
C. Squamous cell carcinoma
D. Large cell carcinoma
A. Adenocarcinoma
Adenocarcinoma = F > M
Small cell carcinoma = M > F
note: Adenocarcinoma was bolded in the powerpoint
Which of the following is the most common cause Mesothelioma?
A. Smoking
B. Asbestos
C. Genetics
D. Two of the above
E. All of the above
B. Asbestos
note: Smoking is NOT related to Mesothelioma
Discuss Mesothelioma:
Mesothelioma
- Cancer of the pleural membranes (visceral and parietal)
- Malignant tumor of mesothelial cells
- short survival
- Most pts (70%) have an esbestos exposure history
- Smoking is NOT related to mesothelioma
All of the following Lung cancers are associated with smoking EXCEPT:
A. Adenocarcinoma
B. Small cell carcinoma
C. Mesothelioma
D. Bronchioloalveolar carcinoma
C. Mesothelioma
