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Mechanisms of Disease > Respiratory System Diseases > Flashcards

Respiratory System Diseases Flashcards

1
Q

What is another name for infectious rhinitis?

A

The common cold

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2
Q

What type of pathogen is the most common cause of infectious rhinitis?

A

Rhinoviruses

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3
Q

Describe the clinical presentation of infectious rhinitis

A
  • Nasal congestion with watery discharge
  • Sneezing
  • Scratchy, dry, sore throat
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4
Q

What are some potential complications of infection rhinitis? (3)

A
  1. Bacterial infection due to swelling/fluid accumulation
  2. Middle ear infection (otitis media)
  3. Sinus infection (sinusitis)
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5
Q

True or false. Viral infections can be secondary to bacteria causing pharyngitis/tonsilitis.

A

False. Bacterial infections are secondary to viral

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6
Q

Which viruses most commonly cause pharyngitis and tonsilitis? (3)

A
  1. Rhinoviruses
  2. Echoviruses
  3. Adenoviruses
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7
Q

What are the most serious consequences of untreated pharyngitis or tonsilitis? (3)

A
  1. Rheumatic fever
  2. Glomerulonephritis
  3. Chronic tonsillar enlargement
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8
Q

What is atelectasis?

A

Collapse of a previously inflated lung

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9
Q

What are the 3 subtypes of atelectasis? Which one is not reversible (***).

A
  1. Resorption: blockage of airway
  2. Compression: accumulation in pleural space
  3. ***Contraction: fibrosis restricts expansion
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10
Q

What is a pulmonary embolism?

A

Something that blocks the vessels in the lung(s):

Ex: blood clot, air bubble, fatty deposit, other debris

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11
Q

95% of pulmonary emboli are _____

A

blood clots from large leg veins

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12
Q

Blockage in a vessel causes _____ downstream and _____ upstream.

A
  • Ischemia
  • Increased pressure
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13
Q

Approximately 10% of pulmonary emboli result in _______

A

Pulmonary infarct

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14
Q

What is cor pulmonale?

A

Right-sided heart failure

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15
Q

Why do large blockages caused by pulmonary emboli kill quickly?

A
  • Increased pressure damages the heart
  • Leads to cor pulmonale
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16
Q

Right-sided heart failure leads to ______, while left-sided heart failure leads to ______.

A
  • Cor pulmonale
  • Pulmonary hypertension
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17
Q

Pulmonary embolism signals the body to lower _____ and in turn _____.

A
  • Blood pressure
  • Cardiac output
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18
Q

What are some reasons for atelectasis with a pulmonary embolism? (2)

A
  1. Lack of surfactant
  2. Reduced movement in response to pain
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19
Q

What are the treatment options for a pulmonary embolism?

A
  1. Anticoagulant (e.g. heparin)
  2. Thrombolytic (risky; only in hospitals)
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20
Q

What vascular changes occur in pulmonary hypertension?

A
  • Medial hypertrophy of muscular and elastic arteries in the lungs: intimal fibrosis
  • Plexiform lesions (advanced) that cause dilated thin-walled arteries to rupture
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21
Q

Pulmonary hypertension can be caused by? (6)

A
  1. Chronic obstructive or interstitial lung diseases
  2. Heart disease (left-sided)
  3. Recurrent emboli
  4. Autoimmune diseases
  5. Obstructive sleep apnea
  6. Idiopathic (80% have genetic basis)
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22
Q

What are the symptoms of pulmonary hypertension?

A
  • Dyspnea
  • Fatigue
  • End-stage: severe respiratory distress and cyanosis
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23
Q

True or false. Chest pain is rarely seen in pulmonary hypertension.

A

True

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24
Q

True or false. Pulmonary hypertension is only detectable when it’s advanced.

A

True

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25
Q

What are the potential treatments for pulmonary hypertension? (3)

A
  1. If secondary: treatment of primary disease
  2. If autoimmune or refractory (untreatable): vasodilators
  3. Lung transplant
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26
Q

What is Goodpasture syndrome?

A
  • Complex multigenetic disorder
  • Pulmonary hemorrhage syndrome
  • Autoimmune destruction of alveolar basement membranes
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27
Q

What are the potential treatment options for Goodpasture syndrome?

A
  1. Plasmapheresis to remove autoantibodies
  2. Immunosuppression
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28
Q

What does Goodpasture Syndrome look like histologically in the lungs?

A
  • Intra-alveolar hemorrhage
  • Focal necrosis in alveolar walls
  • Macrophage accumulation
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29
Q

What is pulmonary edema?

A

Leakage of fluid into alveolar space

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30
Q

Hemodynamic pulmonary edema is most commonly the result of _______

A
  • Left-sided congestive heart failure
  • Increased pressure in LV → Increased pressure in lungs → fluid forced out of the capillaries
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31
Q

What is acute respiratory distress syndrome (ARDS)?

A
  • Severe acute lung injury indicated by:
    • Abrupt onset of hypoexemia
    • Bilateral pulmonary infiltrates
    • Bilateral edema throughout
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32
Q

Explain the pathogenesis of ARDS

A
  1. Initiated by macrophages
  2. Inflammatory mediators damage endothelium and pneumocytes
  3. Neutrophils invade and debris accumulates (hyalinization)
  4. Healing starts when macrophages produced TGFβ and PDGF
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33
Q

In ARDS, what are the consequences of damage to type I (squamous) vs type II (cuboidal) pneumocytes?

A
  1. Increased permeability
  2. Decreased surfactant and alveolar collapse
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34
Q

What are the symptoms of ARDS?

A
  1. “Heavy” feeling lungs
  2. Lungs filled with fluid (can be heard on auscultation)
  3. Stiff lungs due to surfactant loss
  4. Dyspnea/tachypnea
  5. Cyanosis/hypoxemia
35
Q

What are some potential treatments for ARDS?

A
  1. 100% oxygen therapy
  2. Mechanical ventilation
  3. Treat underlying cause (such as sepsis)
36
Q

Pneumonia can be caused by what?

A
  1. Bacteria
  2. Viruses
  3. Mycoplasms
  4. Fungi
37
Q

Pneumonia is responsible for ____ of US deaths.

A

1/6

38
Q

Does pneumonia cause pulmonary edema or does pulmonary edema cause pneumonia?

A

Either or both

39
Q

What is a common risk factor for hospital-acquired pneumonia?

A

Mechanical ventilation

40
Q

What typically causes aspiration pneumonia?

A
  • Vomiting
  • Markedly debilitated patients, stroke victims, etc.
  • Abnormal gag/swallowing reflex
41
Q

True or false. Chronic pneumonia only occurs in immunocompromised patients.

A

False. Immunocompetent*

42
Q

What are some causes of pneumonia? (5)

A
  1. Cough reflex suppression/inhibition
  2. Mucociliary apparatus damage
  3. Accumulation of secretions
  4. Decreased macrophage activity
  5. Edema or congestion (mucus)
43
Q

What form of pneumonia is often fatal?

A

Aspiration (necrotizing) pneumonia

44
Q

What are the two ways bacterial pneumonia can present?

A
  1. Bronchopneumonia: opaque spots
  2. Lobar: entire lobe is opaque
45
Q

Describe the clinical course of pneumonia

A
  • Rapid onset: fever, chills, cough (mucous with signs of infection)
  • Fibrinosuppurative pleuritis: Lung swelling, pleuritic pain, and pleural friction rub
46
Q

Stage 2 (early red hepatization) of acute pneumonia is indicated by what histologically?

A
  • Neutrophil infiltrate
  • Congestion of septal capillaries
47
Q

Stage 3 (gray hepatization) of acute pneumonia is indicated by what histologically?

A

Alveolar exudate in air spaces

48
Q

Stage 4 (resolution) of acute pneumonia is indicated by what histologically?

A
  • Fibromyxoid masses (attempts at rebuilding)
  • Macrophages
  • Fibroblasts
49
Q

What virus is responsible for infecting pneumocytes and causing viral pneumonia?

A
  • SARS-CoV
  • FIrst time a coronavirus infected somewhere other than the upper respiratory tract
50
Q

What are the initial symptoms of Severe Acute Respiratory Syndrome (SARS)? (5)

A
  1. Malaise
  2. Myalgia
  3. Dry cough
  4. Fever
  5. Chills
51
Q

What are some complications that are caused by SARS-CoV-2? (7)

A
  1. Pneumonia and trouble breathing
  2. Organ failure
  3. New-onset cardiac issues
  4. ARDS
  5. Blood clots
  6. Acute kidney injury
  7. Additional viral and bacterial infections
52
Q

Histoplasmosis is caused by what organism?

A
  • Histoplasma capsulatum
  • Dimorphic fungus
53
Q

Describe the gross appearance of histoplasmosis

A
  • Perihilar mass lesions
  • Can look like lymphoma or leukemia
54
Q

Describe the histology of histoplasmosis

A
  • Macrophage aggregates filled with yeast
  • Lymph node infiltration
  • Granulomas with giant cells
  • May develop fibrosis and calcifications
55
Q

What are the differences between obstructive vs. restrictive diseases?

A

Obstructive

  • Partial or complete obstruction at any level
  • Increased resistance to airflow

Restrictive

  • Reduced expansion of parenchyma
  • Decreased total lung capacity
56
Q

How are obstructive and restrictive diseases diagnosed in pulmonary function tests?

A
  • Obstructive: decreased forced expiratory volume (FEV)
  • Restrictive: decreased FEV and vital capacity
57
Q

What is emphysema?

A
  • Permanent enlargement of smaller airspaces
    • No destruction of walls of smaller air spaces
    • No fibrosis
58
Q

_____ is a complex multigenic disease that increases airway responsiveness to stimuli

A

Asthma

59
Q

What are some characteristics of asthma? (3)

A
  1. Episodic bronchoconstriction
  2. Bronchial wall inflammation
  3. Increased mucus section (which exacerbates 1.)
60
Q

What is atopic asthma?

A

Classic hypersensitivity reaction via IgE

61
Q

What is non-atopic asthma?

A

Hyperirritability due to viral infection

62
Q

What drugs are most likely to cause drug-induced asthma?

A
  • Aspirin and other NSAIDS
  • Affects balance of cyclooxygenase activity
63
Q

What are some causes of occupational asthma?

A

Exposure to:

  • Fumes
  • Dust
  • Gases
  • Chemicals
64
Q

What is chronic inflammatory airway disease?

A
  • Recurrent episodes wheezing, breathlessness, chest tightness, and cough
  • Bronchoconstriction (widespread but variable)
  • Airflow limitations (partially reversible)
65
Q

How does recurrent asthma alter airway structure?

A
  • Increased mucus production
  • Thickening of basement membrane and smooth muscle
  • WBC infiltration
  • Increase glandular tissue
66
Q

What does asthma look like histologically?

A
  1. Eosinophil infiltration
  2. Goblet cell hyperplasia
  3. Thick basement membrane
  4. Smooth muscle hypertrophy
67
Q

In cystic fibrosis, mutations in ______ result in viscous mucus that obstructs passageways

A
  • Cystic fibrosis conductance regulator (CFTR)
  • Chloride channel
68
Q

What are some of the consequences of cystic fibrosis? (5)

A
  1. Chronic lung disease
  2. Pancreatic insufficiency (excess fecal fat)
  3. Hepatic cirrhosis
  4. Intestinal obstruction
  5. Male infertility
69
Q

______ is caused by particles recognized the body as foreign, but cannot be eliminated

A

Pneumoconioses

70
Q

What is black lung?

A
  • Complicated coal workers pneumoconiosis
  • Progressive, massive fibrosis
  • Black pigment associated with fibrosis (coal)
71
Q

What are some subtypes of pneumoconiosis?

A
  1. Coal workers pneumoconiosis (CWP)
  2. Silicosis
  3. Anthracosis
  4. Asbestosis
72
Q

True or false. You cannot see silicosis or asbestosis on microscopic analysis.

A

True

73
Q

What are some consequences of CWP? (3)

A
  1. Pulmonary dysfunction
  2. Pulmonary hypertension
  3. Cor pulmonale
74
Q

Asbestosis increases risk of what type of cancer?

A

Mesothelioma

75
Q

What is allergic alveolitis?

A
  • Type of granulomatous disease
  • Hypersensitivity pneumonia
  • Inflammation in alveoli
76
Q

What are some consequences of allergic alveolitis? (3)

A
  • Decreased diffusion capacity
  • Decreased lung compliance
  • Decreased total lung volume
77
Q

Describe the histology of allergic alveolitis

A
  • Patchy infiltrates in the interstitium
  • Loos granulomas without necrosis
  • Lymphocyte, plasma cell, and epitheloid macrophage infiltration
  • Usually around bronchioles
78
Q

What is Sarcoidosis?

A
  • Type of granulomatous restrictive disease
  • Unknown etiology
79
Q

What are some histological characteristics of sarcoidosis?

A
  1. Non-necrotizing granulomas
  2. Frequent giant cells
  3. When chronic, may become scar tissue
80
Q

What are the possible clinical courses for Sarcoidosis?

A
  1. Spontaneous remission
  2. Steroid therapy
81
Q

Accumulation of pleural fluid (pleural effusion) can be caused by? (5)

A
  1. Incrased hydrostatic pressure (CHF)
  2. Increased vascular permeability (pneumonia)
  3. Decreased osmotic pressure (renal disease)
  4. Decreased intrapleural negative pressure (atelectasis)
  5. Decreased lymphatic drainage
82
Q

What is a pneumothroax?

A
  • Air or gas in the pleural space
  • Collapsed lung
83
Q

What causes a spontaneous pneumothorax?

A
  • Idiopathic
  • Rupture of alveolus, abscess cavity
84
Q

What is a flap valve?

A
  • Allows air in but out out
  • In tension pneumothorax

Mechanisms of Disease (13 decks)

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