Revision Questions Flashcards
Why is smoking a risk factor for pneumonia?
Reduces mucociliary clearance and pulmonary macrophage function
Why is alcohol a risk factor for pneumonia?
Reduces neutrophil function, cough and epiglottic reflexes
What changes are seen in the pleural fluid in empyema?
Exudative with neutrophils
Acidic
Low glucose
What kind of necrosis creates lung abscesses?
Suppurative
What is centriacinar emphysema?
Bronchioles are affected and alveoli are spared
More commonly in upper lobes
Cigarette smokers
What is panacinar emphysema?
Acini are uniformly enlarged
Lower lobes
a-1-AT deficiency
What is distal acinar emphysema?
Only alveoli are enlarged
Most associated with pneumothorax
What is irregular emphysema?
Acinus is irregularly involved
Associated with scarring
Most common but also most are asymptomatic
What are the causes of death in COPD?
Respiratory failure
Cor pulmonale
Pneumothorax
What effect can the chronic inflammation of the bronchi do to the airway epithelium?
Can cause squamous metaplasia
What system is used to stage COPD?
GOLD initiate
What are the signs of CO2 retention in COPD?
Warm sweaty palms with dilated veins
Bounding pulse
Chemosis (eye irritation)
Asterixis
What are the signs of hyperinflation in COPD?
Barrel shaped chest Decreased cricosternal distance Reduced chest expansion Impalpable apex beat Hyper-resonant on percussion Absent cardiac dullness Liver pushed down
Which paraneoplastic syndromes are associated with small cell carcinomas?
Cushing’s; ACTH
Hyponatraemia; SIADH
Cerebellar syndrome
Myasthenic syndrome
What paraneoplastic syndrome is associated with squamous cell carcinomas?
Hypercalcaemia; PTHRP, TGFa, IL-1
What paraneoplastic syndrome is associated with adenocarcinoma?
Hypertrophic osteoarthropathy
What is the treatment for small cell carcinomas?
Chemotherapy and prophylactic cranial irradiation
What type of carcinoma can arise near scar tissue?
Adenocarcinoma
Where in the lung does adenocarcinoma usually arise?
Peripheral
What are the steps in the growth of an adenocarcinoma?
Typical adenomatous hyperplasia
Adenocarcinoma in situ
Invasive adenocarcinoma
How does an adenocarcinoma in situ appear on a CT?
Ground glass opacity
What marker is an adenocarcinoma positive for?
TTF-1
What is an intracellular bridge?
Area of cytoplasm connected to another cell via a desmosome when the cells shrink
What are the steps in squamous cell carcinoma?
Squamous metaplasia
Dysplasia
Carcinoma in situ
Invasive squamous cell carcinoma
What IHC markers is a squamous cell carcinoma positive for?
CK5/6 and p63
What mutations are present in adenocarcinoma?
EGFR ALK ROS-1 RET B-RAF
What are the histiological features of small cell carcinomas?
Scant cytoplasm
Necrosis and mitosis
What are the treatments for non-small cell carcinomas?
Surgery
Chemo
Radio
What methods are used to stage non small cell carcinomas?
PET CT
EBUS TBNA
What is the ECOG status?
Evaluates how well a patient will withstand treatment
What are the signs of SVC obstruction?
Dilated anterior chest veins
Distended jugular veins
Hoarseness
Pemberton’s sign
What is the name of a paraneoplastic syndrome that can appear in the skin?
Acanthosis nigricans
What causes hoarseness in lung cancer?
Laryngeal nerve palsy
What are the signs of IPF?
Tachypnoea
Finger clubbing
Reduced expansion
Fine end inspiratory bibasal creps
Mikulicz syndrome
Combined inflammation of uvea and paratid gland
Lofgren’s syndrome
Fever
Erythema nodosum
Polyarthritis
Bihilar lymphadenopathy
Upper zone fibrosis
Coal workers Histiocytosis Hypersensitivity Ankylating spondylitis Radiation TB Silicosis
Lower zone fibrosis
RA Asbestosis IPF Drugs Scleroderma
