Robbins Ch 15 Part I Flashcards
What do the rounded type II pneumocytes produce?
Surfactant
Why type of pulmonary hypoplasia is characterized by reduced space in the thoracic cavity?
Which is characterized by the impaired ability to inhale and can be caused by renal agenesis?
1) Diaphragmatic hernia
2) Oligohydramnios
What are the most common foregut cysts?
Bronchogenic
Pulmonary sequestration is characterized as lung tissue that has abnormal vascular supply arising from?
The aorta or its branches
Which type of pulmonary sequestration has its own pleura?
Which does not?
1) Extralobar sequestration
2) Intralobar sequestration
How does extralobar sequestration generally come to attention?
Mass lesions in infants
When is neonatal respiratory distress syndrome more commonly seen?
1) Males
2) Maternal diabetes
3) Delivery by C-section
What is the cause of neonatal respiratory distress syndrome?
Lack of surfactant
What are the surfactant proteins that can be measured with amniocentesis?
SP-B, SP-C, and surfactant lipids
Increased glucose levels in the mother has what effect on the fetus?
What does this lead to?
1) Increased insulin levels
2) Inhibits the synthesis of surfactant
What complication is noted from high concentration of ventilator administered oxygen for prolonged periods for infants with RDS?
Retrolental fibroplasia
Which form of atelectasis is characterized by complete airway obstruction?
Which is characterized by pleural effusion?
Which is characterized by fibrosis?
1) Resorption
2) Compressive
3) Contraction
Which direction does the mediastinum shift towards with Resorption Atelectasis?
Why?
1) Towards affected lung
2) Lung volume is diminished
Compressive atelectasis can occur due to?
Which direction does the mediastinum shift towards?
1) Pneumothorax
2) Away from affected lung
Hemodynamic pulmonary edema is due to?
Increased hydrostatic pressure often form left sided heart failure
What is a manifestation of Severe Acute Lung Injury (ALI) or Diffuse Alveolar Damage (DAD)?
Acute respiratory distress syndrome (ARDS)
What are damaged with ALI/ARDS?
This leads to the formation of?
1) Type II pneumocytes
2) Hyaline membranes
How does ALI/ARDS present clinically?
Dyspnea and tachypnea
What is the Tx of ALI/ARDS?
Mechanical ventilation while treating the underlying cause
Obstructive lung disease will have a FEV1/FVC of?
What about restrictive lung disease?
1) FEV1/FVC < 0.8
2) FEV1/FVC is normal
Emphysema is the irreversible enlargement of airspaces distal to?
What is the etiology?
1) Terminal bronchioles
2) Tobacco
What is the most common form of emphysema?
Centriacinar (centrilobular) Emphysema
Panacinar (panlobular) Emphysema is associated with what deficiency?
α1-antitrypsin deficiency
Distal Acinar (paraseptal) Emphysema is commonly the underlying lesion in?
Spontaneous pneumothorax in the young
What is the overall pathogenesis of emphysema?
Parenchymal destruction
How does emphysema present clinically?
1) Barrel chested
2) Dyspneic
3) Hunched over
4) Breathes through pursed lips
How does emphysema present on CXR?
Enlarged lungs with flattened diaphragm
The Reid index is a pathological measurement of mucosal gland proliferation in what condition?
Chronic bronchitis
What is chronic bronchitis defined by?
Persistent cough with sputum production for at least three months in at least two consecutive years
What does chronic bronchitis morphologically lead to?
Mucous gland hyperplasia
What Igs are elevated with atopic asthma?
Early onset allergic asthma is associated with what T-cell mediated inflammation?
1) IgE
2) Th2 cells
What drugs can trigger asthma in individuals with nasal polyps and recurrent rhinitis (Samter’s triad)?
Aspirin and NSAIDs
What does the late phase of asthma lead to in the bronchial wall?
Airway remodeling
Polymorphisms in what gene have the strongest and most consistent associations with asthma?
IL-13 gene
What is found in patients with status asthmaticus?
1) Coiled mucus plugs (Curschmann spirals)
2) Charcot-Leyden crystals (eosinophilic protein galectin-10)
Destruction of smooth muscle and elastic tissue by chronic necrotizing infections that leads to permanent dilation of bronchi and bronchioles is characteristic of?
Bronchiectasis
Which form of bronchiectasis is due to CFTR inhibiting ENaC?
Cystic fibrosis
What is the triad seen with Kartagener’s syndrome?
What condition is this syndrome associated with?
1) Sinusitis, Bronchiectasis, and Situs inversus
2) Primary ciliary dyskinesia
Allergic Bronchopulmonary Aspergillosis is characterized by?
Formation of mucous plugs and intense airway inflammation with eosinophils
How does the sputum present with bronchiectasis?
Foul smelling and sometimes bloody
Idiopathic Pulmonary Fibrosis is related to what genetic factor in a 1/3 of all cases in which it increases mucus secretion resulting in higher risk to downstream fibrosis?
What environmental risk factor is associated?
1) MUC5B
2) Cigarette smoking
What does idiopathic pulmonary fibrosis progress to?
Honeycomb lung
Which morphological pattern associated with nonspecific interstitial pneumonia do patients tend to be younger and have a better prognosis?
Cellular pattern patients (compared to fibrosing pattern)
What are characterized by polypoid plugs of loose organizing connective tissue within alveolar ducts, alveoli, and often bronchioles?
What condition are they associated with?
1) Masson bodies
2) Cryptogenic Organizing Pneumonia
What condition depends on the amount of dust retained in the airway and lungs?
What makes it worse?
1) Pneumoconiosis
2) Cigarette smoking
What condition can lead to asymptomatic anthracosis or progressive massive fibrosis?
Coal Workers Pneumoconiosis
What is the histologic hallmark lesion of silicosis characterized by?
A central area of whorled collagen fibers with a more peripheral zone of dust-laden macrophages
What is found on CXR for silicosis?
Eggshell calcifications (calcified hilar lymph nodes)
Silicosis increases the susceptibility to?
1) Tuberculosis
2) Lung cancer
Shipyard workers, construction, and demolition (ceiling insulation) all have an increased risk for?
Asbestos
Asbestosis is indistinguishable from diffuse interstitial fibrosis (honeycomb pattern) except for the presence of?
How are they described?
1) Asbestos bodies (aka Ferruginous Bodies)
2) Dumbbell shaped
What are the most common manifestation of asbestos exposure that histologically shows hyalinized collagen?
Pleural plaque
What does sarcoidosis lead to?
Where is it most common in the U.S?
What are the laminated, calcified proteinaceous concentrations morphologically found in sarcoidosis?
What are the stellate inclusions within giants cells morphologically found in sarcoidosis?
1) Non-caseating granulomas
2) South
3) Schaumann bodies
4) Asteroid bodies
Bilateral sarcoidosis of the major salivary glands is known as?
Mikulicz syndrome
