Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPR 2 Exam 2 > Singh Respiratory Pathology #5 > Flashcards

Singh Respiratory Pathology #5 Flashcards

1
Q

How do you calculate Pack years?

A
  • Packs smoked per day x number of years
  • ex: 1 ppd for 30 yrs= 30 yr hx
  • 2 ppd for 30 yrs = 60 pack years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of cells does squamous cell carcinoma develop from?

A

basal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What cells do small cell carcinomas arise from?

A

Neuroendocrine cells scattered throughout respiratory epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What cells do adenocarcinomas of the lung arise from?

A

type II alveolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What cancers are most common to leawst?

A
  • Adenocarcinoma (50%)
  • Squamous carcinoma (20%)
  • Small cell carcinoma (15%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe progression of Adenocarcinoma?

A
  • Atypical adenomatous hyperplasia (AAH)
    • <5mm, dysplastic pneumocytes along alveoli with interstitial fibrosis
  • Adenocarcinoma in Situ (AIS)
    • <3 cm
    • Dysplastic pneumocytes growing along alveoli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What stain can help diagnose adenocarcinoma of the lung?

A

TTF-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mucinous adenocarcinoma?

A

grows on surface of alveoli, and is not in situ because it spreads so far. Mimics pneumonia on CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is this?

A

squamous carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is this?

A

SCC, orange cytoplasm is keratin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Epidemiology of SCC?

A
  • More common in me
  • Associated with smoking
  • Occurs centrally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is small cell neuroendocrine carcinoma almost always associated with?

A

Smoking

High rate of metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What tumor characteristics should be looked for with adenocarcinoma to help with treatment?

A
  • EGFR
    • can use erlotinib or gefinitib
  • ALK1
    • crizotinib
  • PD1
    • pembrolizumab
  • CTLAA4
    • ipilimumab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what inhibitor should NOT be used to treat squamous carcinomas and why?

A

VEGF as it will cause bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What paraneoplastic syndrome can be seen with squamous carcinoma?

A
  • Hypercalcemia due to PTH-rp released by the tumor
    • causes mental status changes and EKG changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What paraneoplastic syndromes can be seen with small cell carcinoma?

A
  • SIADH
    • hyponatremia
      • mental status changes and siezures
  • Cushing syndrome via secretion of ACTH
    • atypical cushing syndrome, no central obesity or striae
17
Q

What is Trosseau’s syndrome?

A

Migratory thrombophlebitis

18
Q

What is an unexpected way that lung cancers can primarily manifest?

A

As electrolyte disturbances or mental status changes

19
Q

Horners syndrome?

A
  • Oculosympathetic palsy
  • can occur at many sites along sympathetic pathway
20
Q

In horners syndrome, why do patients sometimes have arm pain?

A
  • Depending where the tumor is, the brachial plexus can be involved resulting in pain down the arm
21
Q

What is DIPNECH?

A
  • diffuse interstitial pulmonary neuroendocrine cell hyperplasia
  • High resolution CT scan detects
  • Very small nodules less than 5 mm
  • precursor to carcinoid tumor
22
Q

Describe a carcinoid tumor.

A
  • 5mm or larger (how you tell apart from DIPNECH)
  • can metastasize
  • Indolent
  • Would call this neuroendocrine carcinoma grade 1 tumor
23
Q

What do you see in atypical carcinoid tumors (neuroendocrine carcinoma grade 2) compared to carcinoids?

A
  • necrosis
  • increased mitotic activity
  • disordered growth
24
Q

What is carcinoid syndrome?

A
  • Flushing
  • Diarrhea
  • cyanosis
25
Q

5 yr survival rates for Carcinoid tumors, Atypical carcinoid tumors, and Small cell carcinoma?

A
  • Carcinoid 95%
  • Atypical 70%
  • Small cell 5%
26
Q

what is happening in this 26 yr male patient with SOA and hemoptysis?

A
  • Cannonball mets in testicular cancer
  • Metastatic malignancy
27
Q

Lymphangioleiomyomatosis (LAM) characteristics?

A
  • Proliferation of cells creating cystic spaces
    • tuberous sclerosis association
    • cells are modified smooth mm cells and are positive for melanoma markers such as HMB-45
    • Perivascular epithelioid cells
    • Young women
    • LOF in tumor suppresor TSC2
    • Spontaneous pneumothorax can occur
28
Q

Transudative fluid? What causes it in pleural effusions?

A
  • low protein content
  • few cells
  • decreased colloid osmotic pressure can be seen with nephrotic syndrome
  • Increased hydrostatic pressure causing overflow of liquid from lung can be seen in heart failure
29
Q

Describe exudative fluid and what causes it with a pleural effusion?

A
  • Inflammation!
  • Infection such as bacterial pneumonia or TB
  • PE
  • CTD
  • Malignancy
  • High protein content may contain cells
30
Q

What should a bloody pleural effusion make you think of?

A

Malignancy

31
Q

What is Empyema?

A
  • Inflammatory exudate with accumulation of pus in pleural space
  • Usually bacterial
  • Creates loculations (web like traps for fluids)
32
Q

Tension pneumothorax?

A
  • Injury to chest wall that creates a one way valve allowing air IN but not out
  • Every breath traps more and more air occupying space in the thoracic cavity, pushing the mediastinum
33
Q

Differentiate these two pictures

A
  • left is a primary pneumothorax
    • the left lung is collapsed and you can tell because there are no lung markings (white streaks) it is just black
  • Right side is tension pneumothorax
    • you can tell because the entire mediastinum is shifted to the left and the right lung is not seen
34
Q

How do you initially treat tension pneumothorax?

A

Needle decompression

35
Q

When is a solitary fibrous tumor benign?

A

Benign when it is small and pedunculated

36
Q

How do large solitary fibrous tumors “behave”?

A

like sarcomas

37
Q

Describe Mesothelioma?

A
  • Associated with asbestos exposure
    • may take decades for disease to present
38
Q

What stain is positive for mesothelioma?

A
  • Calretinin stain is positve
  • may also see ferrunginous bodies on histology

CPR 2 Exam 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions