SP2: Lung Diseases Flashcards
What is the acinus?
Terminal respiratory unit containing the alveoli
The respiratory tract is particular prone to which type of infection?
Air-borne infection
What is an infection of the lungs called?
Pneumonia or pneumonitis
Define pneumonia
Infection of the lungs leading to alveolar inflammation
What are the 3 types of pneumonia?
- Lobar pneumonia
- Bronchopneumonia
- Atypical pneumonia
What is affected during lobar pneumonia?
Affects large part or entire lobe
Lobar pneumonia is ‘community-acquired’ what does this mean?
Can affect anyone but typically afflicts previously healthy males aged 20-50
What is the pathogen that causes lobar pneumonia?
Streptococcus pneumoniae
What are some of the clinical features of lobar pneumonia? (5)
- High grade fevers
- Productive cough
- Rusty sputum
- Pleuritic chest pain
- Signs of consolidation (tap chest)
What are the 4 stages of lobar pneumonia?
Give duration of each stage
- Congestion (24 hrs)
- Red hepatisation (2-4d)
- Grey hepatisation (4- 8d)
- Resolution (8-10d)
Explain what occurs during the congestion stage of lobar pneumonia (3)
- Vessel engorges
- Oedema in alveoli
- Lung becomes heavy and red
Explain what occurs during the red hepatisation stage of lobar pneumonia (2)
- Outpouring of neutrophils and RBC’s into alveoli
- Which gives it a liver like appearance
Explain what occurs during the grey hepatisation stage of lobar pneumonia
- Fibrin and macrophages replace neutrophils and RBC’s
What can be a possible complication of untreated lobar pneumonia?
Formation of abscess in the lungs
What is the most common type of pneumonia?
Bronchopneumonia
How is Bronchopneumonia acquired?
Hospital-acquired
What are the 4 groups are most vulnerable of bronchopneumonia?
- Chronic debilitating illness
- Secondary to viral infections
- Infancy
- Old age
(typically when defence systems are weakest)
Which bacteria causes bronchopneumonia?
Any bacteria can cause this
How does bronchopneumonia present on the lungs?
Grey or grey-red spots of consolidation
What is the most likely outcome of bronchopneumonia? Why is this?
Death, because its is usually a terminal event in other debilitating illness or extremes of age
What pathogens cause atypical pneumonia?
Mycoplasmal or viral
Where is the inflammation from atypical pneumonia restricted to? (2)
- Alveolar septa
- Interstitial tissues
Comment on the symptoms of atypical pneumonia
- Symptoms more general than localised
- Symptoms are highly out of proportion
What pathogen causes TB?
Mycobacterium tuberculosis
When does pulmonary TB normally occur?
Infection occurs early in childhood
Which vaccine protects children for Pulmonary TB?
BCG
What do primary TB lesions on the lung represent?
Represents first contact with tubercle bacilli
What is the Ghon complex?
Lesion from primary TB typically 1cm in mid zone with lymph node
What is secondary TB?
Reinfection or reactivation
Where are the lesions of secondary TB situated?
Usually apical, about 3cm at clinical presentation
What is Miliary TB?
Bloodborne dissemination within the lung or throughout the body (TB can spread to any organ)
Which group are fungal infections of the lungs most commonly seen in?
Seen with those who are immunocompromised e.g. patients with HIV
When can you diagnose chronic bronchitis
Patient produces productive cough for at least 3 months in 2 consecutive years
Which 2 types of COPD are coexistent?
- Chronic Bronchitis
- Emphysema
What is bronchial asthma?
Increased irritability of bronchial tree
What is an asthma attack?
Episode of reversible bronchospasm
What is Bronchiectasis?
Permanent dilatation of bronchi and bronchioles with necrosis of their walls
When does bronchiectasis usually manifest?
Usually follows obstruction or childhood viral pneumonia
What are the clinical presentations of bronchiectasis?
Airways become saclike, filled with foul smelling pus
What is a direct cause of lung cancer?
Directly caused by cigarette smoking
How many carcinogens are there in cigarette smoke?
Over 1200
What are the changes in cell type during lung cancer (4)
- Respiratory epithelium
- Stratified squamous
- Squamous dysplasia
- Carcinoma
Which type of lung cancer is not surgically treatable?
Small cell carcinoma
What are some local symptoms of lung cancer? (3)
- Cough
- Haemoptysis (coughing blood)
- Pain
What are some general symptoms of lung cancer? (2)
- Weight loss
- Clubbing
Lung cancer can cause Paraneoplastic syndromes what is this?
Tumour cells secrete hormones which cause other symptoms such as clubbing
What is pulmonary oedema?
Alveolar pink granular fluid builds up in the lungs
How do you treat pulmonary oedema?
With diuretics
What happens to the lungs during Diffuse Alveolar Damage?
Oedema fluid and fibrinous membranes line alveoli
