SP2: Lung Diseases

Question 1

What is the acinus?

Answer 1

Terminal respiratory unit containing the alveoli

Question 2

The respiratory tract is particular prone to which type of infection?

Answer 2

Air-borne infection

Question 3

What is an infection of the lungs called?

Answer 3

Pneumonia or pneumonitis

Question 4

Define pneumonia

Answer 4

Infection of the lungs leading to alveolar inflammation

Question 5

What are the 3 types of pneumonia?

Answer 5

• Lobar pneumonia
• Bronchopneumonia
• Atypical pneumonia

Question 6

What is affected during lobar pneumonia?

Answer 6

Affects large part or entire lobe

Question 7

Lobar pneumonia is ‘community-acquired’ what does this mean?

Answer 7

Can affect anyone but typically afflicts previously healthy males aged 20-50

Question 8

What is the pathogen that causes lobar pneumonia?

Answer 8

Streptococcus pneumoniae

Question 9

What are some of the clinical features of lobar pneumonia? (5)

Answer 9

• High grade fevers
• Productive cough
• Rusty sputum
• Pleuritic chest pain
• Signs of consolidation (tap chest)

Question 10

What are the 4 stages of lobar pneumonia?

Give duration of each stage

Answer 10

• Congestion (24 hrs)
• Red hepatisation (2-4d)
• Grey hepatisation (4- 8d)
• Resolution (8-10d)

Question 11

Explain what occurs during the congestion stage of lobar pneumonia (3)

Answer 11

• Vessel engorges
• Oedema in alveoli
• Lung becomes heavy and red

Question 12

Explain what occurs during the red hepatisation stage of lobar pneumonia (2)

Answer 12

• Outpouring of neutrophils and RBC’s into alveoli

- Which gives it a liver like appearance

Question 13

Explain what occurs during the grey hepatisation stage of lobar pneumonia

Answer 13

• Fibrin and macrophages replace neutrophils and RBC’s

Question 14

What can be a possible complication of untreated lobar pneumonia?

Answer 14

Formation of abscess in the lungs

Question 15

What is the most common type of pneumonia?

Answer 15

Bronchopneumonia

Question 16

How is Bronchopneumonia acquired?

Answer 16

Hospital-acquired

Question 17

What are the 4 groups are most vulnerable of bronchopneumonia?

Answer 17

• Chronic debilitating illness
• Secondary to viral infections
• Infancy
• Old age
  (typically when defence systems are weakest)

Question 18

Which bacteria causes bronchopneumonia?

Answer 18

Any bacteria can cause this

Question 19

How does bronchopneumonia present on the lungs?

Answer 19

Grey or grey-red spots of consolidation

Question 20

What is the most likely outcome of bronchopneumonia? Why is this?

Answer 20

Death, because its is usually a terminal event in other debilitating illness or extremes of age

Question 21

What pathogens cause atypical pneumonia?

Answer 21

Mycoplasmal or viral

Question 22

Where is the inflammation from atypical pneumonia restricted to? (2)

Answer 22

• Alveolar septa

- Interstitial tissues

Question 23

Comment on the symptoms of atypical pneumonia

Answer 23

• Symptoms more general than localised

- Symptoms are highly out of proportion

Question 24

What pathogen causes TB?

Answer 24

Mycobacterium tuberculosis

Question 25

When does pulmonary TB normally occur?

Answer 25

Infection occurs early in childhood

Question 26

Which vaccine protects children for Pulmonary TB?

Answer 26

BCG

Question 27

What do primary TB lesions on the lung represent?

Answer 27

Represents first contact with tubercle bacilli

Question 28

What is the Ghon complex?

Answer 28

Lesion from primary TB typically 1cm in mid zone with lymph node

Question 29

What is secondary TB?

Answer 29

Reinfection or reactivation

Question 30

Where are the lesions of secondary TB situated?

Answer 30

Usually apical, about 3cm at clinical presentation

Question 31

What is Miliary TB?

Answer 31

Bloodborne dissemination within the lung or throughout the body (TB can spread to any organ)

Question 32

Which group are fungal infections of the lungs most commonly seen in?

Answer 32

Seen with those who are immunocompromised e.g. patients with HIV

Question 33

When can you diagnose chronic bronchitis

Answer 33

Patient produces productive cough for at least 3 months in 2 consecutive years

Question 34

Which 2 types of COPD are coexistent?

Answer 34

- Chronic Bronchitis | - Emphysema

Question 35

What is bronchial asthma?

Answer 35

Increased irritability of bronchial tree

Question 36

What is an asthma attack?

Answer 36

Episode of reversible bronchospasm

Question 37

What is Bronchiectasis?

Answer 37

Permanent dilatation of bronchi and bronchioles with necrosis of their walls

Question 38

When does bronchiectasis usually manifest?

Answer 38

Usually follows obstruction or childhood viral pneumonia

Question 39

What are the clinical presentations of bronchiectasis?

Answer 39

Airways become saclike, filled with foul smelling pus

Question 40

What is a direct cause of lung cancer?

Answer 40

Directly caused by cigarette smoking

Question 41

How many carcinogens are there in cigarette smoke?

Answer 41

Over 1200

Question 42

What are the changes in cell type during lung cancer (4)

Answer 42

- Respiratory epithelium - Stratified squamous - Squamous dysplasia - Carcinoma

Question 43

Which type of lung cancer is not surgically treatable?

Answer 43

Small cell carcinoma

Question 44

What are some local symptoms of lung cancer? (3)

Answer 44

- Cough - Haemoptysis (coughing blood) - Pain

Question 45

What are some general symptoms of lung cancer? (2)

Answer 45

- Weight loss | - Clubbing

Question 46

Lung cancer can cause Paraneoplastic syndromes what is this?

Answer 46

Tumour cells secrete hormones which cause other symptoms such as clubbing

Question 47

What is pulmonary oedema?

Answer 47

Alveolar pink granular fluid builds up in the lungs

Question 48

How do you treat pulmonary oedema?

Answer 48

With diuretics

Question 49

What happens to the lungs during Diffuse Alveolar Damage?

Answer 49

Oedema fluid and fibrinous membranes line alveoli