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Pathology II (Kiva) > Topic 32-37: Upper respiratory tract, restrictive and obstructive disorders > Flashcards

Topic 32-37: Upper respiratory tract, restrictive and obstructive disorders Flashcards

1
Q

infections of the upper respiratory tract include:

A 
rhinitis
sinusitis
acute pharyngitis
tonsillitis
otitis media
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2
Q

rhinitis includes several types. briefly describe

A

allergic rhinitis: hay fever, IgE response
Infectious rhinitis: common cold, catarrhal discharge, sneezing, sore throat. Viral!
Chronic rhinitis:repeated acute rhinitis attacks causing secondary bacterial infection with purulent exudate. occurs with nasal polyp

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3
Q

sinusitis includes several types. briefly describe

A

acute sinusitis: preceding acute or chronic rhinitis. typically bacteria from oral cavity
chronic sinusitis: prolonged sinusitis, mixed microfloral infection or even mucor

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4
Q

acute pharyngitis, descibe

A

can be viral or bacterial,

  • rhinovirus, echovirus, adenovirus
  • group a strep (more severe with tonsillitis, exudates)
  • EBV
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5
Q

tonilitis:

A

can be viral or bacterial, more often viral!!

  • reddening, swollen, exudative tonsils
  • streptococcal tonsillitis should be checked because it can lead to peritonsillar abscess, post strep glom nephritis, and acute rheumatic fever
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6
Q

otitis media: what is it generally and it has two types

A

infection of middle ear typically due to eustachian tube, associated with hearing loss, especially seen in young children.

  • acute OM- abrupt ear pain, blacked E tube leads to buildup of air, can be bacterial or viral
  • chronic OM - no symptoms, buildup of fluid, can be bacterial or viral
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7
Q

tracheitis is what ? complications?

A

inflammation of the trachea, almost always bacterial

  • seen in children
  • can cause airway obstruction
  • symptoms are stridor, cough, fever, chest pain

long term incubation causes decubitus

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8
Q

laryngitis has several types

A
  • acute bacterial epiglottitis
  • acute laryngitis
  • laryngotracheobronchitis
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9
Q

acute laryngitis is what? what are some rare forms that you should know?

A

inhalation of an irritant or infectious agent.

tuberculosis - coughing up infectious sputum
diphtheritic - pseudomembrane (fibropurulent exudate)

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10
Q

laryngotracheobronchitis is what

A

normally due to parainfluenzae virus

  • normally in children who live in dry places
  • scary stridor and cough, can narrow airways to cause respiratory failure
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11
Q

vascular pulmonary diseases include:

A
  • pulmonary emboli –> hemorrhage and infarct
  • pulmonary hypertension
  • diffuse pulmonary hemorrhage
  • atelectasis
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12
Q

pulmonary embolisms are dependant on size of the occluded artery. what are the consequences depending on the artery occluded?

A

small

  • alveolar hemorrhage
  • If peripheral - infarct (only 10%)
  • silent

medium
-alveolar hemorrhage

large

  • decreased co
  • RSHF
  • hypoxemia
  • death (due to >60% vasculature occlusion with large or multiple small emboli)
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13
Q

what is the fate of the pulmonary emboli?

A

60-80% silent
10-15% - small or medium a obstruction –> infarct
5% death

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14
Q

pulmonary hypertension is typically due to what?

A

Primary:

  • idiopathic
  • familial

secondary

  • COPD or interstitial lung disease
  • recurrent pulmonary emboli
  • antecedent heart disease (atrial stenosis, right->left shunts, LVHF)
  • NOTE: can be pulmonary arterial or venous hypertension in pathogenesis!!
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15
Q

in primary pulmonary HT, what is the name of the condition and general pathogenesis?

A

uncommon familial pulmonary HT: proliferation of SM and vascular endothelial cells due to mutations of bone morphogenetic protein receptor type 2

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16
Q

diffuse alveolar hemorrhage causes

A

goodpasture syndrome
idiopathic pulmonary hemosiderosis
wegener granulomatosis

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17
Q

goodpasture syndrome is what?

A

antibodies against alpha3 chain of type 4 collagen

  • shows linear Ig pattern
  • hemorrhage and fibrosis
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18
Q

idiopathic pulmo hemosiderosis is what?

A

unknown etiology, looks like goodpasture w/o Ig

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19
Q

wegener granulomatosis is what?

A

pulmonary necrotizing vasculitis and granulomas, hemorrhage, upper airway involvement with sinusitis, nasal perforation
C-ANCA

++Remember Polyarteritis nodosa (p-anca) thus the other one is the other anca

20
Q

acquired atelectasis has three types

A

resorption
compression
contraction

21
Q

resorption atelectasis is:

A

airway obstruction causes trapped air to be resorbed and alveoli collapse

lung volume decreases and mediastinum is pushed towards the collapsed lung

22
Q

compression atelectasis

A

pleural cavity gets filled with fluid or air causing lung to be compressed

mediastinum shifts away from collapsed lung

23
Q

contraction ateletasis

A

fibrosis of pleura or lung prevents full expansion

24
Q

COPD is which 4 disorders? what is their FEV1/FVC ratio

A

asthma
emphysema
chronic bronchitis
bronchiectasis

ration is normal or decreased

25
Q

what are the anatomical locations of COPD?

A

all in the large airways/bronchi except emphysema is in the alveoli

26
Q

asthma is defined as what? what are the types?

A

chronic inflam of the airways

  • atopic asthma - most common type
  • non-atopic asthma - idiopathic, perhaps viral
  • drug induced asthma - aspirin sensitivity with nasal polyps
  • occupational asthma - fumes, dusts, gases
27
Q

what is the 2 wave reaction?

A

early: bronchocontriction, mucus production and vasodilation
late: inflam, active eosiophils, neutrophils, epithelial cells and leukocytes

28
Q

recurrent attacks lead to what?

A

bronchial wall remodelling

  • hypertrophy of SM and glands
  • inc vascularity and subepithelial collagen
29
Q

emphysema: types?

A

centriacinar
panacinar
distal acinar
irregular

30
Q

what are the genetic factors that play a role in emphysema? what also contributes to emphysema?

A

polymorphisms in response to injury enzymes:
-alpha 1 antitrypsin def

polymorphism in MMP expression
-high MMP 9 and 12

Toxin exposure also contributes

31
Q

chronic bronchitis is associated with what two main symptoms

A 
hypersecretion of mucous (hypertrophy of glands)
airway obstruction (due to mucous plugs and fibrosis)
32
Q

bronchiectasis is what? what are the predisposing conditions?

A

dilation of the bronchioles and bronchi

  • bronchial obstruction
  • hereditary conditions (CF, immunodef, kartagener syndrome)
  • necrotizing/ suppurative pneumonia
33
Q

what is the general pathogenesis of bronchiectasis?

A

obstruction and chronic persistent infections

34
Q

diffuse alveolar damage is a histological pattern of what condition? This condition is formed by two mechanisms

A

Acute respiratory distress syndrom (ARDS)

formed by

  • direct lung injury - pneumonia, aspirations, hemorrhage
  • indirect lung injury - sepsis, shock, etc

damage will cause inc permiability of vessels, alveolar flooding, loss of diffusion capacity and surfactant abnormalities

35
Q

ARDS has two morphological stages

A

acute phase - dark, heavy, congested lungs filled with exudate. hyaline membrane formation,

organized phase - proliferation of type II pneumocytes, organization of fibrin exudate

36
Q

pneumoconiosis is due to what and what are the three most common causative agents?

A
  • caused by inhalation of dust

- coal, silica, and asbestos

37
Q

What particle size is most dangerous and why?

A

1-5 micrometers because they get lodged in the bifurcations.

larger particles are cleared away, smaller ones act like gases and move in/out

38
Q

coal dust pneumoconiosis has 3 different morphologies

A
  • anthracosis
  • simple coal workers pneumoconiosis
  • complicated coal workers pneumoconiosis
39
Q

simple coal workers pneumoconiosis is characterized by what?

A

Coal macules - coal laden macrophages

coal nodules- coal macules with collagen

40
Q

complicated coal workers pneumoconiosis is generally what?

A

progression of simple coal workers pneumoconiosis that needs years to develop black scar lesions with dense collagen. causes pulmonary disfunction, HT and cor pulmonale

41
Q

silicosis is associated with what actions

A

sandblasting, rock-mining, roofing. these actions allow silica crystals to be inhales and phagocytosed by pulmonary macrophages, causing fibrosis

42
Q

what is characteristic of silicosis?

A

silicotic nodules - concentrically arranged collagen fibers (whorled appearance)
These eventually join together to form a large scar

43
Q

asbestosis is associated with which health problems?

A
  • pulmonary interstitial fibrosis (asbestosis)
  • fibrous plaques
  • pleural effusions (due to inflam)
  • bronchogenic carcinoma (or other primary lung cancers)
  • mesothelioma
  • laryngeal carcinoma
44
Q

asbestos is carcinogenic how?

A

it can be a tumor initiator, promoter because it can even absorb harmful carcinogens in tobacco smoke

45
Q

what is the anatomical fibrosis progression is asbestosis, silicosis, and CWP?

A

asbestosis starts in the lower lobes and moves up

silicosis and CWP moves down from the upper lobes

46
Q

what is the most common manifestation of asbestosis?

A

pleural plaques

Pathology II (Kiva) (23 decks)

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