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Respiratory II > Vascular lung diseases > Flashcards

Vascular lung diseases Flashcards

1
Q

Primary hypercoagulable states

A

Factor V Leiden mutation
Antiphospholipid antibody syndrome
Prothrombin mutation

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2
Q

Secondary hypercoagulable states

A

Obesity
OCP use
Pregnancy
Recent surgery
Cancer

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3
Q

Mechanism of increased pulmonary vascular resistance in PE

A

Vascular obstruction
Vascular constriction mediated by thromboxane A2 and serotonin

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4
Q

Mechanism of hypoxemia in PE

A

Increased perfusion of lung unites with low ventilation (V/Q mismatch)

Decreased CO with decrease in mixed venous PO2

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5
Q

Mechanism of increased alveolar dead space in PE

A

Vascular obstruction
Absent perfusion with preserved ventilation (V/Q mismatch)

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6
Q

Mechanism of decreased lung compliance in PE

A

Loss of surfactant causing alveolar edema and hemorrhage

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7
Q

Mechanism of increased airway resistance in PE

A

Reflex bronchoconstriction

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8
Q

Mechanism of increased respiratory rate in PR

A

Reflex stimulation of irritant receptors

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9
Q

Measurement of a degradation product of cross-linked fibrin

A

D-dimer

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10
Q

ECG findings in PE

A

S1Q3T3 pattern
Sinus tachy

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11
Q

Describe S1Q3T3 pattern on EKG

A

Large S wave in lead I
Q wave in lead III
Inverted T wave in lead III

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12
Q

Complications of lung infarct

A

Septic infarcts
Abscess

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13
Q

Mutation associated with idiopathic pulmonary HTN

A

BMPR2

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14
Q

Function of BMPR2

A

Binds to TGF-beta, BMP, activin, and inhibin. Leads to dysfunction and proliferation of endothelial cells and vascular smooth muscle cells

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15
Q

Inheritance of BMPR2 mutation

A

Autosomal dominant

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16
Q

Typical demographic for idiopathic pulmonary HTN

A

Female between 20-40 yo

17
Q

Mechanism of secondary pulmonary HTN in chronic obstructive or interstitial lung diseases

A

Obliterate alveolar capillaries and increase pulmonary resistance

18
Q

Grade 1 vascular changes in pulmonary HTN

A

Medial hypertrophy of the pulmonary muscular and elastic arteries

19
Q

Grade 2 vascular changes in pulmonary HTN

A

Intimal and medial hypertrophy

20
Q

Grade 3 vascular changes in pulmonary HTN

A

Pipestem fibrosis of arteries

21
Q

Grade 4 vascular changes in pulmonary HTN

A

Plexiform lesions –> tuft of capillary formations

22
Q

CXR findings in pulmonary HTN

A

Enlarged central pulmonary arteries

23
Q

Complication of pulmonary HTN

A

Cor pulmonale

24
Q

Treatment of primary pulmonary HTN

A

Vasodilators

25
Q

Autoimmune disease defined by presence of anti-glomerular basement membrane antibodies

A

Goodpasture syndrome

26
Q

Typically demographic for Goodpasture syndrome

A

Young males

27
Q

Type II hypersensitivity reaction with antibodies against alveolar and glomerular basement membranes

A

Goodpasture syndrome

28
Q

Auto-antibodies to non-collagenous domain of the alpha-3 chain of collagen IV of the basement membranes

A

Goodpasture syndrome

29
Q

Young male pt presents with rapidly progressive glomerulonephritis and necrotizing hemorrhagic interstitial pneumonitis

A

Goodpasture syndrome

30
Q

Microscopy findings of the lungs in Goodpasture syndrome

A

Focal necrosis within alveolar walls with intra-alveolar hemorrhages and hemosiderin-laden macrophages. Fibrous thickening of septum.

31
Q

Immunofluorescence findings in the lungs in Goodpasture syndrome

A

Linear deposits of immunoglobulins along the basement membranes of the septal wall

32
Q

Clinical features of Goodpasture syndrome

A

Crescentic glomerulonephritis and renal failure
Hemoptysis

33
Q

Causes of diffuse pulmonary hemorrhage

A

Goodpasture syndrome
Idiopathic pulmonary hemosiderosis
Vasculitis associated –> polyangiitis with granulomatosis

34
Q

Autoimmune disease involving upper respiratory tract and/or lung

A

Polyangiitis with granulomatosis/Wegener granulomatosis

35
Q

Diagnostic test for polyangiitis with granulomatosis

A

Transbronchial lung biopsy

36
Q

Transbronchial lung biopsy findings in polyangiitis with granulomatosis

A

Scattered, poorly formed granulomas

37
Q

Triad of polyangiitis with granulomatosis

A

Acute necrotizing granulomas of URT and/or LRT

Necrotizing or granulomatous vasculitis

Focal necrotizing, often crescentic, glomerulonephritis

38
Q
A

Respiratory II (17 decks)

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