XIII - The Lung Flashcards
Loss of lung volume cause by inadequate expansion of airspaces, resulting in shunting of inadequately oxygenated blood from pulmonary arteries into veins.
Atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480
Atelectasis which occurs when an obstruction prevents air from reaching distal airways.
Resorption atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480
Atelectasis usually associated with accumulation of fluid, blood, or air within the pleural cavity, which mechanically collapse the adjacent lung.
Compression atelectasis (aka passive or relaxation atelectasis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481
Atelectasis which occurs when either local or generalized fibrotic changes in the lung or pleura hamper expansion and increase elastic recoil during expiration.
Contraction or cicatricial atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481
Lungs are dark red, firm, airless and heavy. There is capillary congestion, necrosis of alveolar epithelial cells, interstitial and intra-alveolar edema and hemorrhage and neutrophils in capillaries. Hyaline membrane is also characteristic, lining the alveolar ducts.
Acute Respiratory Distress Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 482
Diffuse pulmonary disease characterized by limitation of airflow, usually resulting from an increase in resistance caused by partial or complete obstruction atvany level.
Obstructive pulmonary disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
Diffuse pulmonary disease characterized by reduced expansion of lung parenchyma accompanied by decreased total lung capacity.
Restrictive lung disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
Lung volumes in obstructive lung disease:FEV1FVCFEV1:FVC ratio
FEV1 - decreasedFVC - normal / increasedFEV1:FVC ratio - decreased(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
Lung volumes in restrictive lung diseaseFEV1FVCFEV1:FVC ratio
FEV1 - normal/decreasedFVC - decreasedFEV1:FVC ratio - near normal(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483
Characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of their walls without obvious fibrosis. There is thinning oof the alveolar walls and loss of elastic tissue.
Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema involving the central or proximal parts of the acini, formed by respiratory bronchioles, while distal parts are spared. Lungs deep pink and less voluminous, affecting the upper 2/3 of the lungs. Occurs in smokers.
Centriacinar (centrilobular) Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema wherein the acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal alveoli. Occurs more commonly in the lower lung zones. Occurs in a-antitrypsin deficiency.
Panacinar (panlobular) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485
Type of emphysema wherein only the distal part is primarily involved. Lesion is adjacent to the pleura along the lobular connective tissue septa and at the lobe margins. More severe at the upper half of the lungs, forming bullae.
Distal acinar (paraseptal) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 486
Barrel-chested, dyspneic, prolonged expiration, sits forward in a hunched-over position, adequate oxygenation of oxygen. “Pink puffers”.
COPD predominantly emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
History of recurrent infections with purulent sputum, less prominent dyspnea and respiratory drive, becomes hypoxic and are pften cyanotic and obese. “Blue bloaters”.
COPD predominantly chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.
Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Mucosal lining of the larger airways is usually hyperemic and swollen with edema fluid, often covered by a layer of mucinous or mucopurulent secretions. Trachea and bronchi have enlarged mucus-secreting glands.
Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Characterized by goblet cell metaplasia, mucus plugging, inflammation and fibrosis, and sometimes complete obliteration of the lumen due to fibrosis.
Chronic bronchiolitis (small airway disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Most important underlying risk factor for chronic bronchitis.
Cigarette smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Triad of 1.intermittent and reversible airway obstruction2.chronic bronchial inflammation with eosinophils3.bronchial smooth muscle cell hypertrophy and hyperreactivity
Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489
Collections of crystalloids made up of eosinophil proteins.
Charcot-Leyden crystals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
Whorls of shed epithelium found in mucus plugs.
Curschmann spirals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
Curshmann spirals and Charcot-Leyden crystals are found histologically in this disease.
Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492
Permanent dilation of bronchi and bronchioles caused by destruction of theuscle and elastic supporting tissue, resulting from chronic necrotizing infections.
Bronchiectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493
An autosomal recessive disorder frequently associated with bronchiectasis and sterility in males.
Kartagener syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493
Refers to a pulmonary disorder of unknown etiology characterized patchy interstitial fibrosis. Grossly, pleural surfaces of the lung have the appearance of cobblestones because of retraction scars along the interlobular septa.
Idiopathic Pulmonary Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 495
A thrombus that lodges astride a pulmonary artery bifurcation, which causes pulmonary hypertension, which can lead to hypoxia and cor pulmonale.
Saddle embolus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 505
Most common symptom of pulmonary embolism.
None, asymptomatic 60-80% of the time.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
Mean pulmonary pressures reach one-fourth or more of systemic pressures.
Pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
Encountered in young persons, more commonly in women, marked by fatigue, syncope, dyspnea on exertion, and sometimes chest pain. Cause of increased pulmonary pressures is unknown.
Primary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506
Clinical features of this disease reflect the underlying disease, with accentuation of respiratory insufficiency and right-sided heart strain.
Secondary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 507
Pneumonia with a patchy distribution of inflammation involving more than one lobe.
Bronchopneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 509
Four stages of pneumococcal pneumonia.
Congestion, red hepatization, gray hepatization, resolution(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 510
Affected areas are red-blue, congested and subcrepitant. Inflammatory reaction is largely confined within the walls of the alveoli. Septa widened and edematous, with mononuclear infiltrates of lymphocytes, histiocytes and plasma cells. Alveolar spaces are free of cellular exudate.
Atypical pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 513
A localized area of suppurative necrosis within the pulmonary parenchyma, resulting in the formation of one or more large cavities.
Lung abscess(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515
Pulmonary abscess resulting from aspiration of infective material are much more common on the left or right side?
Right side since it’s shorter and more vertical.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515
Form of tuberculosis that develops in a previously unexposed, unsensitized person.
Primary tuberculosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
Implantation of the inhaled M. tuberculosis bacilli in the distal airspaces of the lungs, causes the formation of this 1 - 1.5 cm area of gray-white inflammatory consolidation.
Ghon focus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
Ghon focus + nodal involvement = ________
Ghon complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
Radiographically detectable calcified Ghon complex.
Ranke complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518
Pattern of disease that arises in previously sensitized host to M. tuberculosis.
Secondary or reactivation TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520
Occurs when TB bacilli drain through the lymphtics into lymphatic ducts, which eventually empty into the rightside of the heart and into pulmonary circulation. Individual lesions are small, visible foci of yellow-white consolidation scattered through the parenchyma.
Miliary TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520
The most frequent form of extrapulmonary TB.
TB Lymphadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521
TB lymphadenitis of the cervical LN.
Scrofula(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521
Round to oval small yeast forms measuring 2-5 um in diameter.
Histoplasma capsulatum(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
Thick walled non-budding spherules 20-60 um diameter, often filled with small endospores.
Coccidiodomycosis immitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
Round to oval and larger fungi, which reproduce by broad-based budding.
Blastomycosis dermatitidis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523
Cells infected by this virus exhibit gigantism of the cell and nucleus. An enlarged inclusion surrounded by a clear halo “owl’s eye” is seen. It is the most common opportunistic viral pathogen in AIDS.
Cytomegalovirus (CMV)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 524
Opportunistic infection of the lungs having a characteristic intra-alveolar foamy, pink-staining exudate “cotton candy exudate”, with thickened septa and mononuclear infiltrate.
Pneumocystis carinii pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526
Most frequent disease-causing fungus.
Candida albicans(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526