Zalogas Lectures

Question 1

type I pneumocytes

Answer 1

gas exchange

Question 2

type II pneumocytes

Answer 2

surfactant production

stem cells

Question 3

resorption atelectasis

Answer 3

mediastinum shifts TOWARD collapsed lung

Question 4

compression atelectasis

Answer 4

mediastinum shifts AWAY

Question 5

Pulmonary edema

Answer 5

-interstitial fluid in alveolar spaces -> hemosiderin laden macrophages (heart failure cells)

• HYALINE membranes in non-cardiogenic from alveolar septal injury
• also caridiogenic cause -> left side heart failure

Question 6

acute respiratory distress syndrome

Answer 6

• HYALINE membranes from protein leakage

- damage type II pneumocytes -> fibrosis

Question 7

emphysema

Answer 7

• PINK PUFFERS
• distal acinar affected -> upper lungs -> spont. pneumothorax (not from smoking)
• panacinar -> A1AT def. -> BASES
• centriacinar -> SMOKE -> UPPER lobes
• causes: Smoke, protease imbalance, A1AT deficiency
• BARREL chest, PURSED lips, cor pulmonale

Question 8

Chronic Bronchitis

Answer 8

• smokers
• mucous gland and goblet cell hyperplasia -> obstruction
• blue bloaters (CO2 trapping)
• reid index >50

Question 9

Asthma

Answer 9

• immune rxn
• REVERSIBLE
• Curschmann spirals (mucous plug)
• Charcot-Leyden crystals (eosinophils + MBP)
• type I hypersensitivity -> TH2 T cells and eosinophils
• treat w/ steroids

Question 10

bronchiectasis

Answer 10

• DILATION of bronchioles
• caused by cystic fibrosis or kartagener syndrome
• HYPERSENSITIVITY rxn to ASPERGILLUS
• foul smelling sputum
• can lead to cor pulmonale and secondary AA amyloidosis

Question 11

Idiopathic pulmonary fibrosis

-aka cryptogenic fibrosing alveolitis

Answer 11

• cyclic injury to lung -> cyclic healing
• due to smoking
• TGF-beta -> fibrosis
• lung transplant to treat
• HONEYCOMB LUNG (cystic spaces)
• fibroblastic foci

Question 12

Cryptogenic organizing pneumonia

Answer 12

• noninfectious
• bronchiolitis obliterans organizing pneumonia (BOOP)

-MASSON bodies

Question 13

coal worker pneumoconiosis

Answer 13

• carbon dust
• anthracosis (carbon laden Macs)
• simple CWP -> centrilobular emphysema
• compl. CWP -> BLACK LUNG

Question 14

silicosis

Answer 14

• silicon dioxide
• fibrotic nodules
• increase risk for TB and lung cancer**

Question 15

asbestos

Answer 15

• asbesto fibers
• fibrosis of lung and pleura (plaques)
• cancer of lung and pleura (mesothelioma)
• laryngeal and ovarian neoplasms
• ASBESTOS bodies
• pleural plaques

Question 16

2 drugs that can cause interstitial fibrosis

Answer 16

• bleomycin

- amiodorone

Question 17

Sarcoidosis

Answer 17

• systemic non-caseating granuloma disease
• bilateral hilar lymphadenopathy

-HLA-A1 and HLA-B8**

• Schaumann bodies
• ASTEROID bodies (inclusions in giant cells of granuloma)

-involve LUNGS and LYMPH NODES

Question 18

Hypersensitivity Pneumonitis

Answer 18

• Non-caseating granulomatous rxn to inhaled antigens -> fibrosis
• T cell mediated (type 4) hypersensitivity
• Farmer’s lung, Pigeon breeder lung, humidifier
• involve INTERSTITIUM and BRONCHIOLES

Question 19

pulmonary eosinophilia

Answer 19

• infiltration of eosinophils (IL-5)

- respond well to corticosteroids

Question 20

Pulmonary Langerhans cell histiocytosis

Answer 20

• collection of Langerhan cells (dendritic cells)
• • for S100, CD1a, CD207
• due to smokers
• BRAF mutations -> tumor

Question 21

smoking related interstitial diseases

Answer 21

1. Desquamative interstitial pneumonia -> Macs in ALVEOLI

2. Respiratory bronchiolitis-associated interstitial lung disease -> Macs in respiratory BRONCHIOLES

Question 22

Pulmonary Alveolar Proteinosis (PAP)

Answer 22

• defects in GM-CSF or pulmonary Mac dysfunction -> accumulate surfactant
• treat w/ whole lung lavage