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Pulmonology > 08.18 - Obstructive, Restrictive Dz (Nichols) - Questions > Flashcards

08.18 - Obstructive, Restrictive Dz (Nichols) - Questions Flashcards

(78 cards)

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1
Q

Bronchiectasis: Obstructive or Restrictive?

A

Obstructive

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2
Q

Pneumoconiosis: Obstructive or Restrictive?

A

Restrictive

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3
Q

Sarcoidosis: Obstructive or Restrictive?

A

Restrictive

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4
Q

4 types of Non-infectious interstitial lung disease

A

Usual Interstitial Pneumonia; Crytogenic Organizing Pneumonia; Nonspecific Interstitial Pneumonia; Radiation Pneumonitis

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5
Q

3 cytokines involved in pathogenesis of emphysema

A

IL-8, TNF, and LeukotrieneB4

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6
Q

What causes pulmonary HTN in emphysema

A

Decr pulmonary vascular capacitance –> Same blood thru smaller vessels –> Incr pulmonary arterial pressure

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7
Q

Pulmonary arterial pressure in Emphysema

A

Increased –> Cor Pulmonale

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8
Q

Emphysema due to smoking is usually ___-acinar

A

Centri-

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9
Q

Type of emphysema in young male smokers with spontaneous pneumothorax

A

Distal Acinar

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10
Q

Most typical symptom of pure emphysema

A

Insidious onset of progressive dyspnea

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11
Q

Mucus hypersecretion thought to be mediated by what cytokine and incr transcription of what gene

A

IL-13; MUC5AC

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12
Q

From where do the cytokines originate that cause mucus hypersecretion in CB

A

T Cells –> IL-13

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13
Q

Symptom of CB

A

Productive Cough

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14
Q

Distinctive, defining feature of CB

A

Bronchial hypersecretion of mucus

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15
Q

Bronchiectasis is permanent dilation of bronchi due to ____ by ___

A

destruction of muscle and elastic tissue by necrotizing infection

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16
Q

3 underlying states leading to infection causing Bronchiectasis

A

(1) CF; (2) Immunodeficiency; (3) Kartagener Syndrome

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17
Q

What is Kartaganer Syndrome

A

Ciliary impairment

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18
Q

Localized bronchiectasis can occur

A

distal to a bronchial tumor or from necrotizing pneumonia

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19
Q

Symptoms of Bronchiectasis

A

Chronic persistent cough productive of copious purulent sputum

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20
Q

Signs of Bronchiectasis

A

Expiratory Rhonchi

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21
Q

Early acute phase asthma

A

IgE, Mast Cells, Histamine, Leukotriene B4, Vagus Nerve

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22
Q

Late Acute Phase Asthma

A

Eosinophils, Neutrophils, Lymphs, IL-1, TNF, IL-6, Leukotrienes C4, D4, E4, PGD2, PAF

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23
Q

Asthma exhibits ___-type inflammation

A

TH2-type

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24
Q

Three C’s of Asthma

A

Curschmann’s Spirals; Charcot-Leyden Crystals; Creola Bodies

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25
Curschmann's Spirals
Small whorled mucus strands
26
Creola Bodies
Fragments of degenerated sloughed respiratory epithelium
27
Presence of goblet cells in bronchioles
Not normally present --> Appear in Asthma
28
Pneumoconioses
Fibrosing restrictive lung diseases caused by inhalation of particles
29
Fibrosing restrictive lung diseases caused by inhalation of particles
Pneumoconioses
30
Coal Worker's: Activation of __ and __ production leads to fibrosis
Activation of Inflammasome and IL-1 production
31
What percent of Coal Worker's results in progressive massive fibrosis
Less than 10%
32
Most prevalent chronic occupational disease in the world
Silicosis
33
Ingestion of Silica by alveolar macrophages leads to release of
TNF, IL-1, Fibronectin, ROS, and TGF-B --> Fibrosing chronic inflammation
34
Gross pathology of Silicosis
Discrete, palpable grey-tan nodules w/ or w/out anthracotic pigment
35
Microscopic pathology of Silicosis
Nodules of concentrically arranged hyalinized collagen
36
Tissue response to asbestos
Coated with iron and elicit fibrosis
37
Signs of Asbestosis
Basal pulmonary crackles
38
Symptoms of Asbestosis
Dyspnea and persistent dry cough
39
4 most common sites of sarcoidosis
Lung, Lymph Node, Eye, Skin
40
Sarcoid: stimuli cause ___ response, mediated by ___
TH1 CD4 response, mediated by IL2, IFN-g, and TNF-A
41
Role of IL-8 in Sarcoid
attract neutrophils
42
Sarcoid: IL-4 mediates
later transition to fibrosing inflammation; chemoattractant to fibroblasts
43
later transition to fibrosing inflammation; chemoattractant to fibroblasts
IL-4
44
Type of granulomas in Sarcoidosis
Non-caseating; Non-necrotic; Tight naked
45
Pulmonary signs of Sarcoidosis
Usually none
46
Classic CXR of Sarcoidosis
Reticulonodular pulmonary infiltrates and bilateral hilar lymphadenopathy
47
Reticulonodular pulmonary infiltrates and bilateral hilar lymphadenopathy
Sarcoidosis, Histoplasmosis, Tuberculosis
48
Distribution of granulomas in Sarcoidosis
Lympharangitic distribution along bronchovascular bundles and in bilateral hilar lymph nodes
49
Symptoms and Signs of UIP/IPF
Insidious onset of dyspnea; Pulmonary crackles
50
Gross pathology of UIP/IPF
Large discrete scars, making lung firmer and more gray than usual; Visceral pleura has nodularity
51
Microscopic Hallmark of UIP/IPF
Fibroblast foci of immature fibrosis bulging into alveoli from interstitium
52
Definitive dx of UIP/IPF is made by
lung biopsy
53
Treatment of UIP/IPF
Transplantation
54
Why is it important to differentiate UIP from COP and NSIP
COP and NSIP respond to steroid therapy
55
Epidemiology of COP
Late middle age non-smokers
56
Histologic Hallmark of COP
Masson Bodies: Plugs of fibrosing granulation tissue in the alveoli
57
Masson Bodies
Plugs of fibrosing granulation tissue in the alveoli: COP
58
Symptoms and Signs of COP
Present with cough, sometimes productive; Dry inspiratory crackles
59
CXR of COP
Ground Glass Bilateral Opacities
60
Tx of COP
Steroids
61
Epidemiology of NSIP
Middle age women non-smokers
62
Presentation of NSIP
Dyspnea and Cough
63
CXR of NSIP
Bilateral Ground Glass Opacities
64
Microscopic features of Radiation Pneumonitis
Atypical Type 2 Pneumocyte Hyperplasia and blood vessel injury
65
Young male smoker with spontaneous pneumothorax
Distal Acinar Emphysema
66
Top relevant Interleukin in Asthma vs COPD
IL-5; IL-8
67
Charcot-Leyden crystals are composed of
Galectin-10
68
UIP is usually due to
Genetically-determined aberrant healing from aspiration of gastric contents, smoking, exposure to toxins
69
Temporality of UIP
Heterogenous
70
Lobar location of UIP
Worse in peripheral lower lobes
71
UIP genetic predisposition in many patients
TERT or TERC genes
72
Fibroblast Foci
Histologic Hallmark of UIP
73
Masson Bodies are found in
COP
74
Temporality of NSIP vs UIP
Homogenous vs Heterogenous
75
Number of infections/injuries in NSIP, UIP, COP
1 in NSIP and COP; repeated in UIP
76
Patients with Silicosis are more prone to __ due to ___
Tuberculosis, paralyzed macrophages
77
Tight, well-formed, non-caseating granulomas
Sarcoidosis
78
Caseating Granulomas =
Tuberculosis

Pulmonology (31 decks)

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