11/2 - Lung Pathology

Question 1

what are vascular lung diseases

Answer 1

1. pulmonary embolism and infarction
2. pulmonary hypertension

Question 2

Almost all large pulmonary artery thrombi are embolic in origin, usually arising from the _____

Answer 2

deep vein of the lower leg

Question 3

risk factors of pulmonary embolism

Answer 3

1. Prolonged bed rest or immobilization
2. leg surgery
3. Severe trauma
4. Use of oral contraceptives
5. Congestive heart failure
6. Disseminated cancer
7. Inherited forms of hypercoagulable states (Protein S & C deficiency etc. + Disseminated cancer)

Question 4

60-80% of pulmonary emobli are what?
5% cause what?
remainder related to what?

Answer 4

60-80 = silent
5% cause acute cor pulmonale, shock, or death

Remainder cause symptoms related to ventilation-perfusion mismatch and/or pulmonary infarction, particularly dyspnea or chest pain

Question 5

is risk of recurrence in pulmonary emoblism high or low

Answer 5

HIGH

Question 6

what is defined as mean pulmonary artery pressure greater than or equal to 25 mm Hg at rest

Answer 6

pulmonary hypertension

Question 7

is pulmonary hypertension mostly IDIOPATHIC?

Answer 7

yes

Question 8

what is pulmonary hypertension charaterized by

Answer 8

Increased vascular resistance
Blood vessel narrowing within the pulmonary vasculature

Question 9

symptoms of pulmonar hypertension

Answer 9

Usually complicate those of underlying lung disease
right sided heart failure

Question 10

treatment of pulmonary hypertension

Answer 10

If secondary to another disease, focus is on the treatment underlying disease
Calcium channel blockers

Question 11

Answer 11

normal -> thickened -> occluded

Question 12

what is invasion of lung tissues by disease-causing agent (mostly bacteria)

Answer 12

pneumonia

Question 13

what causes exudative solidification of the (consolidation) of the pulmonary tissue

Answer 13

pneumonia (invasion of lung tissue by disease causing agent)

Question 14

what are two subcategories of pneumonia

Answer 14

1. Lobar pneumonia
2. Bronchopneumonia

Question 15

Lobar Pneumonia

Answer 15

Question 16

Bronchopneumonia

Answer 16

Question 17

what is pneumonia classification based on

Answer 17

1. specific organism
2. clinical setting (if no pathogen can be identified)

Question 18

Answer 18

branchopneumonia -> lobar pneumonia

Question 19

how can pneumonia be acquired based on clinical setting

Answer 19

1. Community-acquired
2. Nosocomial (in hospital setting) Greek: “tending to the sick”
3. Aspiration pneumonia
4. Immunocompromised

Question 20

what are types of infectious pneumonias

Answer 20

1. bacterial infection pneumonia
2. virus (AIDS, HIV) or fungal (peumocystis jiroveci) pneumonia: cell mediated defects

Question 21

what is a cause of fungal pneumonia

Answer 21

pneumocystis jiroveci

Question 22

Community Acquired

Answer 22

Question 23

Hospital Acquired

Answer 23

Question 24

types of lung carcinomas

Answer 24

1. non-small cell carcinoma
2. small cell carcinoma

Question 25

what lung carcinoma has highest association with smokers

Answer 25

small cell carcinoma

Question 26

what lung carcinoma is associated with squamous cell (more common in smokers) or adenocarcinoma (more common in non-smokers)

Answer 26

non-mall cell carcinoma

Question 27

90% of lung cancers arise in ___ or recent quitters

Answer 27

active cigarette smokers

Question 28

who is considered a heavy smoker

Answer 28

2 packs/day/20 yrs. 60X nonsmoker incidence

Question 29

peak incidence of lung carcinoma

Answer 29

55-60 years

Question 30

sex and survival of lung carcinoma

Answer 30

Sex: 2 Male: 1 female Survival: all stages, all types combined 15% at 5 years; 5% at 10 years At time of diagnosis, about 50% of lung cancershave already distant metastatic disease

Question 31

what disease: 50% have history of asbestos exposure 25-40 yrs. latent period Asbestos not used since 1960

Answer 31

malignant meseothelioma

Question 32

is there direct link between smoking and mesothelioma

Answer 32

NO

Question 33

is pleural tumor mesothelioma curable? survival rate?

Answer 33

Essentially incurable unless detected at limited stage Median survival 11 months