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DEVINE Flashcards

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1
Q

ATELECTASIS

A

collapse of lung w/absorption of air from alveoli

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2
Q

resorptive type

A

obstruction/block of bronchus by foreign body/mucous/tumor

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3
Q

most common cause of dyspnea

A

resorptive type - 1st 24hrs postop

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4
Q

compression type

A

mechanical collapse: pneumothorax, pleural effusion

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5
Q

ARDS

A

capillaritis = increased permeability»inflammation>widened gap jxn>exudation>neutrophils mediate injury

SARS/influenza
micro=diffuse alveolar damage
permits exudation fr injured vessles into alveoli w/formation of HYALINE MEMBRANES

INCREASED CAP PERMEABILITY

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6
Q

ARDS clinical

A

rapidly progressive dyspnea w/hypoxemia. poor response to O2 therapy

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7
Q

ARDS causes

A

local: inhalation smoke/chemicals; near drowning; aspiration of gastric contents, pulm infections, radiation

**SYSTEMIC: systemic inflamm response. septic shock, trauma, narcotics, surgery

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8
Q

spirometry: obstructive

A

decreased FEV1

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9
Q

spirometry: restrictive

A

decreased FVC

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10
Q

obstructive disease

A

block air, destruction of elastic fibers
most common
low O2, normal pH

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11
Q

obstructive disease CAUSES

A 
parenchymal disease of lung (decreased FEV1)
asthma
emphysema
chronic bronchitis/bronchiolitis
bronchiectasis
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12
Q

bronchiectasis

A 
bad smelling sputum
PERM. dilation and scarring
persistent &/or sever infection 
immotile cilia
cystic fibrosis
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13
Q

asthma

A

smooth muscle hypertrophy
type I: IgE
wheezing

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14
Q

emphysema

A

acinus (sac)
airspace enlargement - alveolar wall destruction
tobacco smoke (elastase fr neutrophils…LOSS OF ELASTIC RECOIL)
dyspnea

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15
Q

bronchiectasis

A

bronchiole

inflamm scarring

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16
Q

pulmonary emphysema

A

dyspnea. barrel chest
“pink puffer” - malnourished, SOB w/o serious hypoxia. pursed lips, hunched over
may die fr resp failure, pneumothorax fr rupture bullae
secondary pulmonary hypertension w/cor pulmonale

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17
Q

bullae

A

subpleural balloon-like spaces (blebs)
associations w/all forms of pulm emphysema
lung apex
may rupture to produce spontaneous pneumothorax

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18
Q

intersitial emphysema

A

air w/in connective tissue of the lung

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19
Q

CHRONIC BRONCHITIS

A

prolonged cough productive of sputum (3mo-2yr)
tobacco smoke
submucosal mucous glands/gob cells increased: hyperplasia/trophy
infiltrates of lymphocytes//mucus plugs, incur mucus glands

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20
Q

ASTHMA

A

type 1
pollen, allergy
eosinophils, mast cells, IgE

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21
Q

asthma detail

A

IgE formed in response to exposure to allergen.
IgE antibody attaches to mast cells; mast cells release histamines, proteases; vagal receptors stimulated to produce edema and bronchial constriction.
Eosinophils and neutrophils recruited that damage mucosa; leukotrienes elaborated from arachadonic acid that intensify (2nd phase) bronchoconstriction.
Nonatopic type due to exercise, viral infection or aspirin
Morphology of asthma: Bronchi demonstrate edema, infiltrate of eosinophils, increase in mucous glands and smooth muscle hypertrophy

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22
Q

asthma clin course

A

first attack = childhood
recurrent eps of sever dyspnea w/wheezing, chron cough last >hours
may progress to COPD

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23
Q

bronchiectasis (ectasis=dilation)

A

PERMANENT ABNORMAL DILATION OF BRONCHI/BRONCHIOLES due to NECROSIS by INFECTION of WALL

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24
Q

bronchiectasis causes

A

CF

persistent cough, smells horrible

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25
restrictive lung diseases
``` decreased FVC (lung vol) ground glass/reticulo (net) nodular appearance on radiographs honeycomb lung of increased interstitial fibrosis on biopsy ```
26
restrictive lung disease causes
lung disease in lupus scleraderma, RA, other type III systemic immune complex diseases immune complexes no cough = no FEV1 = no obstructive
27
RLD pathology
type I pneumocyte injury /activation of macrophages w/producion of fibrogenic cytokines resulting in fibrosis of lung w/decreased compliance
28
interstitial fibrosis
injury, repair, injury, repair | dry/velcro like rub
29
pneumonoconisis
chronic fibrosing diseases of the lung due to occupational exposure to inhaled dusts
30
silica
increased risk of TB
31
ASBESTOS
``` insulation pleural plaques- CARCINOGENIC asbestos/ferruginous bodies (looks like a screw) progressive, involves lower lobes years after exposure ```
32
radiation & lung
1-6 mo after radiation hyaline membranes, responds to corticosteroids chronic radiation pneumotitis: interstitial fibrosis (permanent)
33
SARCOIDOSIS
``` multisystem disease characterized by NONCASEATING GRANULOMAS in many tissues & organs TYPE IV (cell mediated) GRANULOMAS = ALWAYS TYPE IV NON TB RELATED ```
34
laryngeal carcinoma
squamous cell carcinoma arises from dysplasia>carcinoma in situe Most associated with tobacco smoking and alcohol abuse May be due to asbestos; radiation  Tumors of the true vocal cords (glottis tumors) cause hoarseness Local growth into tissues of the neck; cure rate 65% //suffocates one locally; doesn’t metastasis
35
laryngeal papillomas
Benign HPV-related neoplasm(s) of vocal cords, larynx | May be multiple and may recur, esp. in children
36
laryngeal nodules
nonneoplastic reactive proliferation of vocal cord due to voice oversuse, eg "singers nodes" HOARSENESS
37
mesothelioma
(uncommon, distractor) most assoc w/ asbestos. no tobacco assoc. pleural cav: encases lungs, leads to pulm effusion; resp failture pericardial: encases heart: heart failure peritoneum: obstructs intestines not curable morphology: asbestos body
38
pneumothorax
air in pleural cav due to puncture secondary to rupture emphysematous bleb in a pt w/emphysema or ruptured cavity spontaneous pneumothorax: occurs in young adults (tall) due to paraseptal emphysematous bulla/bleb
39
HORNER SYNDROME
pancoast tumor - apex of lung unilateral enophthalmos (shrunken in eyeball) ROUND THE HORN, ROUND THE COAST
40
SUPERIOR VENA CAVA SYNDROME
tumour grows around VC blocking venous return fr head/arms head & neck congested cyanotic inoperable
41
local effects of lung cancer
obstruction of bronchus: pneumonia growth into adjacent organ/tissue - esophagous: diff swalling; rib: pain/fracturel recurrent laryngeal nerve (hoarseness) & othrs including SVC and symp ganglia
42
hyperplastic pulm osteoarthopathy
clubbing of distal fingers/arthritis | causes: lung cancer - paraneoplastic,CBD, RL shunt
43
paraneoplastic syndrome
effects related to a neoplasm distal from the tumor | not due to local extension
44
chronic pneumonia
lasts weeks-months | caseating (cheesy) granuloma
45
lung abscess
pus-filled cavity contains neutrophils, living pyogenic BACTERIA xray demonstrates air-fluid level
46
atypical pneumonia
viral infection interstitial pneumonia w/lymphocytic response no alveolar exudates, no consolidation no sputum
47
aspiration pneumonia
due to anesthesia, no gag reflex mixture of microbes + gastric acid high death rate
48
morphology of lobar pneumonia
Congestion>red hepatization>gray hepatization>resolution (good) or organization (scar)
49
goodpasture syndrome
TYPE2 hypersensitivity develops following injury exposing basement membrane: resp infection in someone exposed to solvents pt produces anti-glomerular basement membrane antiB that cross reacts w/basement membranes in the lung
50
destruction of centriacinar septae
tobacco smoke
51
destruction of panacinar
alpha 1 antitrypsin deficiency
52
destruction of irregular septae
aging
53
destruction of paraseptal
spontanoues pneumothorax due to bleb rupture
54
ectasis
dilation
55
sarcoidosis assoc
gland enlargement/dry eyes & mouth: MICKULICZ DISEASE
56
hemoptysis causes
pulmonary emboli, lung cancer, TB, goodpasture, wegener's granulomatosis
57
wegener's granulomatosis
vasculitis w/cANCA antibodies causes nasopharyngeal necrosis eye/oribtal lesions renal glomerular disease
58
pulmonary hypertension primary
defect in endothelium/SM | young women
59
pulmonary hypertension secondary
all chronic lung disease recurrent pulmonary emboli l-r shunts of CHD
60
common cause of lobar pneumonia
strep pneumonia
61
common cause of bronchopneumonia in COPD
h. influenza
62
lobar
confluent via alveolar pores large dose virulent organisms more common in alcoholics, smokers
63
bronchial
patchy, spread from bronchioles elderly & very young follows resp. infection/aspiration
64
LOBAR
CRGR
65
aenocarcinoma "non small"
more common in women may arise in scar: stab= cancer later trousseau syndrome
66
small cell carcinoma - neuroendocrine
aggressive local growth | adh production

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