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FHHD > Diseases of the Lungs > Flashcards

Diseases of the Lungs Flashcards

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1
Q

What is pneumonia/pneumonitis

A

Infection of the lung causing alveolar inflammation

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2
Q

What are the types of pneumonia

A

Lobar pneumonia
Bronchopneumonia
Atypical pneumonia

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3
Q

What bacteria causes lobar pneumonia in 90% of cases

A

Streptococcus pneumoniae

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4
Q

What are the clinical features of lobar pneumonia

A

High grade fevers with rigors, productive cough, rusty sputum, pleuritic chest pain and signs of consolidation

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5
Q

What are the 4 pathological stages of lobar pneumonia

A

Congestion
Red hepatisation
Grey hepatisation
Resolution

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6
Q

Describe the features of the congestion stage of lobar pneumonia

A 
Occurs for 24 hours
Vessels engorged
Oedema in alveoli
Heavy 
Red lung
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7
Q

Describe the features of the red hepatisation stage of lobar pneumonia

A 
Occurs for 2-4 days
Outpouring of neutrophils and RBC's into alveoli
Red
Solid
Airless
"liver like" lung
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8
Q

Describe the features of the grey hepatisation stage of lobar pneumonia

A 
Occurs for 4-8 days
Fibrin and macrophages replace neutrophils and RBC's 
Grey 
Solid
Airless lung
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9
Q

Describe the features of the resolution stage of lobar pneumonia

A

Occurs for 8-10 days

Gradual return to normal

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10
Q

What is the most common form of pneumonia

A

Bronchopneumonia

“hospital acquired”

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11
Q

What are the 4 typical clinical settings in which bronchopneumonia is found

A
  • Chronic debilitating illness
  • secondary to viral infections
  • Infancy
  • Old age
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12
Q

How does bronchopneumonia often develop

A

starts as bronchitis and bronchiolitis then spreads to the alveoli

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13
Q

Which bacteria tend to cause bronchopneumonia

A

Staph
Strepto viridans
H influenzae
Coliforms

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14
Q

Describe the histology of bronchopneumonia

A
  • Bilateral, basal, patchy
  • Grey or grey-red spots of consolidation
  • Microscopically acute inflammatory infiltrate in bronchioles and alveoli
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15
Q

What are some of the complications of bronchopneumonia

A

Death, cus usually happens with other illnesses/extreme age
Resolution
Scarring
Abscess/empyema - rare

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16
Q

What kind of infection can cause interstitial (atypical) pneumonia

A

Mycoplasmal or viral

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17
Q

Where does inflammation occur in atypical pneumonia

A

Restricted to the alveolar septa and interstitial tissues

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18
Q

Why is interstitial pneumonia referred to as “atypical”

A

There is no alveolar exudate

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19
Q

What bacteria causes TB

A

Mycobacterium tuberculosis

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20
Q

Describe the symptoms and features of primary TB

A
  • Represents response to first contact with tubercle bacilli
  • Usually asymptomatic
  • Ghon complex: lesion typically 1cm focus in midzone with draining lymph node
  • Heals with fibrosis and calcification
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21
Q

Describe the pathology of secondary TB

A
  • Reinfection or reactivation

* Fibrosis is usually apical, about 3cm at clinical presentation

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22
Q

Describe the microscopic pathology of TB

A
  • Characteristic inflammation based changes resulting from Type IV hypersensitivity
  • Granulomas that try to attack TB bacteria with caseous necrosis, Langhan’s giant cells and epithelioid macrophages
  • Ziehl-Neelsen stain reveals the characteristic acid-fast bacilli
  • Definitive diagnosis is by sputum culture
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23
Q

What does Pulmonary TB do over time to the lungs

A

Causes progressive fibrocavitary TB, gradually destroys lung through necrosis, cavitation and fibrosis

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24
Q

Give some examples of COPDs

Study These Flashcards
A
  • Chronic bronchitis
  • Emphysema
  • Bronchial Asthma
  • Bronchiectasis
25
What is almost always the cause of bronchitis and emphysema
Smoking
26
Which COPD almost always occurs with chronic bronchitis
Emphysema
27
What causes chronic bronchitis
Mucous gland hypertrophy and therefore mucous hyper secretion
28
What are some symptoms of chronic bronchitis
- Productive cough - Hypoxia - Hypercapnia
29
What causes emphysema
Permanent dilatation of airways distal to terminal bronchiole Caused by elastin destruction leading to loss of elastic recoil
30
What is bronchial asthma and what can be a symptom
This is an increased irritability of the bronchial tree and causes paroxysms of reversible bronchospasm
31
What causes the most common form of bronchial asthma
Most common = Atopic | Caused by type 1 hypersensitivity to common allergen
32
What is bronchiectasis
Permanent dilatation of bronchi and bronchioles with necrosis of their walls. The airways become saclike and are filled with foul smelling pus.
33
What are some symptoms of bronchiectasis
Chronic paroxysmal cough, typically brought on by change in posture, copious amounts of foul smelling sputum
34
What usually precedes bronchiectasis
Obstruction or childhood viral pneumonia
35
What complications can arise as a result of bronchiectasis
Abscess, fibrosis, amyloid, clubbing
36
What is the mist common site for secondary cancers
The lungs
37
Name some factors that cause lung cancer
Cigarette smoking, asbestos, mineral dusts, radiation, pollution
38
Name a few cancers that can be caused by smoking
Lip, tongue, floor of mouth, larynx, oesophagus, urinary bladder, pancreas and kidney
39
Describe the development of the respiratory epithelium into a carcinoma
1. Respiratory epithelium - ciliated, mucus secreting, pseudo stratified, columnar 2. Stratified squamous 3. Squamous Dysplasia 4. Carcinoma
40
What are the different histological classifications of lung cancer
- Squamous cell carcinoma (25-40%) - Adenocarcinoma (25-40%) - Small cell carcinoma (20-25%) - Large cell carcinoma (10-15%)
41
Describe the clinical features of small cell carcinomas
- Not treatable surgically - Usually widely disseminated at time of diagnosis - Rx chemotherapy
42
Describe the clinical features of non small cell carcinoma
- Surgically treatable | - Classification into adeno or squamous important for targeted therapy; many new molecular targets available
43
What are the local and general symptoms of lung cancer
Local - Cough, haemoptysis and pain | General - Weight loss, Clubbing, Hypertrophic pulmonary osteoarthropathy
44
What are paraneoplastic syndromes
A group of rare disorders that are triggered by ectopic hormone production by tumour cells
45
Give an example of paraneoplastic syndromes
Hypercalcaemia | SIADH - Symptoms of inappropriate anti diuretic hormone
46
What are occupational lung diseases caused by
Diseases caused by inhalation of dust particles, mineral or organic substances over many years due to occupational exposure
47
What are the 2 main mechanisms of injury to the lungs in occupational lung diseases
– scarring from chronic irritation: inert substances , eg coal workers’ pneumoconiosis – hypersensitivity: organic dusts
48
What can coal workers' pneumoconiosis cause
Anthracosis, Macules, Progressive massive fibrosis
49
What can silicon occupational inhalation cause
Silicosis, Caplan’s syndrome
50
What can asbestos occupational inhalation cause
Asbestosis, pleural plaques, Caplan synd, mesothelioma, Ca lung, lx, stomach, colon
51
What can organic dust occupational inhalation cause
Farmers’ lung, Baggassosis, Byssinosis, Bid breeders’ lung
52
Name some lung diseases that come from a vascular origin
- Pulmonary Oedema - Diffuse Alveolar Damage (ARDS, shock lung) - Emboli and Infarction - Pulmonary Hypertension
53
Describe the clinical features of pulmonary oedemas
- As BP increases fluid is pushed into lungs and causes heavy and wet lungs - Alveolar pink granular fluid may contain haemosiderin-laden macrophages (heart failure cells)
54
What are the causes of Diffuse alveolar damage (ARDS, shock lung)
Oedema caused by injury to alveolar capillary endothelium - Shock - Trauma - Sepsis - Viral infections - Noxious gases - Radiation
55
How does Diffuse alveolar damage progress
It proceeds to cause severe scarring and is a rapid life threatening respiratory situation
56
What causes emboli and infarctions in the lungs
Occlusion of pulmonary arteries by circulating clots usually from the low limb veins
57
Describe the complications associated with large saddle emboli
Immediately fatal - lodge at bifurcation of pulmonary trunk
58
Describe the features of small emboli
Causes a characteristic wedge shaped infarcts
59
How long should a productive cough last before you diagnose chronic bronchitis
more than 3 months

FHHD (21 decks)

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