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Flashcards - Pulm

1
Q

plexiform lesions

A

pulmonary hypertension

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2
Q

Birbeck’s granules (tennis rackets)

A

Langerhans histiocytosis - S100 and CD-1a positive

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3
Q

1gm of Hb binds to mL of O2

A

1gb Hb = 1.34mL of O2

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4
Q

Taut hemoglobin

A

low affinity for O2

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5
Q

relaxed hemoglobin

A

high affinity for O2

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6
Q

methemoglobiemia

A

treat with methylene blue - caused by nitrites, benzocaine - can be induced to treat cyanide

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7
Q

Kiesselbach plexus

A

anterior segment of nostril - most common site of nose bleed

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8
Q

Sphenopalatine artery

A

posterior - branch of maxillary - life threatening nose bleed

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9
Q

lines of Zahn

A

platelet+fibrin/RBC layers in PE, premortem

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10
Q

Pulmonary artery hypertension

A

bone morphogenic protein receptor 2 (BMPR2) - smooth muscle proliferation

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11
Q

Rifampin

A

inhibits DNA-dependent RNA polymerase - inhibits CYP450

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12
Q

Ethambutol

A

inhibits mycolic wall synthesis - optic neuropathy

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13
Q

Isoniazid

A

inhibits mycolic acid synthesis - can cause B6 deficiency, neuropathy

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14
Q

neuroendocrine (Kulchitsky cells) - dark blue cells, chromogranin+

A

central - small cell carcinoma - smokers - ADH, ACTH, Eaton-Lambert

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15
Q

squamous cell carcinoma

A

central - smokers - keratin pearls/intercellular bridges(desmosomes) - PTHrP

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16
Q

adenocarcinoma

A

peripheral - non-smokers - glands/mucin - KRAS, EGFR, ALK

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17
Q

large cell carcinoma

A

central/peripheral - smokers - poorly differentiated large cells

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18
Q

bronchoalveolar carcinoma

A

peripheral - non-smokers - columnar cells arising from clara cells, grows along bronchioles/alveoli - pneumonia-like

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19
Q

carcinoid tumor

A

central/peripheral - non-smokers - chromogranin +, polypoid, nests of neuroendocrine cells

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20
Q

aspiration bacteria

A

bacteroides, fusobacterium, peptococcus - treat with clindamycin

21
Q

aortic/carotid bodies chemoreceptor

A

PaO2 + PaCO2 driven

22
Q

central chemoreceptors

A

PaCO2 driven only

23
Q

sarcoidosis

A

non-caseating granulomas - CD4+ T-cell mediated - causes increased ACE, Ca2+

24
Q

IPF

A

TGF-b induced - bleomycin/amiodarone

25
stellate inclusions/asteroid bodies
sarcoidosis
26
coal workers/black lung
associated with RA, Caplan syndrome - carbon laden macrophages - upper lobes
27
upper lobe fibrotic nodules, eggshell calcifications, birefringent particles
silicosis - increases risk of TB (decreased phagolysosomes in macrosomes) - upper lobes
28
berylliosis
non-caseating granulomas - upper lobes - increased risk of lung Ca
29
fusiform rods resembling dumbbells, fibrosis of lung/pleura, long gold-brown fibers w/ iron, "ivory white"
asbestosis - lower lobes
30
Allergen immuno
induces TH2 in CD4+ cells, secretes IL-4,5,10 --> rexposure = IgE activation of mast cells
31
ARDS
hyaline membrane deposits - activation of neutrophils --> protease/free radical damage --> fibrosis
32
asplenic susceptibility
S. pneumo, H. flu, N. meningitidis
33
ABPA
high IgE, eosinophilia, IgG to Aspergillus
34
legionella growth medium
buffered charcoal yeast extract with L-cysteine and iron
35
mycobacteria pneumoniae growth medium
acellular medium with cholesterol
36
congestion
first 24 hours - red, heavy, boggy - vascular dilation, alveolar exudate with bacteria
37
red hepatization
days 2-3 - red, firm lobe - alveolar exudate with erythrocytes, neutrophils and fibrin
38
gray hepatization
days 4-6 - gray brown firm lobe - RBCs disintegrate - exudate contians neutrophils and fibrin
39
resolution of bronchopneumonia
restoration of architecture - enzymatic digestion of exudate
40
club cells
degrades toxins - produces component of surfactant
41
lobar pneumonia causes
S. pneumo, Legionella, Klebsiella
42
bronchopneumonia causes
S. pneumo, S. aureus, H. flu, Klebsiella, pseudomonas (CF), moraxella, legionella
43
Interstitial pneunomia causes
Viruses (influenza, CMV, RSV, adenovirus), mycoplasma, legionella, chlamydia, coxiella burnetti (Q fever)
44
pleomorphic keratin-positive epithelial cells in background of lymphocytes
nasopharyngeal carcinoma - EBV - involves cervical lymph nodes
45
croup
laryngotracheobronchitis - parainfluenza
46
acute epiglottitis
H. flu b - muffled voice, stridor, obstruction
47
hypersensitivity pneumonotis
granulomatous reaction to organic antigens - eosinophils - pigeon breeders lung
48
Curshmann spirals
shed-epithelium forms whorled mucus plugs - asthma

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