histo resp Flashcards
(130 cards)
1
Q
what are the obstructive lung diseases
A
COPD asthma bronchiectasis emphysema bronchilitis
2
Q
pathology of chronic bronchitis
A
dilation of airways and excessive mucus prouction
3
Q
histology of chronic bronchitis
A
dilation of airways goblet cell hyperplasia hypertrophy of mucus glands
4
Q
clinical features of chronic bronchitis
A
cough WITH SPUTUM for most days of three months over a two year period
5
Q
causes of chronic bronchitis
A
alpha 1 antitrypsin deficiency smoking air pollution
6
Q
complications of chronic bronchitis
A
hypoxia pulmonary hypertension recurrent infections
7
Q
histological feature of bronchiectasis
A
permanently dilated bronchi
8
Q
congenital causes of bronchiectasis
A
kartageners syndrome CF hypogammaglobulinaemia yellow nail syndrome youngs syndrome
9
Q
pathology of bronchiectasis
A
airway dilatation and scarring
10
Q
clinical features of bronchiectasis
A
cough with purulent sputum fever
11
Q
complications of bronchiectasis
A
infections pulm HTN amyloidosis haemoptysis
12
Q
histology of asthma
A
whorls of shed epithelium (curschman spirals) eosinophils smooth muscle hyperplasia charcot leyden spirals
13
Q
pathology of asthma
A
mast cells degranulate histamine IL1 eosinophils
14
Q
site of asthma pathology
A
bronchus
15
Q
site of emphysema pathology
A
acinus
16
Q
clinical features of emphysema
A
dyspnoea cough
17
Q
histological features of emphysema
A
loss of alvealar parenchyma distal to the terminal bronchiole
18
Q
pathology of emphysema
A
airspace enlargment and wall destruction
19
Q
causes of emphysema
A
alpha 1 antitrypsin defiicency smoking
20
Q
complications of emphysema
A
pneumothorax pulmonary HTN
21
Q
inflammatory causes of bronchiectasis
A
asthma systemic disease e.g. connective tissue post inflammatory e.g. aspiration
22
Q
respiratory disease causing bronchiectasis
A
interstitial fibrosis- sarcoidosis, CFA bronchiolar disease- OB
23
Q
immunological causes of bronchiectasis
A
primary: hypogammaglobulinaemia secondary: chemo
24
Q
young’s syndrome
A
azoospermia, bronchiectasis and rhinosinusitis
25
yellow nail syndrome
yellow dystrophic nails, lymphoedema, pleural effusion and bronchiectasis
26
pattern of restrictive lung disea
FEV1 and FVC are both low ratio is therefore norman
27
spirometry findings for restrictive lung disease
reduced compliance decreased lung volume decreased CO diffusion capacity
28
presentation of restrictive lung disease
end inspiratory crackles sob cyanosis, pulm HTN HONEYCOMB LUNG
29
fibrosing restrictive lung disease
CFA/ IPF pneunoconiosis cryptogenic organising pneumonia drug induced ratiation pneumonitis connective tissue disease
30
granulomatous restrictive lung disease
sarcoid EAA (churgstrauss, wegeners and microscopic polyangiitis) esoinophilic smoking
31
CFA/ IPF histological findings
sub pleural PATCHY INTERSTITIAL FIBROSIS (honeycomb lung)
32
pathology of CFA/ IPF
usual interstial pneumonia starting at periphery and moving inwards. patchy sub pleural fibrosis hyperplasia of type 2 pneumocytes and cyst formation
33
clinical features of IPF/ CFA
CLUBBING progressive exertional dyspnoea cyanosis pulm hTN
34
treatment of IPF/ CFA
steroids, cyclophosphaminde, azothioprine
35
site of pneumoconiosis pathology
upper lobes
36
subtypes of pneuoconiosis
coal miners lung, asbestosis, silicosis
37
where does asbestosis occur and what is the complication
lower lobes mesothelioma
38
is pneumoconiosis a neoplastic process
no it is a lung reaction to inhaled particles
39
histological findings of asbestosis
plaques, fibrosis
40
what is a granuloma
collection of histocytes, macrophages +/- multinucleate giant cells
41
granulomatous lung disease pathology
prolonged exposure to orangic allergics inhaling organic particles causing widespread alveolar inflammation
42
symptoms of granulomatous lung disease
acutely: fever, chills, chest pain, sob, cough choronic EAA: clubbing, wt loss and persistent productive cough and sob
43
histological findings in granulomatous lung disease
polypoid plugs of loose connective tissue in bronchioles and alveoli resulting in organising pneumonia and granuloma formation
44
microorganism for farmers lung
saccharopolyspora rectivirgula
45
pigeon fanciers lung microbe
protein in bird feathers/ excretia
46
humidifiers lung microbe
thermactinomyces spp
47
cheeseworkers lung
aspergillus clavatus penicillium casei
48
maltworkers lung
aspergillus clavatus aspergillus fumigatus
49
stages of lobar pneumonia
1. consolidation 2. red hepatisation (neutrophilia) 3. grey hepatisation (fibrosis) 4. resolution
50
pathology of lobar pneumonia
finbrinosuppurtive consolidation
51
pathology of atypical pneumonia
interstitial pnumonitis with no inta alveolar inflammation
52
pathology of bronchopneumonia
patchy bronchial or peribronchial distribution
53
SCC of the lung mutations
c-myc/ p53 mutations
54
location of scc of the lung
central (proximal bronchi) results in obstructive symptoms such as IVC compression
55
is smoking correlated with SCC of the lung
YES
56
cytology of SCC of the lung
squamous cell
57
histology of SCC of the lung
keratinisation intercellular prickles (desmosomes)
58
endocrine association of SCC of the lung
hypercalcaemia
59
two subtypes of SCC of the lung
papilliary, basaloid
60
progression of SCC of the lung
epithelium- hyperplasia- squamous metasplasia- angiosquamous dysplasia- carcinoma in situ- invasive carcinoma
61
adenocarcinoma molecular mutations
EGFR
62
adenocarcinoma of the lung location
peripheral with early mets
63
histology of adenocarcinoma of the lung
glandular differentiaion and mucin production
64
cytology of adenocarcinoma of the lung
cells with mucin vacuoles
65
cell division in adenocarcinoma of the lung
atypical adenomatous hyperplasia- non-mucinous BAC- mixed pattern
66
small cell lung cancer location
central with early mets
67
small cell lung cancer causes/ mutations
smoking p53, RB1
68
cells in small cell lung cancer
neuroendocrine cells
69
syndromes as a consequence of small cell lung cancer
lambert-eaton, SIADH cerebellar degeneration
70
features of large cell lung cancinoma
large cells with large nuclei and prominant nucleoli no glandular or squamous degeneration
71
paraneoplasitc syndrome from ADH production
SIADH
72
paraneoplasitc syndrome from ACTH
Cushing's syndrome
73
paraneoplasitc syndrome from bradykinin
cough
74
paraneoplasitc syndrome from PTH/ PTHrH
hyperparathyroidism, hypercalcaemia and bone pain
75
paraneoplasitc syndrome from calcitonin
hypercalcaemia
76
paraneoplasitc syndrome from serotonin
carcinoid syndrome (flushing, diarrhorrea and bronchoconstriction)
77
mutations that indicate poor response to tyrosine kinsase inhibitors in lung cancer
AML4-ALK Kras
78
when are tyrosine kinase inhibitors useful in lung cancer
presence of EGFR mutation (adenocarcinoma)
79
when are NSCLC unlikely to response to cisplatin
ERCC! mutation
80
mesothelioma locatoion
parietal or visceral pleura
81
symptoms of mesothelioma
pleural effusion, chest pain and dyspnea
82
class 1 pulm HTN
pulmonary arterial hypertension
83
causes of class 1 pulm htn
idiopathic hereditary drugs/ toxins associated with congenital heart disease
84
class 2 pulm HTN
pulm HTN associated with left heart disease
85
class 3 pulm HTN
pulm HTN due to lung disease
86
class 4 pulm HTN
chronic thromboemolic pulm htn
87
class 5 pulm HTN
unclear multifactorial mechanisms
88
causes of pulomonary hypertension
precapilliary: chronix hypoxia/ pulonary embolus capilliary: pulmonary fibrosis post capilliary: left heart disease/ veno-occlusivie disease pulonary vasoconstriction of arterioles- intimal fibrosis/ thickened walls
89
histology of pulmonary oedema
intra-alveolar fluid, iron laden macrophages
90
definition of pulomonary oedema
intra alveolar fluid accumulation leading to poor gas exchange
91
histology of diffuse alveolar damage
lung is expanded PLUM COLOURED airless
92
causes of diffuse alveolar damage
ARDS (infection, trauma, aspiration) hyaline membrane disease in neonates insufficiant surfactant in premature babies
93
cytology of SCC of the lung
squamous cell
94
histology of SCC of the lung
keratinisation intercellular prickles (desmosomes)
95
endocrine association of SCC of the lung
hypercalcaemia
96
two subtypes of SCC of the lung
papilliary, basaloid
97
progression of SCC of the lung
epithelium- hyperplasia- squamous metasplasia- angiosquamous dysplasia- carcinoma in situ- invasive carcinoma
98
adenocarcinoma molecular mutations
EGFR
99
adenocarcinoma of the lung location
peripheral with early mets
100
histology of adenocarcinoma of the lung
glandular differentiaion and mucin production
101
cytology of adenocarcinoma of the lung
cells with mucin vacuoles
102
cell division in adenocarcinoma of the lung
atypical adenomatous hyperplasia- non-mucinous BAC- mixed pattern
103
small cell lung cancer location
central with early mets
104
small cell lung cancer causes/ mutations
smoking p53, RB1
105
cells in small cell lung cancer
neuroendocrine cells
106
syndromes as a consequence of small cell lung cancer
lambert-eaton, SIADH cerebellar degeneration
107
features of large cell lung cancinoma
large cells with large nuclei and prominant nucleoli no glandular or squamous degeneration
108
paraneoplasitc syndrome from ADH production
SIADH
109
paraneoplasitc syndrome from ACTH
Cushing's syndrome
110
paraneoplasitc syndrome from bradykinin
cough
111
paraneoplasitc syndrome from PTH/ PTHrH
hyperparathyroidism, hypercalcaemia and bone pain
112
paraneoplasitc syndrome from calcitonin
hypercalcaemia
113
paraneoplasitc syndrome from serotonin
carcinoid syndrome (flushing, diarrhorrea and bronchoconstriction)
114
mutations that indicate poor response to tyrosine kinsase inhibitors in lung cancer
AML4-ALK Kras
115
when are tyrosine kinase inhibitors useful in lung cancer
presence of EGFR mutation (adenocarcinoma)
116
when are NSCLC unlikely to response to cisplatin
ERCC! mutation
117
mesothelioma locatoion
parietal or visceral pleura
118
symptoms of mesothelioma
pleural effusion, chest pain and dyspnea
119
class 1 pulm HTN
pulmonary arterial hypertension
120
causes of class 1 pulm htn
idiopathic hereditary drugs/ toxins associated with congenital heart disease
121
class 2 pulm HTN
pulm HTN associated with left heart disease
122
class 3 pulm HTN
pulm HTN due to lung disease
123
class 4 pulm HTN
chronic thromboemolic pulm htn
124
class 5 pulm HTN
unclear multifactorial mechanisms
125
causes of pulomonary hypertension
precapilliary: chronix hypoxia/ pulonary embolus capilliary: pulmonary fibrosis post capilliary: left heart disease/ veno-occlusivie disease pulonary vasoconstriction of arterioles- intimal fibrosis/ thickened walls
126
histology of pulmonary oedema
intra-alveolar fluid, iron laden macrophages
127
definition of pulomonary oedema
intra alveolar fluid accumulation leading to poor gas exchange
128
histology of diffuse alveolar damage
lung is expanded PLUM COLOURED airless
129
causes of diffuse alveolar damage
ARDS (infection, trauma, aspiration) hyaline membrane disease in neonates insufficiant surfactant in premature babies
130
