ILD Oct11 M1 Flashcards by Django E.

acinus def

everything distal to terminal bronchiole

How well did you know this?

Not at all

Perfectly

lobule def

lung parenchyma surrounded by intralobular septae (acini of 1 terminal bronchiole)

How well did you know this?

Not at all

Perfectly

how many acini per lobule

6-8

How well did you know this?

Not at all

Perfectly

what is found in an acini

1st, 2nd and 3rd order respiratory bronchioles, alveolar duct, alveolar sac

How well did you know this?

Not at all

Perfectly

primary lobule def and how many per acinus

lung unit distal to resp bronchiole (ducts, sacs, alveoli). 30-50 per acinus

How well did you know this?

Not at all

Perfectly

secondary lobule (lobule) arterial, venous and lymphatic supply

centrilobular artery running parallel to centrilobular bronchiole
pulmonary veins + lymphatics run in interlobular septum

How well did you know this?

Not at all

Perfectly

parenchyma def and contents

region involved in gas exchange

alveolar airspace
alveolar wall (type 1 and type 2 cells, capillaries, alv-cap BM, interstitial tissue)
CT surrounding small vessels and lymphatics

How well did you know this?

Not at all

Perfectly

non-parenchymal structures (give some)

large airways, large blood vessels, pleura, chest wall

How well did you know this?

Not at all

Perfectly

Interstitial tissue surround small arteries and small bronchi: what it connects to

connects directly with alveolar interstitium of alveolar septum

How well did you know this?

Not at all

Perfectly

function of the interstitial tissue of the lung

supporting framework for airways, vessels and alveolar airspaces

How well did you know this?

Not at all

Perfectly

two interconnected compartments of lung interstitial tissue and do they connect

parenchymal and non parenchymal compartment of lung IS tissue. They connect

How well did you know this?

Not at all

Perfectly

parenchymal lung IS tissue: where

in alveolar wall and surrounding small vessels and lymphatics

How well did you know this?

Not at all

Perfectly

non-parenchymal lung IS tissue: where

pleura, interlobular septa, surrounding large vessels and airways

How well did you know this?

Not at all

Perfectly

how big is the lung parenchymal IS

barely (not) visible on histology slide of alveolar duct

How well did you know this?

Not at all

Perfectly

3 spaces that can be involved in ILD

parenchymal IS, non-parenchymal IS, alveolar airspace

How well did you know this?

Not at all

Perfectly

ex of disease affecting parenchymal interstitium

pneumocytosis pneumonia

How well did you know this?

Not at all

Perfectly

ex of diseases (2) affecting non parench IS

sarcoidosis

edema

How well did you know this?

Not at all

Perfectly

condition where dyspnea is worse when lying down

orthopnea

How well did you know this?

Not at all

Perfectly

Moderate oedema or interstitial pulmonary oedema (non-parenchymal disease) (filling with gelatinous apperance) symptoms examples

dyspnea, orthopnea, RR 14, O2 sat 90%, mild resp distress, still able to speak in full sentences

How well did you know this?

Not at all

Perfectly

interstitial pulmonary edema (moderate) CXR findings

Extra lines in the lung fields running straight to pleura: Kerley B lines.
Heart bigger
Larger pericardiac silouhette

How well did you know this?

Not at all

Perfectly

interstitial pulmonary edema (moderate) CT findings

Kerley B lines (1 cm in length, go right out to the pleura)

How well did you know this?

Not at all

Perfectly

what kerley B lines are or represent

interlobular septa

How well did you know this?

Not at all

Perfectly

gross histology of interlobular septa in interstitial pulmonary edema (moderate)

1mm thickness, gelatinous appearance, loose. Fluid within. Loose appearance joins with IS tissue around bronchus and pulm artery

How well did you know this?

Not at all

Perfectly

alveolar pulmonary edema (severe) symptoms examples

severe dyspnea, sitting up doesn't relieve. always breathless, coughin up (with small amounts of frothy pink sputum)
RR 30 
O2 sat 82
cyanosis
speak max 3-4 words at a time

How well did you know this?

Not at all

Perfectly

alveolar pulmonary edema CXR findings

more white radioopacities in both lungs | radiolucent linear lines (airways)

name of radiolucent linear lines (airways) seen on severe (alveolar pulmonary) edema on CXR

Air bronchograms | black lines, transparent to X-ray

why see air bronchograms in CXR of alveolar pulmonary edema

No disease in airways so are radiolucent (let X ray through and appear black) bc disease in airspace

name of pattern seen on CXR of alveolar pulmonary edema and explanation

Acinar pattern. bc airspaces filled with something (fluid in case of edema)

Acinar pattern: what is the differential or what can be filling the airways

fluid, pus (pneumonia), blood (alveolar hemorrhage), pissou

alveolar pulmonary edema appearance on gross histology

lung parenchyma grey instead of red. greyish tissue goes 1 cm around edge of bronchial wall Alveolar airspaces filled or obliterated

3 categories of edema

early pulmonary edema interstitial pulmonary edema (non parenchymal) alveolar pulmonary edema (parenchymal)

early pulm edema: pulm capil wedge pressure + CXR findings

13-18 mmHg. Engorged blood vessels, resulting in redistribution

interstitial pulmonary edema: pulm capil wedge pressure + CXR findings

18-25 mmHg. Kerley B lines. Thickened fissures

alveolar pulmonary edema: pulm capil wedge pressure + CXR findings

more than 25mmHg. Air bronchograms + Consolidation

redistribution meaning on X-ray

normally, see vessels in airways better on lower parts of lungs. If pressure increase bc of left heart failure, redistribution of blood towards top of X-ray

mechanism of edema in left heart failure

increase in pressure in pulm circulation and so in pulm capillaries too. Fluid leaks to alveolar airspace

why initially non parenchymal IS affected in edema and only severe edema affects parenchymal

initial leak in alveolar airspace is sucked in non parenchymal IS (making interlobular septa and perivascular IS thick) to keep gas exchange At certain point, this capacity is surpassed

Name of phenomenon when airspaces are filled with fluid

Consolidation | of whole lobule or acinus

Treatment to edema

Diuretic to mobilize fluid (diuretic = makes you pee)

Pneumonia def

lung infection with bacteria, virus or fungus

pneumonia symptoms examples

slowly progressive dyspnea, low grade fever (38.2)

pneumonia CXR findings

fluffyness. Cloudy white appearance.

interstitial pneumonia histology of the alveoli

Thicker alveolar septum. Lymphocytes. | Might see something inside alveolar airspace if is also involved

what interstitium do we mean to be affected when say interstitial pneumonia

parenchymal interstitium

Normal CT: what we can see

vessels, airways, intralobular septum

Abnormal CT: what can be seen

Parenchymal, IS or airspace disease with variety of patterns (whitening of parenchyma area, complete whitening is consolidation), etc.

Sarcoidosis example of symptoms

painful red eye, blurred vision

sarcoidosis X ray findings

``` enlarged hilar lymph nodes on both sides (bilateral hilar adenopathy) interstitial pattern (kerley B lines but not exactly) ```

lymphadenopathy definition

disease of the lymph nodes, in which they are abnormal in size, number, or consistency.

Low magnif histo stain finding in sarcoidosis

Normal parenchyma. non parenchymal IS surrounding vessels is involved (appears pink)

higher magnif histo stain finding in sarcoidosis

non necrotizing granuloma. middle cells have elongated nuclei + lightly eosinophilic center

Important cell type found in non parench IS in sarcoidosis

Epitheloid histiocyte (activated macrophage)

sarcoidosis: bands of pinker tissue that is hypocellular, in the granulomas: what is it + shows what

collagen. shows fibrosis

how sarcoidosis heals (2)

treatment or by itself, giving fibrosis

from inside to outside of granuloma, how epitheloid histiocyte number varies. in sarcoidosis