Lecture 2 Flashcards

Question

What is pneumothorax and different types

Answer 1

Definition: • Air in the pleural space → lung collapse • Symptoms: • Dyspnea (shortness of breath) • Uneven chest expansion • Chest pain • ↓ Tactile fremitus, hyperresonance, ↓ breath sounds on the affected side ⸻ Types of Pneumothorax: 1. Primary Spontaneous Pneumothorax • Cause: Rupture of apical blebs/cysts • Most common in: Tall, thin, young males • Linked to smoking 2. Secondary Spontaneous Pneumothorax • Cause: Underlying lung disease (e.g., emphysema, Marfan syndrome, infections) • Can also result from barotrauma in mechanical ventilation 3. Traumatic Pneumothorax • Cause: Blunt or penetrating trauma (e.g., rib fracture, gunshot, iatrogenic like central line or lung biopsy) 4. Tension Pneumothorax (Life-threatening) • Air enters but cannot exit the pleural space • Leads to rising intrathoracic pressure → • Tracheal deviation (away from affected side) • Mediastinal shift • ↓ Venous return → ↓ cardiac output • Obstructive shock: hypotension, tachycardia, JVD • Emergency: Needs immediate needle decompression + chest tube placement

Answer 2

Excess fluid accumulated in pleural space so we have restricted lung expansion. Transudative pleural effusion: pressure driven infiltration, increased hydrostatic pressure. Clear fluid due to increased hydrostatic pressure Educative pleural effusion: local inflammatory processes-> leaky capillaries. Cloudy fluid due to infection

Answer 3

Alveolar collapse Causes: - obstruction of airway stops new air from reaching distal airways - compressive: external compression on lung decreases lung volume - contraction: scaring of lung parenchyma - adhesive: lack of lung sufactant

Answer 4

Definition: Blockage of pulmonary arteries by: • Thrombus (blood clot) • Fat embolus • Air embolus • Tumor tissue • Embolus: A clot or plug that travels through the bloodstream and blocks a smaller vessel, disrupting blood flow • Emboli travel to the lungs and lodge in pulmonary vessels • Size and number of emboli determine where they get stuck • This causes obstruction of blood flow → ↓ perfusion to part of the lung • That lung area is still ventilated (air enters), but not perfused (no blood flow) • → This leads to a ventilation-perfusion (V/Q) mismatch • → Hypoxemia (low oxygen in the blood) results

Answer 5

Most PE cases come from thrombi (clots) that form in: • Deep veins of the calf, femoral, popliteal, or iliac regions (DVT) • Other emboli sources include: • Tumors, fat, air, bone marrow, amniotic fluid • Septic thrombi • Infective endocarditis vegetations (on heart valves) Major surgeries (especially hip, knee, abdominal, pelvic) → reduce blood flow → ↑ risk of clots • Prolonged immobility: • Long flights • Sitting for extended periods • Cramped travel conditions

Answer 6

Sites of metastasis: liver, adrenal, bone, brain Complications: SPHERE: superior vena cava, pancoast tumor, Horner syndrome, endocrine, recurrent laryngeal nerve compression, effusions Squamous cell and small cell carcinomas are often caused by tobacco smoking

Answer 7

Small cell ( oat cell): centrally located, undifferentiated and very aggressive, may cause neurological paraneoplastic syndromes and endocrine paraneoplastic syndromes

Answer 8

Adenocarcinoma: peripheral location, mutation of KRAS, EGFR and ALK associated w clubbing Squamous cell carcinoma: central location, hilar mass from bronchus, hypercalcemia Large cell carcinomas: peripheral location, highly anaplastic undifferentiated tumor may produce hCG Bronchial carcinoid tumor: central or peripheral, metastasis is rare and we have nest of neuroendocrine cells Pancoast tumor: occurs in apex of lung

Answer 9

T1: tumor less than 3cm w/o pleural or mainstream bronchus T2: tumor 3-5cm with involvement of mainstream bronchus. T3: tumor 5-7cm involves parietal pleura, chest wall, phrenic nerve T4: tumour more than 7cm w invasion of mediastinum, heart etc N0: no metastasis to regional lymph nodes N1: ipsilateral intraparenchymal involvement N2: metastasis to ipsilateral mediastinal lymph nodes N3: metastasis to contralateral mediastinal lymph nodes M0: no metastasis M1: distant metastasis

Answer 10

Horners syndrome Superior vena cava syndrome SIADH Eaton lambert syndrome Clinical features: facial and upper extremity swelling, low Ach release

Answer 11

Abnormal processing of surfactant by macrophages (primary or acquired) • Deposition of amorphous lipoproteinaceous material (phospholipids and surfactant apoproteins)in the alveoli

Answer 12

Acute inflammatory condition, confined to supraglottic structures, main cause is haemophillus influenza type B

Answer 13

Acute: H influenza is the cause and we see a thumb sign on x ray Laryngeal: parainfluenza virus is the cause and we see a steeple sign on x ray

Answer 14

Infectious granulomatous disease caused by Mycobacterium (acid-fast bacilli) • Forms caseous (cheese-like) granulomas called tubercles, mainly in lungs and lymph nodes • Can affect any organ, commonly: • Lungs, lymph nodes, liver, spleen, pleura, intestines • Symptoms vary depending on the organs involved Transmitted by: infected cattle, they inhale the air, feaces, milk, urine, vaginal and uterine

Answer 15

Spreads in two stages: 1. Primary complex 2. Postprimary dissemination ⸻ Primary Complex (early stage): • Includes: • Initial lesion at the site of entry (usually lungs via inhalation) • Regional lymph node involvement • Sometimes lesions are only seen in pharyngeal or mesenteric lymph nodes • Primary focus appears within 8 days • Calcification starts by 2 weeks • A tubercle forms: necrotic center surrounded by granulation tissue, monocytes, and plasma cells • Bacteria spread to nearby lymph nodes and cause similar lesions

Answer 16

Chronic, mild cough (not loud, occurs once or twice at a time) • Triggered by pharynx pressure, exercise, cold, or in the morning • In advanced stages: • Dyspnea (shortness of breath) with rapid, deep breathing • Abnormal chest sounds: • Dullness on percussion • Absent breath sounds in damaged areas • Crackles (squeaky) in affected lung regions • Bronchial lymph node enlargement may: • Compress airways → worsen dyspnea • Cause mediastinal lymph node swelling, linked to persistent ruminal tympany

Answer 17

Involves intradermal injection of bovine PPD (purified protein derivative) • A positive result shows swelling at the injection site after 72 hours, indicating delayed hypersensitivity

Lecture 2 Flashcards

(41 cards)