Lecture 6- Pulmonary Pathology I

Question 1

each lung is … grams

Answer 1

200-250 (R. heavier)

Question 2

lungs have a … blood supply

Answer 2

dual (pulmonary and bronchial)

Question 3

the vocal cords are lined by

Answer 3

stratified squamous epithelium

Question 4

the large airways (larynx, trachea bronchi) are lined by… with mucus glands, neuroendocrine cells and cartilage

Answer 4

pseudostratified ciliated columnar epithelium

Question 5

what are the 2 cell types of alveoli?

which produces surfactant?

Answer 5

type 1- flat, 95%

type 2- cuboidal (produce surfactant)

Question 6

4 pulmonary defenses

Answer 6

upper resp tract- filtering

lower resp tract- mucociliary units

lymphoid tissues- cellular and humoral immunity

alveolar macrophages

Question 7

…is coughing up blood

Answer 7

hemoptysis

Question 8

… is diff. of breathing (SOB)

Answer 8

dyspnea

Question 9

… is collapse of the lung

Answer 9

atelectasis

Question 10

… is air in the pleural space leading to collapse

Answer 10

pneumothorax

Question 11

… is suppuration in pleural cavity

Answer 11

empyema

Question 12

pleural effusion is fluid in the … space and it can be filled with either … or …

Answer 12

pleural

transudate (low protein fluid caused by increased venous pressure)

exudate (high protein fluid caused by increased vascular permeability)

Question 13

In pulmonary edema, accumulation of fluid in the lungs is first in the … tissues then ultimately filling up the … air spaces

Answer 13

interstitial

distal

Question 14

3 causes of pumonary edema

Answer 14

increased intravascular pressure (CHF)

hypoproteinemia

vascular damage (infections, autoimmune disease)

Question 15

2 main problems of pulmonary edema

Answer 15

inhibits normal oxygen exchange

predisposes to infection

Question 16

4 predisposing factors of thrombo-emboli

Answer 16

chronic illness

prolonged bed rest

hypercoagulable state (factor V leiden)

DVTs

Question 17

COPD is the combination of… and …

Answer 17

emphysema

chronic bronchitis

Question 18

4 classic disorders in obstructive pulmonary diseases

Answer 18

emphysema
chronic bronchitis
bronchiectasis
asthma

Question 19

… is the permanent enlargement of the distal small air spaces due to destruction of alveolar septal walls

Answer 19

emphysema

Question 20

Clinical presentation of emphysema

Answer 20

dyspnea
cough
prolonged exhalation
“pink puffers” (their oxygenated but need to really force air out because elastic walls have been destroyed)

Question 21

pathogenesis of emphysema

Answer 21

imbalance between protease and anti-protease enzymes

Question 22

what is the major cause of the imbalance between protease and anti protease enzymes in emphysema?

Answer 22

smoking

Question 23

2 forms of emphysema

Answer 23

centriacinar

panacinar

Question 24

… emphysema involves the central portion of the acini and usually affects the upper lobes and is most often related to smoking

Answer 24

centriacinar

Question 25

... emphysema involves the entire acinar unit from the respiratory bronchioles to terminal alveoli, usually affects lower lobes

Answer 25

panacinar

Question 26

which kind of emphysema is seen in patients with alpha antitrypsin deficiency

Answer 26

panacinar

Question 27

... is defined by a cough with sputum for 3 consecutive months in 2 consecutive years

Answer 27

chronic bronchitis

Question 28

patients with ... may have hypoxemia and cyanosis "blue bloaters"

Answer 28

chronic bronchitis (have trouble getting air in)

Question 29

pathogenesis of chronic bronchitis

Answer 29

chronic irritation (smoking) and infections

Question 30

pathology of chronic bronchitis

Answer 30

increased mucus gland layer, chronic inflammation, fibrosis and narrowing of airways

Question 31

predisposing factors for chronic bronchitis and emphysema (4)

Answer 31

smoking atmosphere pollutants infections genetic factors (CF, alpha 1 at deficiency)

Question 32

smoking causes mucus gland ..., increases ... muscle tone, inhibits ... and .... and induces squamous...

Answer 32

hypertrophy smooth muscle tone cilia and phagocytosis metaplasia

Question 33

... is defined as chronic infection with permanent major airway dilation; secondary to obstruction, infection or both

Answer 33

bronchiectasis

Question 34

clinical presentation of bronchiectasis

Answer 34

severe cough bloody mucoid expectoration dyspnea

Question 35

complications of bronchiectasis

Answer 35

abscess pneumonia bronchopleural fistula empyema

Question 36

predisposing factors of bronchiectasis

Answer 36

obstructive tumors foreign bodies CF other COPD suppurative necrotizing pneumonua

Question 37

pathology of bronchiectasis

Answer 37

dilated distal bronchi and bronchioles chronic infection with inflamm. and variable purulence

Question 38

.... is defined as increased irritability and prominence of smooth muscle in bronchi and bronchioles marked with reversible episodes of contraction and irway constriction

Answer 38

asthma

Question 39

initiating factors of asthma

Answer 39

``` allergies infections exercise drugs emotions ```

Question 40

is asthma common?

Answer 40

yes affects 5% of adults and 7-10% of kids especially inner city children

Question 41

clinical presentation of asthma

Answer 41

wheezing long exhalation hyperinflation of lungs

Question 42

types of asthma

Answer 42

atopic and non-atopic

Question 43

3 causes of atopic (extrinsic) asthma

Answer 43

type I hypersensitivity (IgE mediated) environmental antigen positive FH

Question 44

cause of non-atopic | ( intrinsic) asthma

Answer 44

may be initiated by viruses or air pollutants

Question 45

Either atopic or nonatopic an be triggered by

Answer 45

emotional stress exercise cold temps

Question 46

what disorder has the following pathology? | increased mucus glands, smooth muscle hypertrophy, inflammation with eosinophils and type 2 helper T cells

Answer 46

asthma

Question 47

Pathogenesis of asthma: antigen binds to surface .... on mast cells releasing a large number of mediators including ... and ...

Answer 47

IgE histamine leukotrienes

Question 48

asthma tx

Answer 48

inhalation bronchodilators for immediate relief (albuterol) controller medications (corticosteroids)