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Lungs > Lung II - Diseases > Flashcards

Lung II - Diseases Flashcards

1
Q

Hypoxia lung response

A

Hypoxic Pulmonary Vasoconstriction
- redirect blood flow to areas w more oxygen

chronic hypoxia leads to hypertension, inflammation;

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2
Q

Whats Type I vs Type II respiratory failure

A

Type 1 “alveoli/gas exchange problem”

  • Hypoxia without Hypercapnia; pO2 low, pCO2 normal
  • Ventilation okay but gas exchange oxygen in affected; Corrected by hyperventilation

Type 2 “+ ventilation problem”

  • pO2 low, pCO2 HIGH
  • RETENTION of CO2 - by ventilation problem
    • Obstruction, neuromuscular problem
    • when failure of Type 1 compensation - Type 2 progression; failure of hyperventilation, hypoxia of brain - ventilation control gone;
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3
Q

What respiratory failure does COPD cause

A

Type II

  • obstruction - leads to ventilation problems
  • V/Q mismatch w V decreased
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4
Q

Name causes of Type I respiratory failure [4]

A

V/Q mismatch w Perfusion decreased
[Oxygenation problem]

  • Pulmonary embolism
  • Pneumonia, ARDS (these are oxygen diffusion problems, alveolar damage)
  • Pulmonary Edema
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5
Q

Pulmonary Oedema pathophysiology and histo feature

A

LHF

  • backpressure, capillary rupture;
  • edema in interstitium, edema in alveolar spaces
  • hemosiderin engulfed by macrophage - heart failure cells
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6
Q

Pulmonary Hypertension causes [4]

A

Cardiac:
Backpressure: LHF
Forward: Left to right shunt

Lung:

  • Hypoxic Vasoconstriction of arteries
  • Pulmonary emboli
  • Idiopathic
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7
Q

Pulmonary HT histological changes [2]

A

Medial hypertrophy, intimal proliferation

- positive feedback - increased pressure

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8
Q

What necrosis found in Pulmonary Emboli and sequelae

A

Dual Blood Supply - Hemorrhagic Necrosis

  • emboli (tissue damage) blocks blood leaving, necrosis; then hemorrhage, interrupts oxygenation, further necrosis
  • pO2 low, ventilation ok - Type I respiratory failure
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9
Q

4 outcomes of Thrombus formation

A

Propagation - accumulate platelets and fibrin
Embolize - mobile thrombi
Dissolution - tPA break up
Organization - ingrowth of smooth muscle, fibroblast - forming capillary-sized channels

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10
Q

Most common type of G-nephritis?

A

IgA deposition

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11
Q

What’s atelectasis and causes [3]

A

Lung collapse

  • Resorption - 2nd to obstruction
  • Compression - pneumothorax
  • Contraction - fibrosis, high surface tension - loss of surfactant
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12
Q

Lung infections general category between URTI and LRTI

A

URTI - viral

LRTI - bacteria + viral; if reflex bad, defenses bad from primary viral damage, bacteria from URT enters LRT

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13
Q

Bronchitis and Bronchiolitis causes

A

Viral mostly

Bacteria: Mycoplasma pneumoniae, Bordetella Pertussis

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14
Q

Whats pneumonia

- components and CXR presentation

A

Infective inflammation, exudate, consolidation

  • debris, dead cells, pus, stiffening, scarring
  • CXR: solid areas, Airless - hence radio-opaque - WHITE
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15
Q

Give classifications of Pneumonia by mode of spread

A

Bacteria:
Bronchopneumonia - bronchi to alveoli
Lobar Pneumonia - alveoli to alveoli

Viral:
Interstitial Pneumonia

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16
Q

Bronchopneumonia and Lobar Pneumonia

infective routes

A

BP: Primary infection on bronchi then spread to alveoli

  • follows airway pattern
  • More commonly HAPs: Staphylococcus aureus, Klebsiella, E. coli and Pseudomonas (from wiki)

LP: infect at distal airspaces rather than starting at bronchi - then spread bronchioles and alveoli spaces through entire LOBE

  • usually Strep Pneumonia, H. Influenza, TB, Klebsiella
  • Klebsiella both can

Recall MSSA makes penicillinase

17
Q

Classify pneumonia by acquisition / Clinical classification lol

A

CAP: usually Gram Positive
Strep Pneumonia, H. Influenza (Gram-negative, coccobacillary)

HAP/ Ventilator AP: usually Gram neg
- Klebsiella pneumoniae, E. Coli, Pseudomonas aeruginosa (all these are GNR)

Recall P. Aeruginosa AB:

  • Carbapenems minus ertapenem: imipenem, meropenem
  • 3rd gen Ceft: Ceftazidime
  • combine w Aminoglycosides (tobramycin, gentamicin, and amikacin)

also recall Streptomycin for TB

18
Q

Pneumonitis vs Pneumonia

A

Interstitium Inflammation (allergy and what not)

  • Pneumonia has INFECTION - pus, consodliation
19
Q

Whats aspiration pneumonia and whats it caused by

A

Impaired swallowing, Unconsciousness

- commonly Oral anaerobes, OP bacteria + gastric acid + food

20
Q

Whats atypical pneumonia

A

Marked inflammatory inflitrate - pneumonitis BUT minimal airspace exudate - absence of consolidation

but is infection
- atypical bacteria or atypical pattern

21
Q

Give 2 infections and 1 cancer for HIV

A

Infection
- pneumocystis jirovecii, Cryptococcus neoformans

Cancer - kaposi sarcoma HHV 8

22
Q

Whats bronchiectasis

Pathogenesis

A

Dilatation of bronchi

  • with chronic inflammation, purulent exudate
  • due to repeated, persistent infection

Poor drainage - predispose to R+P infection

  • Obstruction
  • Mucous viscosity increases - CF
  • Immotile cilia syndrome
  • hence persistence inflammation, damage to bronchial wall - Bronchiectasis

Studies have demonstrated that the small airways in bronchiectasis are obstructed from an inflammatory infiltrate in the wall. As most of the bronchial tree is composed of small airways, the net effect is obstruction.

23
Q

Whats Lung Abscess

Cx:

A

Suppurative Necrosis, forming large cavities

rupture - empyema - pneumothorax; erode into pulmonary vessel - hemorrhage, sepsis

24
Q

Whats coagulative necrosis

A

Ischemia,

Preserved cell outlines without nuclei

25
Q

Whats liquefactive necrosis

A

ischemic injury in the brain
- infection elsewhere - neutrophil enzymes degrade stuff to give liquid

Inflammatory cells with numerous neutrophils
+ Pus gives SUPPURATIVE necrosis

26
Q

Whats caseous necrosis

A

Granuloma, necrotic center surrounded by epithelial histiocytes

  • Amorphous
  • TB
27
Q

Whats fat necrosis

A

break down fat - calcium soap formation

  • Pancreas + Breast
28
Q

Whats fibrinoid necrosis

A

Vascular Damage (AI, Immune complex…)

  • also found superimposed in Malignant Hypertension
  • fibrin deposits
29
Q

Whats gangrenous necrosis

A

Ischemic necrosis (coagulative necrosis + liquefactive necrosis if infection) of wherever black - used clinically

30
Q

Children/Neonate lung problems [3]

A

Neonatal respiratory distress syndrome - NRDS

  • deficiency of surfactant, prematurity;
  • hypoxia, endothelial, alveolar damage - fibrin exudation - hyaline membranes
  • Hyaline membrane disease: respiratory disease of the newborn, especially the premature infant, in which a MEMBRANE composed of proteins and dead cells lines the alveoli (the tiny air sacs in the lung), making gas exchange difficult or impossible.

Cystic Fibrosis - AR

  • abnormally viscous mucous
  • bronchiectasis, infection, respi failure

Immotile Cilia Syndrome
- bronchiectasis

Lungs (6 decks)

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