Lung Pathology I

Question 1

aspiration

Answer 1

down right lung - straight bronchus

Question 2

lying down

Answer 2

aspiration to left upper lobe

Question 3

conducting vs. respiratory

Answer 3

respiratory - where alveoli gas exchange occurs

Question 4

size of particles

Answer 4

less than 10 microns - alveolar damage

less than 5 microns - real bad damage to alveoli

Question 5

bronchus

Answer 5

cartilage

AND submucosal glands

Question 6

bronchiole

Answer 6

no cartilage

Question 7

clara cells

Answer 7

in bronchioles

dome shaped cells with short microvilli

Question 8

surfactant

Answer 8

type II pneumocytes

Question 9

pores of kohn

Answer 9

intraalveolar macrophages

Question 10

lobule

Answer 10

cluster of terminal bronchioles and all attached acini

Question 11

acinus

Answer 11

resp bronchiole and all attached alveolar ducts and alveolar sacs

Question 12

canals of lambert

Answer 12

openings between bronchi and alveoli

Question 13

pulmonary hypoplasia

Answer 13

lungs don’t develop fully

-oligohydramnios - uterus squeeze fetus

Question 14

TE fistula

Answer 14

most common - blind pouch

bloated belly - trachea connect to esophagus

blind pouch - can cause oligohydramnios during pregnancy

Question 15

respiratory epithelium midline cyst in mediastinum or hilar location

Answer 15

bronchogenic congenital foregut cyst

Question 16

squamous mucosa midline cyst

Answer 16

esophageal congenital foregut cyst

Question 17

intestinal mucosa midline cyst

Answer 17

enteric congenital foregut cyst

Question 18

congenital cystic adenomatoid malformation

Answer 18

hamartoma lesion with abnormal bronchiolar tissue

adenomatoid - confined to bronchioles

resp difficulty or recurring infection

type I - large good prognosis
type II - smaller , bad, other congen anomalies

Question 19

bronchopulmonary sequestrations

Answer 19

area of lung not connected to airways

blood supply - systemic arteries

Question 20

extralobar bronchopulmonary sequestrations

Answer 20

no connection to pulmonary circulation or bronchiole tree

Question 21

intralobar bronchopulmonary sequestrations

Answer 21

acquired - recurrent infection

-scarring of bronchi - stenotic

Question 22

true nuchal cord

Answer 22

neck wrapped with umbilical cord

-see compression strangulation marks

Question 23

hyaline membrane disease

Answer 23

neonatal respiratory distress syndrome

deficient surfactant - immature lungs

need to stress baby - more surfactant

• stess = delivery
• also - high insulin inhibits secretion

Question 24

glandular

Answer 24

20 weeks

Question 25

saccular

Answer 25

30 weeks - not good air exchange - no surfactant

Question 26

alveolar

Answer 26

term | -but at birth, lung still not mature

Question 27

measure of surfactant

Answer 27

L/S ration > 2 mature <1 immature gold standard

Question 28

foam stability index

Answer 28

shake to see suds

Question 29

mechanism of hyaline membrane disease

Answer 29

``` no surfactant > atelectasis > hypoxemia > acidosis > endo and epi damage > plasma leak > fibrin and necrotic cells deposited = hyaline ``` occurs after birth**

Question 30

preterm baby, mom DM, C section, low APGAR, become cyanotic, rales, reticulonodular ground glass

Answer 30

respiratory distress syndrome | -O2 therapy needed

Question 31

RDS clinical

Answer 31

artifical surfactant steroids O2 therapy - risks of retinopathy and bronchopulmonary dysplasia

Question 32

bronchopulmonary dysplasia

Answer 32

criteria - 28 days O2 therapy and 36 weeks post menstrual age alveolar hypoplasia and thick walls high O2 - decreases lung maturity arrest at SACCULAR stage

Question 33

mucoviscidosis

Answer 33

cystic fibrosis disorder of epithelial transport mutation in CFTR genes

Question 34

Dx of cystic fibrosis

Answer 34

history in sibling positive newborn screening result and - increased sweat chloride two or more occasions** - two CFTR mutations - abnormal epithelial nasal ion transport

Question 35

delta508

Answer 35

mutations in CF

Question 36

Tx of CF

Answer 36

``` pancreatic insufficiency vit deficiency pulmonary disease antibiotics hypertonic saline high dose ibuprofen ``` heart/lung transplant -cor pulmonale

Question 37

antibiotics in CF

Answer 37

cover pseudomonas aeruginosa

Question 38

ALTE

Answer 38

apparent life threatening event infants who have one are increased risk of future resp failure