Lung Pathology II

Question 1

atelectasis

Answer 1

collapsed lung

risk for infection

Question 2

resorption atelectasis

Answer 2

airway obstruction with mediastinal shift toward involved lung

pressure drops distal to obstruction

Question 3

compression atelectasis

Answer 3

something outside of lung in thoracic cavity

mediastinal shift away from involved lung

Question 4

contraction atelectasis

Answer 4

secondary to fibrosis of lung or pleura

irreversible

Question 5

hemodynamic pulmonary edema

Answer 5

left sided heart failure
-increased hydrostatic pressure

basal lower lobes

heart failure cells
brown induration of lung

Question 6

microvascular pulmonary edema

Answer 6

increased permeability

• due to infection, toxic
• if diffuse - leads to ARDS

Question 7

brown induration

Answer 7

hemodynamic pulmonary edema

Question 8

edema of undetermined origin

Answer 8

high altitude

CNS trauma

Question 9

acute lung injury

Answer 9

non-cardiac pulmonary edema

Question 10

criteria for acute lung injury

Answer 10

• acute onset of dyspnea
• hypoxemia
• b/l infiltrates
• absence of left side HF

may lead to ARDS

Question 11

diffuse alveolar damage

Answer 11

adult acute respiratory distress syndrome

pt with severe disease

diffuse damage to alveolar cap walls
> lead to neutrophil migration

secondary loss of surfactant

ex/ formaline

Question 12

50% of cases of acute RDS

Answer 12

sepsis
diffuse pulmonary infection
gastric aspiration
mechanical trauma

Question 13

sick patient with rapid onset dyspnea and tachypnea, cyanosis, resp failure, diffuse bilateral infiltrates on xray

Answer 13

acute respiratory distress syndrome

Question 14

acute interstitial pneumonia

Answer 14

like ARDS but no associated causative disorder

59yo
acute resp failure following illness of < 3 weeks resembling infection

mortality dead within 2 months

aka hamman-rich syndrome

Question 15

obstructive disease

Answer 15

FEV1/FVC reduced < 0.7

due to resistance increase

emphysema
chronic bronchitis
bronchiectasis
asthma

Question 16

restrictive disease

Answer 16

limited total lung capacity and residual volume

FEV1/FVC near normal

chest wall disorders
obesity
ARDS
interstitial fibrosis
pneumoconioses

Question 17

chronic bronchoitis

Answer 17

mucus gland hyperplasia and secretion

cough and sputum production

obstructive

Question 18

emphysema

Answer 18

acinus airway enlargement

tobacco smoke

dyspnea

Question 19

bronchiolitis

Answer 19

small airway disease - scarring and inflammation

cough dyspnea

Question 20

centriacinar emphysema

Answer 20

SMOKING

predominantly upper lobes

majority**

affects respiratory bronchioles

Question 21

panacinar emphysema

Answer 21

alpha1 antitrypsin, smoking

lower lobes, anterior

affect alveolus and alveolar ducts

Question 22

alpha-1 anti-trypsin

Answer 22

inhibits neutrophil elastase

deficient pt - early emphysema - due to proteolytic digestion of alveolar walls

Question 23

barrel chest, dyspnea, cough, wheezing, low FEV1, high TLC and RV

Answer 23

emphysema

formation of bullae

Question 24

pink puffers

Answer 24

forward leaning and pursed lips

emphysema

Question 25

compensatory hyperinflammation

Answer 25

occurs because of loss of adjacent tissue

Question 26

obstructive overinflammation

Answer 26

overexpansion of trapped air object forming one way valve

Question 27

interstitial emphysema

Answer 27

air in emphysema increased air in soft tissues after trauma - rip in lung

Question 28

chronic bronchitis

Answer 28

3 months of productive cough/year for 2 consecutive years hypersecretion of mucus increased reid index can lead to bronchiolitis obliterans

Question 29

red index

Answer 29

ratio of submucosal glands thickness of gland / thickness of wall >0.4 - hyperplasia increased in chronic bronchitis

Question 30

blue bloaters

Answer 30

chronic bronchitis - gas exchange impaired - cyanosis - hypercapnia - hypoxemia co pulmonale

Question 31

asthma

Answer 31

episodic partially reversible bronchoconstriction nighttime, early morning causes - allergens, exercise, cold, etc.

Question 32

status asthmaticus

Answer 32

acute severe asthma

Question 33

type I hypersensitivity

Answer 33

IgE Abs to allergens Th2 resonse with increased IgE and eosinophils mast cell release histamine stimulation of vagal - bronchoconstriction PS

Question 34

RAST testing

Answer 34

for allergens | -high false positives

Question 35

non-atopic asthma

Answer 35

pulmonary infection and air pollutant no eosino or IgE infection lowers threshold for vagal responses

Question 36

drug induced asthma

Answer 36

aspirin - classic cause | -inhibit COX pathway - favored leukotriene production - favor bronchoconstriction

Question 37

asthma morphology

Answer 37

``` epithelial injury fibrosis eosinos hypertrophy/plasia of glands smooth m hypertrophy/plasia increased vascularity ```

Question 38

curschmann spiral

Answer 38

strips of dead epithelium in asthma -as well as charcot leyden crystals (eosino-rich)

Question 39

bronchiectasis

Answer 39

permanent dilation of bronchi and bronchioles secondary to infection foul smelling sputum also CF and kartagener and aspergillosis