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Flashcards in Lungs Deck (111):
1

contrast atopic vs. non-atopic

  • in non-atopic:
    • DON'T see increased IgE,
    • no family history
    • DO see Curschmann spirals, Charcot-Layden crystals and neutrophils

2

describe complications of the condition shown in the image

  • complications:
    • empyema
    • bronchopleural fistula
    • septicemia (meningitis, brain abscess)
    • AA amyloidosis → restrictive cardiomyopathy 

3

describe the image 

sarcoidosis

4

describe the paraneoplastic syndromes associated with the condition seen in the image

  • SIAD (dilutional hyponaterima): leads to cerebral edema and papilledema
  • gonadotropins
  • Cushing syndrome: buffalo hump, purple striae, moon face d/t bilateral adrenal hyperplasia
  • gastrin releasing peptide: stimulates G cells to secrete acid and hyper-motility of GI
  • antibodies to pre-synaptic Ca2+ channels = Lambert-Eaton syndrome 

5

describe the etiology of the condition seen in the image

  • etiology: smoking, radon and asbestos
    • smoking + asbestos = highest risk
    • men > women
    • gene mutations = RB, P16, p53

6

describe the presentation of the cardiogenic form of the disease shown in the image

  • presentation:
    • decreased diffusing capacity, hypoxemia, and shortness of breath
    • increased pulmonary capillary wedge pressure
    • NO hyaline membrane
    • at 2 weeks, hemosiderin layden macrophages/heart failure cells

7

describe the etiology of the disease seen in the image

  • etiology: obligate intracellular bacteria → "walking pneumonia"
    • most common = Mycoplasma pneumoniae (younger people → military recruits/students)
    • chlamydia & Coxiella burnetti (from sheep → farmers/vets)
    • viruses = CMV/influenza

8

describe complications of the disease seen in the image

  • complications:
    • multi-organ problems
    • pulm. failure
    • cor pulmonale
    • contraction atelectasis
    • hypercalcemia → kidney stones

9

describe the image

10

describe the minor form of the condition seen in the image

  • minor = small vessels → asymptomatic
    • if there are a series of recurring minor embolisms → marginate on the walls of the pulm. artery → flow encounters increased resistance → pulm. HTN → RHF WITHOUT LHF 

11

describe the presentation of the disease in the image

  • presentation:
    • dry cough with dyspnea (crackles on inspiration)
    • finger clubbing
    • pulm. fibrosis
    • geographic heterogeneity = favors lower lobe first
    • temporal heterogeneity = coexisting of old type I collagen and new fibrosis
    • cobblestone pleural surface → honeycomb lung (pockets of airspaces (cystic spaces) contain mucus and lined by type II pneumocytes)
    • x-ray: bilateral reticulo-nodular shadows mainly lower lobes w/honeycomb lungs

12

describe why metastatic calcification is seen in the disease shown in the image

  • epithelioid cells activate vit. D via 1-alpha hydroxylase activity → hypercalcemia → metastatic calcification

13

describe the histology of the condition seen in the image

  • keratin pearls = well differentiated in fxn
  • intercellular bridges
  • individual cell keratinization

14

describe investigations for atopic asthma

  • investigations:
    • sputum cytology = Curschmann spirals (shredding of bronchial epithelial cells + mucus) & Charcot-Layden crystals (MBP & eosinophilic cationic protein)
    • x-ray: hyperinflated lung fields
    • flow meter: decreased peak flow rate
    • blood CBC: lots of eosinophils (eosinophilia)
    • pulm. function tests: decreased FEV1: FVC ratio and increased TLC and RV

15

describe the pathogenesis of the disease seen in the image

  • pathogenesis:
    • alveolar spaces are free/empty, inflammation in alveolar wall (thickened septae) → cough is DRY
      • leukocytes + mononuclear cells (NO PMNs bc no cell death)

16

describe the pathogenesis of the disease seen in the image

  • pathogenesis:
    • bilateral fibrosis of interstitium → severe hypoxia

17

describe the image

18

describe the cell of origin for the condition seen in the image

  • cell of origin = Kulchitsky (neuroendocrine cells)
    • 99% associated with cigarette smoking

19

describe NSIPF

20

describe the pathogenesis for small cell carcinoma

  • myc amplification (most common)
  • p53
  • pRB
  • 3p deletion

21

who does the disease in the image mainly effect?

males over 60; smokers

22

describe what condition is seen in the image

atelectasis 

  • lung collapse → decreased O2 → shortness of breath

23

describe the panacinar form of the disease shown in the image

  • panacinar: entire acinus from respiratory bronchioles to the alveolar ducts; lower lobes
    • deficiency of A1AT - PiZZ homozygous recessive on ch. 14 (misfolded protein)
    • A1AT accumulates in the ER

24

describe how the disease shown in the image occurs in young, immunocompetent patients

  • lobar = young immunocompetent
    • streptococcus pneumoniae (95%)
    • COMPLETE RESOLUTION
    • speads via pores of Kohn
      • architecture stays intact
      • confluent consolidation of entire lobe
      • bronchi are NOT involved

25

name indirect causes of the disease shown in the image

  • indirect causes:
    • acute pancreatitis (enzymes causing damage to lung)
    • uremia
    • sepsis
    • burns

26

the patient can die from ____ in the condition seen in the image

patient dies from  respiratory failure due to overproduction of mucin

27

describe the concept of contraction

  • contraction = IRREVERSIBLE due to pulm. fibrosis
    • trachea in either direction or central bc both lungs are affected
    • caused by all restrictive lung diseases which lead to fibrosis (irreversible)
    • FEV1:FVC ration is normal but decreased TLC and RV

28

describe the pathogenesis of the disease seen in the image

29

describe what would be seen on biopsy of the condition seen in the image

  • biopsy = malignant glands invading stroma
    • produce lots of mucin → well differentiated in fxn
    • positive for cytokeratin & PAS (diastase resistant bc no glycogen)
    • prominent nucleus & nucleolus and dispersed chromatin

30

describe complications of the disease seen in the image

  • complications:
    • resp. failure early
    • cor pulmonale early
    • cirrhosis/nutmeg liver
    • resorption atelectasis
    • recurrent pneumonia → lung abscess → bronchiectasis 

31

describe what the condition in the image is composed of

  • composed of:
    • hyaline cartilage
    • fat cells
    • smooth muscle
    • resp. epi.

32

describe the presentation of the disease shown in the image

  • presentation: 
    • skinny (compensating and using accessory muscles)
    • barrel-chested (bc obstructive lung disease)
    • pursed lip breathing
      • "pink puffers" = prolonged expiration through pursed lips → compensating early to prevent cyanosis and hypoxia
    • minimal sputum

33

describe a massive form of the condition seen in the image

  • massive: large saddle embolus straddles the bifurcation of the pulm. artery; caused by DVT
    • sudden obstruction of 60% of pulm. vasculature 
    • sudden death & no time to develop infarction, lungs not affected → look normal
      • death due to electromechanical dissociation
    • example: hospitalized patients who get out of bed 1st time dies immediately

34

describe the image seen

asthma

  • top photo: 
    • yellow arrow = eosinophils
    • blue arrow = smooth muscle hypertrophy
    • green arrow = goblet cell hyperplasia
    • black arrow = thickened BM
  • bottom photo:
    • Curschmann spirals in a patient with bronchial asthma (shredded bronchial epithelial cells found in sputum)

35

describe the immunohistochemical stain for the condition seen in the image

immunohistochemical stains: TTF-1, cytokeratin 7, napsin-A

36

describe what is seen in the image

37

describe what is seen in the image

38

describe the pathogenesis of the disease seen in the image

  • pathogenesis:
    • type IV hypersensitivity with non-caseating granuloma w/ lymphanetic distribution
    • incidental finding of bilateral hilar lymphadenopathy
      • eventually leads to honeycomb lung w/ pulm. fibrosis
    • Schaumann body (laminated Ca2+ concretions due to metastatic calcification)
    • Asteroid bodies = proteinaceous inclusions in giant cells

39

describe the major form of the condition seen in the image

  • major = multiple medium vessels; presents with dyspnea, pleuritic chest pain & hemoptysis, tachypnea, tachycardia and V/Q mismatch
    • if bronchial arteries are intact → only hemorrhage, no infarction/necrosis
    • if bronchial arteries are compromised OR cardiac failure → red infarct (10% bc of collateral circulation)
      • usually in lower lobes

40

describe the image

41

describe what is seen in the image

42

describe the prognosis of the condition seen in the image

  • worst prognosis since already metastasized
  • cannot be resected → need chemotherapy/radiotherapy

43

describe the irregular form of the disease seen in the image

  • irregular (paracictratrical):
    • only one with fibrosis and contraction atelectasis
    • usually asymptomatic 

44

describe the presentation of the disease seen in the image

  • presentation:
    • high spike fevers
    • halitosis
    • productive cough with foul-smelling sputum
    • finger clubbing (due to hypoxia)
    • hemoptysis

45

describe the pathogenesis of the disease seen in the image

  • pathogenesis:
    • bronchus: squamous metaplasia, goblet cell hyperplasia and goblet metaplasia into bronchioles
    • thickened BM
    • hypertrophy of bronchial smooth muscle
    • hypertrophy/hyperplasia of seromucinous glands
  • Reid index (ratio of thickness of submucosal gland:overall bronchial wall) is elevated >50% (normal = 40%)

46

describe the pathogenesis of atopic bronchial asthma

  • atopic: extrinsic; genetic/family history
  • pathogenesis:
    • type 1 hypersensitivity 
      • 1st exposure = antigen presentation, class switch to IgE
      • 2nd exposure = cross-linking on surface of mast cell → mast cell degranulation → histamine & leukotrienes → edema/exudate/neutrophils/bronchoconstriction (early phase)
      • IL-5 → chemotactic for eosinophils → MBP → damages cells and causes bronchoconstriction (late phase reaction, 4-24 hours)

47

describe complications of the disease seen in the image

  • complications:
    • resp. failure
    • pulm. fibrosis
    • contraction atelectasis
    • cor pulmonale
    • nutmeg liver (chronic passive congestion)

48

describe the complications associated with the condition seen in the image

  • complications:
    • centrally located = blocks bronchial lumen and no cilia → resorptive atelectasis
    • mucous trapped → recurrent bronchopneumonia → lung abscess → bronchiectasis
    • bilateral hilar lymphadenopathy
    • SVC syndrome
      • edema of face and upper extremities, DJV, cyanosis
    • hoarseness → left recurrent laryngeal n.

49

what is the most common origin and risk factor for the condition seen in the image?

  • most common origin = deep leg veins (femoral, popliteal, iliac)
  • most common risk factor = stasis
  • most often clinically silent

50

describe the presentation of atopic asthma

  • expiratory wheeze, chest tightness, productive cough, SOB, histamine → edema
    • NO hypertension

51

name complications of neonatal atelectasis

  • intraventricular hemorrhage
  • PDA (persistent hypoxemia)
  • necrotizing enterocolitis (intestinal ischemia)
    • bloody diarrhea
  • hypoglycemia (excessive insulin release)
  • O2 therapy → increased ROS formation, can lead to:
    • damage to lungs (bronchopulmonary dysplasia)
    • cataracts/retinal damage (blindness) 

52

describe investigations for the disease seen in the image

  • investigations:
    • sputum cytology = mixed flora of anaerobes (make it foul smelling) & aerobes
    • high res CT = train track appearance because there is dilatation all the way to pleural surface

53

describe the triad seen in all forms of the disease in the image

  • triad:
    • iron def. anemia (d/t blood loss)
    • cough with hemoptysis
    • pulm. infiltrates on x-ray

54

describe Wegener's granulomatosis (aka granulomatosis with polyangiitis, GPA)

  • URT symptoms = naso-mucosal ulceration, sinusitis
  • LRT = necrotizing pneumonia, granulomatous vasculitis that does NOT spare the lung → lung abscess
  • affects kidneys → renal infarcts and affects glomeruli capillaries (glomerular nephritis → crescent shape) → hematuria

55

describe how the condition in the image occurs

  • aspiration, complicated pneumonia, obstruction, septic emboli
    • predisposing factors: alcoholics, stroke patients (decreased gag reflex), intubated, seizure, Alzheimer's or any hospital bedridden patients
    • aspiration = more common on RIGHT side
      • standing = bottom of right lung
      • laying down = top of right lung

56

describe the pathogenesis of the disease seen in the image

57

describe the histology of the condition seen in the image

  • histology:
    • round, scant cytoplasm, finely granular chromatin
    • frequent mitotic bodies
    • cytology shows nuclear molding (NOT in bronchial carcinoid)

58

describe complications seen in the condition in the image

  • cervical sympathetic syndrome 
    • ipsilateral Horner syndrome (ptosis, anhydrosis, miosis = PAM)
    • wasting of thenar eminence b/c of brachial plexus compression
    • recurrent laryngeal nerve paralysis & dysphagia (compressed esophagus)
    • SVC syndrome = triad: cyanosis, DJV, edema of face and arms

59

describe the secondary cause of the condition seen in the image

  • secondary: endothelial dysfunction due to underlying disorder → loss of vasodilators (NO) or increase in vasoconstrictors (endothelin, serotonin)
    • pulmonary: obstructive and restrictive lung diseases (except bronchial asthma), recurrent minor pulm. embolism
      • high altitude
    • cardiac: L → R shunt (ASD, VSD, PDA), mitral stenosis
      • loud P2: pulmonary valve makes a sound when it closes

60

describe complications of the disease seen in the image

  • complications:
    • respiratory failure and cor pulmonale (R heart failure secondary to pulm. hypertension)
      • after 2 weeks → liver cirrhosis/nutmeg liver 
      • Pores of Kohn are easier to be spread by → lobar pneumonia is worse if acquired

61

in testing for the condition seen in the image, ____ will be elevated

in testing for the condition seen in the image, pulmonary capillary wedge pressures will be elevated (cardiac catheterization measures pressures of heart)

62

describe the paraneoplastic syndrome associated with the condition seen in the image

PTH-related peptide → hypercalcemia → can result in metastatic calcification

63

describe who the disease shown in the image mainly affects

  • AAs, Danish, Swedish; higher incidence in non-smokers and young females (AA female)

64

describe the presentation of the condition seen in the image

  • presentation:
    • dyspnea
    • cachexia (bc of TNF alpha)
    • finger clubbing
    • hemoptysis

65

describe the etiology (cardiogenic) of the disease shown in the image

  • etiology (of cardiogenic pulm. edema)
    • LHF 

66

describe the presentation of the condition seen in the image

  • presentation:
    • productive cough (foul-smelling sputum)
    • halitosis
    • hemoptysis
    • finger clubbing
    • high spiking fever
    • weight loss
  • x-ray: cavity with air-fluid level (liquefactive necrosis due to pyogenic bacteria)
  • sputum: mixed flora

67

describe the diagnosis of the disease seen in the image

  • diagnosis:
    • sudden onset
    • ground glass appearance on XR
    • bilateral diffusion interstitial infiltrates
    • pulm. edema with NORMAL pulm. capillary wedge pressure (not a heart problem, increased wedge pressure seen in heart problems)
    • refractory hypoxemia (even w/ supplemental O2, cyanosis continues due to hyaline membranes → diffusion barrier)

68

describe the image

diffuse pulmonary hemorrhagic syndrome

69

describe the centroacinar form of the disease shown in the image

  • centroacinar: respiratory bronchioles & upper lobes
    • have to be a smoker b/c normal levels of A1AT but elastase overwhelms the A1AT

70

describe the organizing (proliferative) phase of the disease seen in the image

  • organizing (proliferative) phase = 4 days - 3 weeks
    • proliferation of type II pneumocytes & fibroblasts which lay down collagen → organization of fibrin exudates → fibrosis & alveolar septal thickening
      • chronic inflammation = pulm. fibrosis → contraction atelectasis
      • cor pulmonale = R heart failure secondary to lung disease

71

describe the etiology of non-atopic asthma

  • non-atopic: intrinsic; aspirin and viral infxns
    • aspirin: inhibits COX and favors lipooxygenase → increased LTs → bronchoconstriction + bronchospasms
      • aspirin triad = nasal polyps, intrinsic asthma, rhinitis, hives
    • viral: lowers threshold for sub-epithelial vagal receptors to irritants → increased ACh binding → increased PS response → bronchoconstriction

72

name 2 other findings in the disease shown in the image

  • polyclonal hypergammaglobulinemia = dysregulation of T cells
  • cutaneous anergy = develop sarcoidosis following TB, use all T cells and epithelioid cells to form non-caseating granulomas → no cells to mount response to PPD →become PPD (-) (even w/ TB)

73

describe the pathogenesis of the condition seen in the image

  • pathogenesis: pseudostratified → stratified squamous
    • precursor lesion = squamous dysplasia
    • squamous metaplasia → dysplasia → sq. cell carcinoma in situ → invasive sq. cell carcinoma

74

describe the images 

75

name direct causes of the disease shown in the image

  • direct causes:
    • pulmonary contusion (bruises) due to blunt force trauma to chest
    • near-drowning experiences
    • aspiration pneumonia 

76

describe the pathogenesis and location of the condition seen in the image

  • cell of origin = bronchioalveolar stem cell/Clara cell
  • precursor lesion = atypical adenomatous hyperplasia 
  • located peripherally = coin lesion on x-ray

77

describe the investigations and complications of the disease seen in the image

  • investigations:
    • NO dullness on percussion → bc alveolar spaces are empty
    • x-ray = interstitial infiltrates; ground glass opacity
    • serology = IgM, IgG titers = most accurate
  • complications:
    • ARDS → hyaline membranes on autopsy 

78

describe Goodpasture's disease

  • pulmonary-renal disorder typically in young men; type II HS
    • proliferative and rapidly progressive glomerulonephritis
    • hemorrhagic interstitial pneumonia
    • antibodies attacking glomerular & pulmonary BM (α3 chain of type IV collagen)
    • triad seen but also affects kidney → glomerular nephritis → hematuria
    • NEVER see URT → no nasal ulceration or sinusitis

79

describe the concept of resorption 

80

describe the symptoms seen in the disease shown in the image

  • sudden onset SOB, tachypnea, tachycardia, cyanosis → resp. acidosis (high CO2)

81

describe the disease shown in the image

permanent destruction & dilatation of airways distal to terminal bronchioles without fibrosis (exception: irregular type) 

82

describe the presentation of the disease seen in the image

  • presentation: 
    • mild symptoms in the beginning (dry cough and low grade fever), DAD → hyaline membrane

83

describe the presentation of the condition seen in the image

  • presentation: fatigue, syncope, dyspnea upon exertion, chest pain
    • severe resp. insufficiency, cyanosis, death from RHF 2-5 years from diagnosis
    • long standing/chronic severe → plexiform lesions = vasculature channels within the intima → multiple lumina within a small artery at a branch point from a larger artery 
    • smaller capillaries can't take extreme pressure & undergo fibrinoid necrosis, dilations and hemorrhage
      • sign of chronic pulm. HT

84

describe the causes of the disease seen in the image

  • cause:
    • #1 is CF
    • Kartegeners syndrome (sinusitis, bronchiectasis, infertility in males, situs inversus/dextrocardia)
    • chronic bronchitis (mucus plugs)
    • allergic bronchopulmonary aspergillosis
    • TB
    • centrally located tumors

85

describe the presentation of the disease seen in the image

  • presentation:
    • blue bloaters bc mucus plugs trap CO2, increase paCO2 and decrease paO2
      • cor pulmonale → ascites and peripheral edema
    • decreased FEV1:FVC ratio and increased TLC and RV
    • x-ray: see pneumonia bc no cilia and resorption atelectasis bc of mucus plugs blocking the bronchial lumen
    • ABG: hypoxia, hypercapnia, resp. acidosis
      • peripheral chemoreceptors detect low O2 but no increased PCO2 → can't give O2 bc pts stop breathing

86

describe status asthmaticus

common in extrinsic/non-atopic asthma

  • do not respond to medications
  • severe and unresponsive to therapy
  • severe mucus plugs → resportive atelectasis
  • require intubation

87

describe complications of the disease seen in the image

  • complications:
    • can lead to resp. failure, cor pulmonale
    • decreased FEV1:FVC, increased TLC and RV
    • metastatic abscesses
    • sepsis if travels to blood
    • resorption atelectasis due to obstruction of bronchial lumen
    • AA amyloidosis due to chronic inflam. condition

88

describe the acute phase of the disease seen in the image

  • acute phase (exudative phase) = 0-4 days
    • neutrophils, necrotic debris, fibrin
    • heavy and firm lungs, interstitial and intra-alveolar edema/hemorrhage, necrosis and sloughing of alveolar epithelial cells
    • see hyaline membrane → made up of debris and fibrin → diffusion barrier

89

describe the paraneoplastic syndromes associated with the condition seen in the image

  • paraneoplastic syndrome = hematological → all due to MUCIN
    • Trousseau's = thrombus in superficial vein → vein is red, hot, swollen, painful → recurrent and migratory
    • sterile vegetations on heart valves = nonbacterial endocarditis = Marantic endocarditis
      • aortic valve → aortic regurg. → diastolic murmur → pulm. edema

90

describe the presentation of the condition seen in the image

  • presents like lobar pneumonia
    • productive cough with a lot of sputum
    • SOB, pleuritic chest pain
    • NO coin lesion
    • consolidation of the lobe on x-ray

91

describe the disease shown in the image

92

describe the presentation of the condition seen in the image

  • presentation:
    • dyspnea
    • cachexia (b/c of TNF alpha)
    • finger clubbing (all lung cancers)

93

describe the immunohistochemical stain for the condition seen in the image

neuroendocrine markers = synaptophysin, chromogranin, CD56

94

describe the cell of origin and markers for staining for the condition seen in the image

  • cell of origin = Kulchitsky (neuroendocrine) cells
  • same neuroendocrine markers as small cell = synaptophysin, chromogranin, CD56

95

describe how the disease shown in the image can occur in sick, immunocompromised, elderly patients

  • bronchopneumonia: patchy lung; bronchi and bronchioles are damaged
    • Klebsiella → alcoholics, diabetics → aspiration
      • red currant jelly sputum
    • Pseduomonas → CF, ventilators, burns, lung abscesses
    • Klebiella and Pseudomonas both cause necrotizing pneumonia bc they are angio-invasive → endothelial damage
    • S. aureus following viral infxn (influenza)
    • Legionella → contaminated water sources (ACs)

96

what hormone is used to monitor treatment of the disease shown in the image?

ACE is elevated in sarcoidosis → used to monitor response to treatment

97

describe the complications of the cardiogenic form of the disease shown in the image

  • complication:
    • can lead to pulm. HT → heart failure cells
    • will NOT lead to cor pulmonale bc cardiac problem CAME FIRST

98

describe the pattern of growth of the condition seen in the image

there is a  lepidic pattern on biopsy (butterfly on fence)

99

describe carcinoid syndrome

  • carcinoid syndrome = episodic flushing, wheezing, diarrhea due to increased serotonin
    • look for 5-HIAA in urine

100

describe the pathogenesis of the cardiogenic form of the disease shown in the image

  • pathogenesis:
    • <2 weeks = transudate due to increased hydrostatic pressure
    • 2 weeks = alveolar wall fibrosis, heart failure cells

101

describe the septal/distal acinar form of the disease seen in the image

  • septal (distal acinar):
    • rupture into pleural space → bullae & pneumothorax → compression atelectasis

102

describe other causes of the condition seen in the image

  • other causes of lung abscess: vasculitis
    • lymphomatoid granulomatosis: associated with EBV and necrotizing granulomas
    • Wegener's granulomatosis → aspergilloma
    • Churg Strauss

103

name the cell of origin and precursor lesion of the condition seen in the image

cell of origin = bronchoalveolar stem cells (Clara cells)

precursor lesion = atypical adenomatous hyperplasia

104

describe the primary causes of the condition seen in the image

  • primary = mutation in BMPR2 
    • BMPR2 normally binds to TGFB and inhibits smooth muscle proliferation
    • mutation causes hyperplasia of smooth muscle and increased vascular resistance
    • common in young females 20-40

105

describe complications of the condition seen in the image

  • complications:
    • location makes it easy to cause pleural effusions → compression atelectasis
    • left side → pericardial effusion → pericardial tamponade (hypotension, DJV, distant heart sounds = Beck's triad)

106

describe the concept of compression

  • compression = reversible
    • pneumothorax, hemothorax, pneumohemothorax, chylothorax (lymph), empyema (pus), pleural effusion
    • X-ray: trachea deviates to OPPOSITE SIDE 

107

describe diagnosis of the disease seen in the image

  • diagnosis:
    • decreased FEV1:FVC ratio, increased TLC and RV
    • ABG: decreased O2, normal pH and normal CO2
      • later stages = pH drops and CO2 increases while O2 decreases
    • x-ray: hyperlucent (air trapping), hyperinflated lungs with flattened domes of diaphragm and narrow mediastinum
      • increased AP diameter (barrel)

108

describe the genetic mutations seen in the condition in the image

  • etiology:
    • KRAS = smokers
    • EGFR = women, non-smokers, Asians
    • ALK = signet adenocarcinoma in non-smokers

109

describe the etiology of the non-cardiogenic form of the disease shown in the image

  • non-cardiogenic pulmonary edema etiology:
    • ARDS, high altitude, neurogenic, pulm. thromboembolism

110

describe the complications of the condition seen in the image

  • complications: RHF → nutmeg liver
    • HEAD: hepatosplenomegaly, peripheral edema, ascites, distended jugular vein

111

describe the disease seen in the image and its etiology

productive cough of foul-smelling, purulent sputum for 3 consecutive months for 2 consecutive years 

  • etiology: cigarrette smoking, 40-45 years old