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Respiratory II > Misc lung diseases > Flashcards

Misc lung diseases Flashcards

1
Q

2 classification of hemodynamic causes of pulmonary edema

A

Increased hydrostatic pressure
Decreased oncotic pressure
Lymphatic obstruction

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2
Q

Causes of increased hydrostatic pressure leading to pulmonary edema

A

LHF
Volume overload
Pulmonary vein obstruction

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3
Q

Causes of decreased oncotic pressure leading to pulmonary edema

A

Hypoalbuminemia
Nephrotic syndrome
Liver disease
Protein-losing enteropathies

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4
Q

Direct alveolar wall injury causes leading to pulmonary edema

A

Infections
Inhaled gasses
Liquid aspiration
Radiation
Lung trauma

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5
Q

Indirect alveolar wall injury causes leading to pulmonary edema

A

Systemic inflammatory response
Blood transfusion related
Drugs and chemicals

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6
Q

Abrupt onset of hypoxemia and bilateral pulmonary infiltrates in the absence of cardiac failure

A

Acute lung injury and ARDS

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7
Q

Most important causes of ARDS

A

Sepsis
Diffuse pulmonary infections
Gastric aspiration
Mechanical trauma, including head injuries

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8
Q

Diagnostic criteria for mild ARDS

A

PaO2/FIO2 between 200-300 mmHg

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9
Q

Diagnostic criteria for moderate ARDS

A

PaO2/FIO2 between 100-200 mmHg

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10
Q

Diagnostic criteria for severe ARDS

A

PaO2/FIO2 </= 100 mmHg

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11
Q

Microscopy findings in proliferative phase of ARDS

A

Proliferation of type II pneumocytes and granulation tissue formation

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12
Q

Microscopy shows alveolar wall lined by waxy hyaline membranes. There is fibrin rich edema fluid mixed with cytoplasmic and lipid remnants of necrotic epithelial cells.

A

ARDS - exudative phase

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13
Q

Complications of ARDS

A

Sepsis, multiorgan failure, and death
Interstitial fibrosis and restrictive lung disease

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14
Q

Disease characterized by a layer of hyaline proteinaceous material deposited in the peripheral airspaces of neonates

A

Neonatal respiratory distress syndrome (NRDS)

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15
Q

Risk factors for NRDS

A

Preterm
Male
Maternal DM
C section

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16
Q

Reason that maternal DM is a risk factor for NRDS

A

Treatment with insulin –> insulin inhibits surfactant synthesis

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17
Q

These cells produce surfactant

A

Type II alveolar cells/pneumocytes

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18
Q

When is production of surfactant accelerated during gestation?

A

After wk 35

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19
Q

CXR findings in NRDS

A

Reticulogranular densities

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20
Q

Medication given to mother to induce fetal lung maturation

A

Corticosteroid

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21
Q

Useful marker of fetal lung maturity

A

Amniotic fluid phospholipid levels

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22
Q

When is prophylactic administration of exogenous surfactant given at birth?

A

Neonate <28 wks

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23
Q

Complications associated with high concentration of ventilatory administered oxygen in neonates

A

ROP
Bronchopulmonary dysplasia
Emphysema and pneumothorax

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24
Q

Growth factor associated with ROP

A

VEGF

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25
Q

Decrease in alveolar septation and a dysmorphic capillary configuration, a complication associated with NRDS

A

Bronchopulmonary dysplasia

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26
Q

Infants who recover from NRDS are at an increased risk for what?

A

PDA
Intraventricular hemorrhage
Necrotizing enterocolitis

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27
Q

Conditions predisposing to HAPE at altitudes below 2500 m

A

Increased pulmonary blood flow
Pulmonary HTN
Increased pulmonary vascular reactivity

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28
Q

Causes of central sleep apnea

A

Stroke
Neuromuscular disease
Narcotics

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29
Q

ABG findings in sleep apnea

A

Increased bicarbonate

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30
Q

Complications associated with sleep apnea

A

Systemic and/or pulmonary HTN
Arrhythmias
Increased risk of cardiovascular disease
Mild polycythemia
Sudden death

31
Q

Characteristic of Pickwickian syndrome that separates it from OSA

A

Diurnal hypercapnia

32
Q

Atelectasis that occurs due to airway obstruction

A

Resorption/obstructive

33
Q

Causes of obstructive atelectasis

A

Mucus plugs
Aspiration of foreign bodies
Tumor fragments
Mediastinum shifts toward affected lung

34
Q

Atelectasis that occurs from fluid, tumor, or air accumulation within the pleural cavity

A

Compression

35
Q

Which way will the mediastinum shift in compression atelectasis?

A

Away from affected lung

36
Q

Atelectasis type that occurs from focal or general pulmonary or pleural fibrosis prevents full lung expansion

A

Contraction

37
Q

Atelectasis type that occurs in neonates with respiratory distress syndrome

A

Patchy or micro

38
Q

Only non-reversible type of atelectasis

A

Contraction

39
Q

Common cause of pleural effusion caused by increased hydrostatic pressure

A

CHF

40
Q

Common cause of pleural effusion caused by increased vascular permeability

A

Pneumonia

41
Q

Common cause of pleural effusion caused by decreased osmotic pressure

A

Nephrotic syndrome

42
Q

Common cause of pleural effusion caused by increased intrapleural negative pressure

A

Atelectasis

43
Q

Causes of hemothorax

A

Chest injury
Ruptured aortic aneurysm

44
Q

Causes of transudate hydrothorax

A

Liver failure
Cardiac failure
Renal failure

45
Q

Causes of exudate hydrothorax

A

Tumor
Infection
Inflammation

46
Q

Causes of chylothorax

A

Neoplastic obstruction of thoracic lymphatics

47
Q

Tracheal deviation in pleural effusion

A

Away from affected lung

48
Q

Physical exam findings in pleural effusion

A

Dullness to percussion
Decreased breath sounds
Decreased tactile fremitus

49
Q

Light’s criteria

A

Pleural fluid protein/serum protein > 0.5

Pleural LDH/serum LDH >0.6

Pleural fluid LDH greater than 2/3 the upper limit of serum LDH

50
Q

Elevated RBC count in pleural effusion exudate is indicative of what origin?

A

Traumatic or malignant

51
Q

Elevated WBC count in pleural effusion exudate is indicative of what origin?

A

Empyema

52
Q

Elevated eosinophil count in pleural effusion exudate is indicative of what origin?

A

Collagen vascular disease
Pleural air
Blood

53
Q

If pleural effusion exudate pH is <7.2 what is indicated about its origin?

A

Malignancy
RA
Infection

54
Q

If amylase is elevated in pleural effusion exudate what is indicated about its origin?

A

Esophageal rupture
Acute pancreatitis

55
Q

In what type of pleural effusion is triglyceride levels elevated?

A

Chylothorax

56
Q

Treatment required for pneumothorax

A

Needle thoracostomy to relieve pressure

57
Q

Hyperresonance on percussion with decreased breath sounds and decreased tactile fremitus

A

Pneumothorax

58
Q

Focal protrusion of edematous, inflamed nasal mucosa

A

Nasal polyp

59
Q

Microscopy shows edematous finger-like masses lined by epithelium with fibrovascular core, and edema and eosinophil rich inflammatory infiltrate

A

Nasal polyp

60
Q

Benign, highly vascularized tumor of the posterolateral wall of the roof of the nasal cavity. Seen exclusively in fair, red-headed, adolescent males.

A

Nasopharyngeal angiofibroma

61
Q

Microscopy findings in nasopharyngeal angiofibroma

A

Slit-like vascular structures in collagenous stroma

62
Q

Malignant tumor of nasopharyngeal epithelium associated with EBV and diets rich in nitrosamines

A

Nasopharyngeal carcinoma

63
Q

Demographic associated with nasopharyngeal carcinoma

A

African children
Chinese adults

64
Q

Standard treatment for nasopharyngeal carcinoma

A

Radiotherapy

65
Q

Occupational risk factor for nasopharyngeal carcinoma

A

Wood dust exposure

66
Q

3 microscopic patterns of nasopharyngeal caricnoma

A

Keratinizing SCC
Non-keratinizing SCC
Undifferentiated/basaloid carcinoma

67
Q

Microscopic features of reactive nodules of the larynx

A

Loose myxoid tissue covered by squamous epithelium

68
Q

Squamous benign neoplasms located on the true vocal cords associated with HPV 6 and HPV 11

A

Squamous papilloma and papillomatosis

69
Q

Microscopy of larynx lesion shows multiple finger-like projections supported by central fibrovascular cores and covered by stratified squamous epithlium

A

Squamous papilloma and papillomatosis

70
Q

Soft, raspberry-like proliferations on the true vocal cords

A

Squamous papilloma and papillomatosis

71
Q

Risk factors for carcinoma of the larynx

A

Smoking
Alcohol
Asbestos
Irradiation
HPV

72
Q

Large, ulcerated, fungating lesion involving the vocal cord and pyriform sinus, commonly in men in their 60s

A

Carcinoma of the larynx

73
Q
A

Respiratory II (17 decks)

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