Overview Of Lung Disease (6)-Leah*

Question 1

Four ways to classify pulmonary diseases

Answer 1

according to etiology, histology, PFT, and symptoms/ CXR

Question 2

7 pulmonary disease classifications based on etiology

I think this doesn’t need to be fully memorized, just read it a time or two

Answer 2

1. immune (i.e. vasculitis)
2. infectious
3. genetic
4. neoplasm
5. exposure (ie silica)
6. pneumothorax
7. venous thromboembolus

Question 3

5 general histo patterns of lung disease

Answer 3

1. interstitial inflammation
2. “airway disease”
3. vasculitis
4. focal
5. granulomatous

For all of the above remember that there is overlap

Question 4

Coccidiomycosis is assc with what state?

Answer 4

Arizona; can cause fungal pneumonia

Question 5

1 cause of cough

Answer 5

viral infection of the respiratory tract; post infectious

Question 6

Cough with sputum: upper or lower respiratory tract?

Answer 6

with sputum- think lower, although this is NOT correct in EVERY case

Question 7

Non-pulmonary causes of dyspnea (4)

Answer 7

cardiac problems
anemia
neuromuscular disorders
metabolic disturbances/ electrolyte disturbances

Question 8

1 cause of hemoptysis

Answer 8

bronchitis

Question 9

General causes of hempotysis (5)

Answer 9

• bronchitis
• malignancy
• bleeding disorder
• vascular disorder (end stage and associated with RF)
• TB

Question 10

If a person has massive/ frank hemoptysis, what would you see clinically? (2)

Answer 10

• hypoxia

- CXR infiltrates

Question 11

Chest pain is generally NOT caused by what?

Two pulmonary causes of chest pain that are gradual? Two pulmonary causes of sudden chest pain?

Answer 11

• -chronic lung disease does NOT = chest pain.
• • infectious process or neoplasm = gradual chest pain
• -PE and pneumothorax = sudden chest pain

Question 12

Rhonchi:

whats the sound, whats the cause?

Answer 12

• lower pitched “musical noises”.
• obstruction, usually with mucus secretions.
• May be seen in acute CHF (which can cause transudate in the airways)

Question 13

Wheezing:
whats the sound, whats the cause?
example?

Answer 13

• higher pitched noises
• obstruction, usually with swelling
  i. e. asthma

Question 14

What are crackles/ rales? 
Common assc (3)?

Answer 14

suggest fluid in the lung parenchyma– compresses/ pops the alveoli
-clasically assc with CHF, chronic pulm edema, infection

Question 15

When might you get fine/ dry crackles?

Answer 15

when there is scarring (severe interstitial disease)

describes as “velcrow”

Question 16

How do effusion and consolidation effect resonance?

Answer 16

^^ fluid- HYPOresonance

because sound travels better through GAS than solids/liquids.

Question 17

How do pneumothorax and emphysema effect resonance?

Answer 17

^^ air- HYPERresonance

Question 18

When is a pneumothorax life threatening?

What do you do?

Answer 18

“Tension” pneumothoraxes are life threatening; cause rapid cardiopulmonary failure.

• air ENTERS chest but cannot exit through lung or some outside wound= compression of organs.
• Needs chest tube, stat

Question 19

What is ruptured in a pneumothorax (PTX)?

Answer 19

visceral pleura

Question 20

What are some causes of PTX? (3)

Answer 20

1. spontaneous esp in COPD/ tall people
2. trauma
3. iatrogenic

Question 21

What is a pleural effusion?

What causes it? (3)

Answer 21

fluid under the lung/ in the pleural space

caused by any inflammatory process, esp tumor, infection, heart failure

Question 22

Pulmonary nodules- #1 cause; 3 others

Answer 22

#1- benign from environmental allergens 
also early malignancy, CT disease, infection

Question 23

Three tumors that may met to the lung?

Answer 23

testicular, thyroid, kidney

Remember that colon cancer will go to the liver first; this is intuitive if you think about the anatomy and portal circulation

Question 24

Most common pulmonary pathology of all….

Answer 24

viral illnesses

Question 25

``` HE WILL ASK THIS A LOT: Give a quick one word assc for each of these sounds: 1. rales 2. fine/ dry crackles 3. rhonchi 4. wheezing ```

Answer 25

rales/ wet crackles- edema fine/ dry crackles- interstitial rhonchi- secretions wheezing- swelling **MENTIONED 3 FRICKIN' TIMES**

Question 26

What is the word for wheezing heard in the upper airway?

Answer 26

stridor! this is what you would call snoring.

Question 27

common viral infection in smokers

Answer 27

rhinovirus

Question 28

URI vs LRI: which is most likely to be bacterial?

Answer 28

LRI more commonly bacterial; URI mostly viral

Question 29

Influenza infection predisposes the lung to what other pathogen?

Answer 29

strep pneumo bacterial pneumonia

Question 30

What three pathogens can act as super antigens? | What do super antigens incite?

Answer 30

staph aureus, strep pnuemo, influenza= super antigens | super antigens= sepsis

Question 31

"crackles at the base of the lung" | What is this a classic description of?

Answer 31

CHF

Question 32

"Hyporesonance and pain at the base of lung" | What is this a classic description of?

Answer 32

Pleural effusion **"I WILL PROBABLY GIVE YOU A QUESTION LIKE THIS." - Meadows

Question 33

What would you see on CXR in the case of a pneumothorax?

Answer 33

black area without lung lines

Question 34

What would a PFT show in the case of a pleural effusion?

Answer 34

-would present like a restrictive disease; | normal FEV1:FVC, low TLC/ DLOC

Question 35

What percentage of RA patients have lung involvement?

Answer 35

nearly half.

Question 36

What do acute and chronic heart failure sound like in the lung?

Answer 36

Acute: fluid transudate--> ronchi Chronic: WET CRACKLES at lung base

Question 37

Three causes of finger clubbing?

Answer 37

Congenital heart disease, pulm. fibrosis, lung cancer

Question 38

What does it mean if you see an ^ AP diameter on PE?

Answer 38

chronic hyperinflation (COPD, emphysema)

Question 39

How long would a cough due to RT irritation typically last in an asthmatic or a smoker?

Answer 39

3-8 weeks; will be self limited and you can differentiate this from interstitial disease based on hx *note that when patients say they feel like they need to cough up mucus in this case it is actually just infammation in the airway*

Question 40

Phrenic nerve paralysis: how does this present? | What is a common cause?

Answer 40

Common on lt side after CABG You will hear HYPOresonace on percussion exam because you are hitting the liver and the paralyzed diaphragm does not allow lung to expand and fill w air ...

Question 41

#1 cause of lung cancer ww?

Answer 41

biomass smoke-- i.e. wood burning stove; think women in honduras