Pathology of the lung I Flashcards Preview

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Flashcards in Pathology of the lung I Deck (42)
1

definition: atelectesis

incomplete expansion of lungs or collapse of previously inflated lung substance, usually reversible

2

definition: resorptive atelectasis

excessive secretions, mediastinal shift toward atelectic lung

3

what is the cause of resorptive atelectesis?

complete airway obstruction

4

definition: compression atelectesis

excessive air, fluid, blood, or tumor in pleural space, mediastinum shifts away from affected lung

5

definition: patchy atelectesis

loss of surfactant, RDS, postsurgical

6

definition: contraction atelectesis

fibrosis around lung

7

what are the four types of atelectesis?

resorption
compression
patchy
contraction

8

what are the primary causes of pulmonary congestion and edema?

hemodynamic disturbances (hydrodynamic or cardiogenic pulmonary edema)

edema caused by microvascular injury (direct increases in capillary permeability due to microvascular injury)

9

what is the most common cause of hemodynamic pulmonary edema?

increased hydrostatic pressure

10

what is the mechanism of edema caused by microvascular injury?

injury to capillaries of alveolar septa

11

COPD usually refers to what conditions?

COPD
chronic bronchitis

12

what are the spirometry value changes seen in obstructive disease?

decreased FEV1
normal (or increased) TLC and FVC
decreased FEV1 / FVC

13

what are the spirometry value changes seen in restrictive disease?

decreased TLC
decreased FVC
FEV1 / FVC normal

14

smoking stimulates the release of what significant compound from neutrophils in the lung? why is it significant?

elastase

macrophage elastase is NOT inhibited by a1AT

15

what are the four types of emphysema?

centriacinar
panacinar
paraseptal
irregular

16

centriacinar emphysema is mostly caused by what condition?

chronic bronchitis

17

what is affected most in centriacinar emphysema?

respiratory bronchioles

18

where is the greatest severity in centriacinar emphysema?

apical segments of upper lobes

19

panacinar emphysema is associated mostly with what condition?

a1AT deficiency

20

where is the greatest severity in panacinar emphysema?

basilar

21

paraseptal emphysema

enlargement with destruction of distal portion of acinus, usually worse in upper zones

22

where is the greatest severity in paraseptal emphysema?

adjacent to pleura, septae, lobule margins, scarring, fibrosis, atelectesis

23

paraseptal emphysema is associated with what condition?

spontaneous pneumothorax

24

what is bullous emphysema?

subpleural emphysematous spaces more than 1-2 cm in diameter

25

what are the features of death in emphysema?

respiratory acidosis and coma
right sided heart failure
massive collapse of lungs secondary to pneumothorax

26

what are the treatment options for emphysema?

bronchodilators
steroids
lung volume reduction surgery
lung transplantation

27

blue bloaters

chronic bronchitis

28

pink puffer

emphysema

29

cor pulmonale typically occurs more in patients with chronic bronchitis or emphysema?

chronic bronchitis

30

what are the features of chronic bronchitis microscopically?

1. hypertrophy of submucosal glands of trachea and bronchi (Reid index)
2. goblet cell metaplasia

31

what are the bacterial etiologies of chronic bronchitis?

H. influenza
Strep pneumo

32

what are the viral etiologies of chronic bronchitis?

adenovirus
respiratory syncitial virus

33

what is the status of elastic recoil in bronchitis? emphysema?

bronchitis - normal
emphysema - low

34

initial sensitization for type I hypersensitivity asthma is due to what cell type?

CD4+ cells of Th2 type

35

TH2 cells release what cytokines in response to type I hypersensitivity asthma?

IL4, IL-5

36

what are curschmann spirals?

whorls of shed epithelium

37

what are charcot-leyden crystals?

crystalloids made of eosinophilic proteins

38

definition: bronchiectasis

what is the cause?

permanent dilation of bronchi and bronchioles

caused by destruction of muscle and elastic supporting tissue, resulting from or associated chronic necrotizing infections - IRREVERSIBLE

39

what two conditions are required for bronchiestasis?

obstruction and chronic persistent infection

40

what are the general associations for bronchiestasis?

obstructive
congenital or hereditary conditions
necrotizing (suppurative) pneumonia

41

what is the hereditary pattern of kartegener syndrome?

AR

42

what is the mechanism of kartagener syndrome?

structural defect in cilia, decreased motility and loss of radial spokes and dynein arms