Pulm Flashcards by Brooke Prince

cavity (with thick wall)

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emphysema

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25 y/o with bronchiectasis must be worked up for what disease?

most cases present early childhood/neonatal, but some can present later in life

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55 y/o F presents w/ pleuritic chest pain which she describes as sharp, intermittent, and positional. Shortness of breath with exertion

bronchoscopy 3 days ago

faint wheeze in left lung; distant sounds in left apex

likely diagnosis?

Pneumothorax (iatrogenic)

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ABPA

allergic bronchopulmonary aspergillosis

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Acute phase of DAD is marked by what steps?

death of type I cells, no protection –> influx of neutrophils, cytokines, fluid –> inflammation and edema

formation of hyaline membrane from necrotic cells and fibrin

cell death

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Aerosilized dornase-alpha (recomibinant human DNase) is used to treat what?

Cystic fibrosis

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alpha 1- antitrypsin deficiency

panacinar emphysema

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bronchiectasis

very high serum IgE levels

eosinophilia in blood

= ?

ABPA

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Bronchopulmonary dysplasia

aka: neonatal chronic lung disease

results from effects of oxygen and mechanical ventilation in newborns with RDS

infants with birth weight <1250 grams = 97% of cases

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Cause of ARDS

infections resulting in sepsis

trauma, surgery, drugs, etc.

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Causes of exudative effusion

abnormality/injury to pleura increased hydraulic conductance or decreased osmotic pressure connective tissue diseases pulmonary embolism tuberculosis malignancy parapneumonic effusion or empyema

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causes of pulmonary edema

hemodynamic- CHF

alveolar injury

idiopathic- high altitude sickness

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Causes of transudative effusion

CHF cirrhosis renal failure increased mean hydrostatic pressure or decreased plasma protein osmotic pressure

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Charcot Leyden Crystal

marker for?

Asthma

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Common infectious pathogens causing Acute Bronchiolitis

mycoplasma

RSV

influenza

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COPD- physical findings

barrel chest

increased tympany to percussion

retraction of chest wall at base (hoober’s sign)

pursed-lipped breathing

cyanosis

prolonged expiratory phase

rhonchi

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COPD- Clubbing or no?

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CT- diagnosis?

Normal

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DAD caused by what?

radiation

huge pneumocytes

hyaline membranes

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Definition of Chronic Bronchitis

presence of cough and sputum production for at least 3 months of 2 consecutive years

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Diagnosis of CF

clinical symptoms, sibling with CF, abnormal newborn screen AND evidence of CFTR dysfunction

requires 2 abnormal sweat tests (>60) to make diagnosis

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Diagnosis?

bronchiectasis

– inflammatory destruction of wall

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Diagnosis?

paraseptal emphysema

blebs under the pleura and around septae

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diagnosis?

traction bronchioectasis abnormalities are secondary to parenchymal fibrosis

Difference between DAD and ARDS

DAD (diffuse alveolar damage) is a pathologic term and ARDS is a clinical term

disease?

pulmonary edema

Emphysema seen in smokers

centriacinar (centrilobular) emphysema

fiindings? diagnosis?

hyperinflation flattened diaphragm == COPD

focus on patient's left lung

emphysema lots of open air space

focus on white blob

mucoid impaction + dilated airways = bronchiectasis

Hyaline membrane formation occurs in what phase?

acute phase

LAMA

long acting muscarinic antagonist (i.e. anticholinergic) ex: tiotropium, aclidinium bromide, umeclidinium bromide

LDH (pleural fluid/serum ratio) = 0.6

exudative effusion (

lesion

cysts

likely taken from a patient with what disease?

asthma

location of hyaline membrane

alveolar space

Metastatic disease to pleura- treatment

systemic chemo chest drainage (w/ tube) pleurodesis via chemicals or mechanical long term indweilling pleural catheter

Most common pathogens for CF patients

staph aureus-- kids pseudomonas-- adults

Mucus sample what cells do you see? what can cause this?

eosinophils asthma attack

mutation in F508

Cystic fibrosis most common mutation

name of opacity cause?

tree in bud acute bronchiolitis

name of cells? disease causing them?

hemosiderin laden macrophages--\> CHF RBCs leak out of capillaries slowly and macrophages digest them can cause hemodynamic pulmonary edema

Parapneumonic effusion

pleural effusion that occurs along with infectious pneumonia effusion can be sterile (due to irritation) or infected with bacteria (empyema)

Pathogenesis of bronchiectasis

permenant dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue of the bronchus typically results from chronic inflammation

patient presenting with productive cough (about 1 cup of sputum per day) PMH of pulmonary infections in childhood ronchi, wheezing, and bronchial breath sounds are heard on exam possible diagnosis?

bronchiectasis

Patient's lung removed prior to transplant history of smoking and dyspnea Diagnosis?

Emphysema

pattern seen here? diagnosis?

"finger in glove" mucoid impaction--\> severe bronchiectasis secondary to ABPA

Physical findings of Pleural Effusion

decreased expansion of ipsilateral hemithorax decreased or absent fremitus on ipsilateral side dull or flat percussion decreased breath sounds pleural rub (occasional) contralateral tracheal or mediastinal shift

Physiology of Tension Pneumothorax and Causes

air under pressure within the pleural space displaces mediastinal structures and compromises cardiopulmonary function. results from any lung parenchymal or bronchial injury that acts as a one-way valve and allows free air to move into an intact pleural space but prevents the free exit of that air

Pleurodesis

fusion of the visceral and parietal pleura

sign seen here? diagnosis?

signet ring sign bronchiectasis

signet ring sign

bronchiectasis

situs inversus bronchiectasis sinusitis

Primary ciliary dyskinesia | (cilia is poorly functioning)

Subpleural blebs lined focally by mesothelial cells

paraseptal emphysema

Clinical manifestations of tension pneumothorax

Respiratory distress, chest pain, tachycardia , ipsilateral air entry , deviation of mediastinal structures to contralateral side, compromised cardiopulmonary function, hypotension, death

Therapy that reduces mortality in COPD

oxygen smoking cessation

thick basement membrane; smooth muscle hypertrophy = diagnosis?