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Flashcards in Pulmonology - Diseases Deck (11):

Obstructive Sleep Apnea

Repeated cessation of breathing overnight lasting > 10 seconds; causes disrupted sleep pattern and daytime somnolence, also associated with systemic/pulmonary hypertension, cardiac arrhythmias, and sudden death

Findings: Elevated RBC/Hct due to increased erythropoiesis secondary to nocturnal hypoxia

Treatment: Weight loss, CPAP, surgery


Neonatal Respiratory Distress Syndrome

Commonly seen in premature infants born at <35 weeks gestation; characterized by deficient surfactant production by immature Type II pneumocytes causing increased alveolar surface tension and collapse (atelectasis)

Presents with tachypnea, dyspnea, and cyanosis shortly after birth

X-ray shows diffuse, bilateral consolidation

Treated with maternal glucocorticoids before birth, artificial surfactant for the neonate



Malignancy of the pleura, associated with asbestosis; commonly seen in ship-yard workers and plumbers

Presents with hemorrhagic pleural effusion, shortness of breath, chest pain

Findings: Ferruginous bodies - asbestosis fibers coated in hemosiderin; Psammoma bodies


Legionnaire's Disease

Caused by gram negative rod Legionella pneumophila

Diagnosis: Organism grows on charcoal yeast extract + Cystine + iron; gram stains poorly but visualized with silver stain

Transmitted from aerosolized water from environmental sources (air conditioning, hot water heaters, etc.); no person-to-person transmission

Presents as severe pneumonia, fever, GI symptoms (diarrhea), and CNS symptoms

Treated with Macrolide or Fluoroquinolone


Pontiac Fever

Mild, flu-like illness caused by Legionella pneumophila



Air in the pleural space

Presents as unilateral chest pain, dyspnea, chest expansion, decreased tactile fremitus, hyperresonance, diminished breath sounds

May see deviation of trachea/mediastinum away from the affected lung in tension pneumothorax


Panacinar Emphysema

Associated with alpha-1 antitrypsin deficiency; uninhibited elastase activity in the lungs destroys elastin in alveolar walls leading to decreased DLCO, increased compliance, and decreased recoil

Presents as "pink puffer" phenotype (barrel-chested, exhalation through pursed lips); also associated with liver cirrhosis with PAS+ globules


Centriacinar Emphysema

Associated with smoking; destruction of alveolar walls leads to decreased DLCO, increased compliance, and decreased recoil

Presents as "pink puffer" phenotype (barrel-chested, exhalation through pursed lips)



Associated with shipbuilding, roofing, and plumbing; associated with increased incidence of bronchogenic carcinoma and mesothelioma

Histology shows hemosiderin-laden "ferruginous bodies"


Chronic Bronchitis

Defined as productive cough > 3 months/year (not necessarily continuous) for > 2 years; caused by hyperplasia of mucus-secreting glands

Presents with wheezing, crackles, cyanosis, hypercapnia, secondary polycythemia

Findings: Reid index > 50%


Pancoast Syndrome

Caused by a tumor in the apex of the lung, where it compresses the superior cervical sympathetic ganglion

Presents as Horner syndrome (ptosis, miosis, anhidrosis of the ipsilateral face) + shoulder pain