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Flashcards in Pulmonology - Diseases Deck (11):
1

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

2

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

3

Mesothelioma

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

4

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

5

Pontiac Fever

Mild, flu-like illness caused by Legionella pneumophila

6

Pneumothorax

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

7

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

8

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)

9

Asbestosis

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

Histology shows hemosiderin-laden "ferruginous bodies"

10

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%

11

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