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Resp Path Gomez structural Flashcards

1
Q

Bronchopulmonary sequestrations (2)

A

No normal airway connection, no pulmonary circulation,
Extra lobar - outside lung tissue (other cong defect)
Intralobar - Recurrent Inf, Bronchiectasis, acquired

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2
Q

RDS (newborn) (definition, causes, and intrauterine induction) Risk with O2

A

Lack of surfactant. Mom anesthesia, DM, C section, cord wrapped around neck. To induce give move steroids.
Risk - retinopathy with O2 administration

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3
Q

L/S ratio

A

Lecithin/ sphingomyelin ratio, Used to tell maturity of lungs through amniocentesis.
2 both lungs are mature

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4
Q

Bronchopulmonary dysplasia. Time frame, Dx req, factors involved

A

Req 28 days of O2 therapy and age >36 weeks.
Alveolar hypoplasia
Decreased VEGF
Increased TNF, iL-8

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5
Q

Cystic Fibrosis (genes, Signs, Dx, clinical presentation)

A

CFTR Gene absent or missing,
508 heterozygosity (70%)
DX - Sibling w/ CF, ^ sweat Cl on 2 occasions, Nasal Ion transport, ID of mutations.
Immunoreactive trypsinogen-pancreatic protein elevated

Clinically - recurrent infections and salty sweat
Pancreatic insufficiency, Decreased ADK vitamins

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6
Q

Atelectasis - 3 types

A

Compression - Fluid pneumo, Mediastinum away

Resorption - Obstruction, air past obstruction will get absorbed by blood, lung will shrink and mediastinum toward

Contraction - Fibosis/scarring

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7
Q

Acute lung injury (4 criteria)

A

Acute dyspnea, Hypoxemia, Bilateral infiltrates, No Hx of heart failure

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8
Q

Adult ARDS (describe, cells, hemodynamic state, Conditions associated with(4))

A

Alveolar/capillary wall dmg w/ neutrophils. 2º loss of surfactant, (d/t loss of type 2 pneumocyte)
Prothrombotic
Sepsis, Gastric Aspiration, Head injury, diffuse pulmonary infection

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9
Q

Acute interstitial pneumonia

A

Similar presentation to ARDs but no causative disorder identified (basically idiopathic)

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10
Q

Chronic Diffuse Lung Disease (2 types)

A

Obstructive - Low FEV/FVC (COPD, emphysema, bronchiectasis, astham, chronic bronchitis)

Restrictive - normal FEV/FVC (Obesity, ard, fibrosis)

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11
Q

Emphysema (3 of 4 types and associations)

A

Centriacinar/centrilobular (95%) - SMOKING Upper Lobar (bronchi)

Panacinar/Panlobar - SMOKING, Alpha-1 antitryptase deficiency, Lower Lobes (Bronchi to Alveoli)

Distal Acinar - Pneumothorax (alveloi)

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12
Q

Emphysema MOA and inhibitor, Clinical presentation

A

Neutrophils release elastase to degrade tissues in lungs, (inhibited by alpha 1 antitryptase

Clinical - Low FEV/FVC, Barrel chest, Punk Puffers, High TLC

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13
Q

Random increased air conditions

A

Compensatory - Removal of one lung

Obstructive overinflation - Water heater thing

Interstital emphysema - sounds like rice crispies

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14
Q

Chronic Bronchitis (Dx time frame, histological findings, physiological findings, Leads to ?)

A

3 months/year for 2 consecutive years
Hyperplasia of goblet cells, Bronchiectasis, Increased Reid index (Ratio of glands to total thickness >.4 = hyperplasia) , Bronchiolitis obliterans

Leads to cor pulmonal

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15
Q

Asthma (definition, inducers)

A

Partially reversible - bronchiodilaters,
Aggravations - Cold, exercise, allergens
Can lead to fibrosis

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16
Q

Type 1 asthma ( factors to know)

A

Hypersensitivity - IgE, increased TH2, Eosinophils

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17
Q

Drug induced asthma

A

Primarily aspirin, leukotriens can produce bronchoconstriction

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18
Q

Curschmann Spiral

A

Asthma - shed epithelium

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19
Q

Bronchiectasis

A

Permenant dilation, recurrent infections, Cystic fibrosis

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20
Q

Kartageners

A

Cystic fibrosis, situs inversus, ciliary retardation, Male infertility

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21
Q

Categories of chronic interstital lung disease

A

Usual interstital pneumonia, Nonspecific interstital pneumonia, Cryptogenic (unsure of cause), Pneumoconiosis, Sarcoidosis, Eosinophilic pneumonia,

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22
Q

Idiopathic pulmonary fibrosis/ Usual interstital (cells, inhibited factor, Clinical)

A

Hyperplasia of Type 2 - increased mucous, Inhibition of caveolin allows deposition of collagen

Clinical - Digital clubbing (bone enlargement d/t hypoxemia and nonspecific ), honeycomb lung

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23
Q

Nonspecific interstital pneumonia (clinical)

A

SOB and cough for several moths
No honeycombing/fibrosis
Milder than IPF/UIP

24
Q

Cryptogenic Organizing Pneumonia

A

Alveolar disease w/ well circumscribed lesions. No fibrosis

25
Collagen vascular disorder-related insterstital lung disease (caplan syndrome)
Usually Rheumtoid arthritis, When combined with pneumoconiosis is caplan syndrome
26
Coal workers pneumoconiosis (2 types)
Simple - asymptomatic, some nodules Complex - SOB, symptomatic, >2 cm lesions, Can lead to pulmonary massive fibrosis, Pulm HTN, Cor Pulmonale
27
Silicosis(frequency, Increased risk, appearance)
Mos prevalent environemtnal pneumoconiosis in the world, increased incidence of TB, Birefringent in polarization, Carcinogenic
28
Asbestos (associated health problems, buzz words, xray)
Mesothelioma(ampiboles) = asbestos, but lung cancer is more common (laryngeal carcinoma) Fibrous pleural plaques xray - peripheral plaques(meso) by ribs.
29
Sarcoidosis ( xray, histological buzzword, diagnostic test)
Granulomas, anergy to PPD/candida, Increased ACE, Asteroid bodies - inside cell, Schaumann body - calcified body inside macrophage
30
Hypersensitivity pneumonitis (location and types 3)
Alveolar, Farmers - Actinomyces in hay , Brid fancier - serum in feces, Humdfier lung - thermophillic actinomyces
31
Intersitial diseases related to smoking (3)
Desquamative Interstitial pneumonia - Smokers macrophages, steroids and not smoking cures Respiratory bronchiolitis-associated interstital lung disease - Pigmented macrophages in Bronchioles w/ peribronchiolar fibrosis Pulmonary Langerhans Cell Hitiocytosis ** - Eosinophilic granuloma, CD1a associated
32
Pulmonary alveolar proteinosis (clinical presentation + 3 classes
Build up of surfactant - shiny gelatinous phlegm. Autoimmune(90%) Ab to GM-CSF ( defecting phagocytosis of surfactant) Secondary - Rare - pneumocoiosis associated Hereditary - Rare- fatal w/o transplant
33
Pulmonary embolism (location, COD, 2º major effect, types)
Lower lobe, Death d/t arrythmia from strain on R ventricle d/t emboli, acute cor pulmonale Fat, marrow, aminotic fluid, talc (gloves)
34
Primary pulmonary HTN (gene and demographic)
Lack of BMPR2 - smooth muscle hypertrophy | Females 20-40 yrs
35
Goodpasture (ab, Clinical signs)
Ab to collagen 4. Renal failure, ^ creatinine, SOB, Hemoptysis.
36
Idiopathic pulmonary hemosiderosis (demographics, location, tmnt)
Children, deposits in alveolar walls, Immunosupression works
37
Polyangitis w/ Granulomatosis (wegners) (triad, antibody)
Upper resp lesions, Granulomatous vascular lesions, Masses in lungs, problems in kidneys PR3/c-anca
38
Pneumonia Syndromes (community, 4 alveolar w/ associations, Atypical pneumonias (4), Aspiration (4), Immunocompromised (5)
(alveolar) Strept pneumoniae - MOST COMMON increased risk of splenectomy Haemophilus influenza - COPD Staph Aureus - Common post viral pneumonia Pseudomonas aeruginosa - cystic fibrosis ``` Atypical interstitial Myco pneumoniae (cold agglutins) Chlamydia Coxiella burnetti Viruses ``` Aspiration (lead to necrotizing pneumonia/lung abscess) Bacteroides, Fusobacterium, Peptostrept, Prevotella Immunocompro Myco avium-intracellular, Cytomegalovirus, Pneumocystis jirovecii, Aspergillosis, Candidiasis
39
Viral pneumonias
Usually a chest cold but can be fatal
40
Pulmonary abscess (Organisms 4, presentation, Sources)
Staph aureus, Bacteroides, fusobacterium, Peptococcus Present - foul smelling/bloody sputum, non specific, empyema, hemorrhage, brain abscess Sources - Aspiration, septic embolism, neoplasm
41
Respiratory Syncytial Virus (demographic/associated symptoms)
Most common cause of Bronchiolitis/pneumonia in kinds <12 months. Otitis Media associated
42
TB Pneumonia
Chronic, Primary - Ghon Complex (Lymph node and lesion) Secondary - Reactivation of old lesion Milliary - shotgun appearance, vessel invasion
43
Fungal Pneumonias (Species, Size, Location)
Histoplasma capsulatum - smaller than RBC, ohio, michigan, carribean (Dumbbell, granuloma Blastomyces dermatidis - about RBC size, Central/SE US, india, africa, Cocciodes immitis - bigger than RBC, Cali, Mexico, Far West
44
Immunocompromised pneumonies (5)
Pneumocystis Jirovecii, Cytomegalovirus, Myco Avium cellulair, Aspergillus, Candida
45
Indications for lung transplant (4)
Emphysema, Idiopathic pulmonary fibrosis, Cystic fibrosis, Idiopahic/Familial pulmonary HTN
46
Immunocompromised organism Buzz words
Pneumocystis jirovecii -Frothy/Cotton candy exudate, Cup and Saucer cells Cytomegalo virus - Owl eye Candida - spaghetti and meatball Cryptococcus - mucous capsule - will have a surrounding area on mucin stain Aspergillus - 45º hyphae
47
Pulmonary Hamartoma
Same/right tissue in an abberant place, "popcorn calcifications"
48
Pancoast tumor (location and associated syndrome)
Apical lung tumor, Ulnar nerve pain, Horner - Enopthalmos, Ptosis, Miosis, Anhidrosis
49
Paraneoplastic syndromes
PTHrp - Squamous cell carcinoma | ADH, ACTH, Calcitonin
50
Squamous cell Carcinoma (location, associated hormone)
98% of smokers - D/T dmg of epithelium, Central - bronchioles PTHrp - Parathyroid hormone related protein (hypercalcemia)
51
Adenocarcinoma (demographic, location, Gene)
Female non-smokers Peripheral Mucin production TTF1 positive (Thyroid transcription factor 1)
52
Bronchioloalveolar Carcinoma in Situ
Alveolar, aerogenous spread, Non invasive vs Micronvasive which has <5mm spread
53
Large Cell Carcinoma (location/defining characteristic)
Undifferentiated and Central or peripheral
54
Small Cell Carcinoma (location, cell type, hormone/ion)
Central w/ some peripheral growth | Neuroendocrine, ^ADH, ^ Ca
55
Pleural Neoplasms (Most common type, buzz words)
MEtastatic are most common Primary - more rare, MEsothelioma Calretenin, Mesothelin, WT-1
56
Mesothelioma (appearance & histological)
Can look like adenocarcinoma Thick band encasing lungs Long packed microvili

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