Respiratory 1

Question 1

Atelectasis is collapse of lung due to

Answer 1

compression of the lung when fluid or air accumulates in the pleural cavity

Question 2

pulmonary hypertension results in

Answer 2

increased work and right heart failure (cor pulmonale)

Question 3

pulmonary emboli may arise where…and pass where….

Answer 3

may arise in deep leg veins and pass in the venous circulation to heart/pulmonary arteries

Question 4

What occurs in clinical settings marked by venous stasis?

Answer 4

pulmonary emboli

Question 5

Liver cirrhosis with portal hypertension will result in …

Answer 5

pulmonary thromboemboli

Question 6

pulmonary emboli are rarely due to non-thrombotic material

Answer 6

1 cancer-embolization of clumps of tumor cells
2 fractures-fat, bone marrow emboli
3 childbirth-amniotic fluid embolism
4 foreign material-bullet materials

Question 7

What is pneumonia’s pathological method of spread?

Answer 7

1 Air space spread (usually bacterial)

OR

2 interstitial spread (usually viral)

Question 8

pneumonia clinical classification

Answer 8

1 community-acquired
2 hospital acquired (nosocomial)
3 acquired in special environments
4 immunosupressed patients
5 aspiration pneumonia

Question 9

bronchopneumonia

Answer 9

acute bacterial pneumonia centered on bronchi that spreads to adjacent alveoli

Question 10

If broncopneumonia is healed, what happens?

Answer 10

fibrosis

Question 11

lobar pneumonia

Answer 11

microorganisms colonize distal alveolar air spaces rather than bronchi

Question 12

What does the lobe of Lobar pneumonia look like?

Answer 12

lobe is consolidated and airless

Question 13

histopathology of lobar pneumonia

Answer 13

alveoli filled with acute inflammatory exudate which is limited by pulmonary fissures

Question 14

Can you recover from lobar pneumonia?

Answer 14

**many recover with return to normal structure and function

Question 15

What gram positive bacteria is 33% of community acquired pneumonia?

Answer 15

Streptococcus pneumoniae

Question 16

How do we diagnose hospital acquired pneumonia?

Answer 16

bronchial lavage with contaminated expectorated sputum of the oropharynx

Question 17

when does hospital-acquired pneumonia occur?

Answer 17

• 2 days + after hospitalization

- incidence is 5% of those admitted

Question 18

What is the most lethal form of viral pneumonia?

Answer 18

influenza, viral interstitial pneumonitis

Question 19

Fungal Pneumonia

Answer 19

typically in immunosuppressed

Question 20

Opportunistic infections in the immunosupressed with pneumonia

Answer 20

**candida, asperigillus, pneumocystis jirovecii (alveoli filled with fine, foam like material; fungus)

Question 21

How does lobar pneumonia spread?

Answer 21

spreads through alveoli to involve whole lobes

Question 22

most hospital acquired cases of pneumonia is due to what kind of organisms?

Answer 22

gram negative organisms

Question 23

Bronchiectasis

Answer 23

Permanent abnormal dilation of bronchial tree due to chronic infection with inflammation and necrosis of bronchial wall

Question 24

Asthma extrinsic type (immune, atopic)

Answer 24

1 mediated by type I hypersensitivity response involving IgE bound to mast cells
2 begins in childhood, usually in families with history of allergy

Question 25

Emphysema

Answer 25

clinically increased anteriorposterior diameter of the chest (barrel-chest) increased total vital capacity

Question 26

What has an imbalance between proteases and protease inhibitors?

Answer 26

Emphysema 1 smoking- increases release of proteases (ex elastase) from neutrophils and macrophages; inactivates alpha-antitrypsin 2 congenital-lack of protease inhibitors

Question 27

Chronic bronchitis

Answer 27

airway obstruction due to luminal narrowing and mucous plugging

Question 28

What two diseases cause airway narrowing?

Answer 28

chronic bronchitis and asthma

Question 29

chronic obstructive airway diseases summary part 2

Answer 29

1 emphysema caused by unregulated extracellular protease (secreted from inflammatory cells) activity -two patterns of generalized emphysema: centrilobular and panacinar 2 in chronic bronchitis, airways show mucus hypersecretion with gland hyperplasia -may patients with chronic bronchitis have an asthmatic component, as well as emphysema 3 pulmonary hypertension and right sided heart failure are common in long standing obstructive pulmonary disease (COPD)

Question 30

portal hypertension

Answer 30

increase in the blood pressure within the portal venous system

Question 31

bronchoalveolar lavage

Answer 31

bronchoscope is passed through the mouth or nose into the lungs and fluid is squirted into a small part of the lung and then collected for examination

Question 32

pulmonary embolism

Answer 32

obstruction of a blood vessel in the lungs, usually due to a blood clot, which blocks a coronary artery.

Question 33

polycythemia

Answer 33

disease state in which the proportion of blood volume that is occupied by red blood cells increases

Question 34

forms of influenza

Answer 34

rhinitis, pharyngitis, tracheobronchitis, interstitial pneumonitis

Question 35

**Most lethal form of viral pneumonia

Answer 35

Influenza, viral Interstitial pneumonitis

Question 36

What is hypoxemia?

Answer 36

abnormally low level of oxygen in the blood

Question 37

hypercapnia

Answer 37

elevated carbon dioxide (CO2) levels in the blood

Question 38

pulmonary hypertension

Answer 38

increased pulmonary arterial pressure leads to structural changes

Question 39

venous stasis and pulmonary emboli

Answer 39

primary venous disease, congestive heart failure, prolonged bed rest or immobilization, prolonged sitting while traveling

Question 40

What causes pulmonary edema?

Answer 40

left ventricular failure

Question 41

What does pulmonary hypertension cause?

Answer 41

right-sided heart failure

Question 42

Pulmonary thromboembolism is most commonly from

Answer 42

deep leg vein thrombosis

Question 43

What may large pulmonary emboli cause?

Answer 43

acute right heart failure and death

Question 44

What is known as airspace pneumonia?

Answer 44

lobar pneumonia

Question 45

In what condition is the affected lung firm, airless, dark red or gray?

Answer 45

Bronchopneumonia

Question 46

In what condition may the pus be in peripheral bronchi?

Answer 46

Bronchopneumonia

Question 47

What are variable causative organisms of bronchopneumonia?

Answer 47

staph. aureus, Haemophilus, Klebsiella, strep. pyogenes

Question 48

What occurs when microorganisms widely colonize distal alveolar air spaces rather than bronchi ?

Answer 48

lobar pneumonia

Question 49

What pneumonia usually occurs in alcoholics and adults?

Answer 49

lobar pneumonia

Question 50

Lobar Pneumonia

Answer 50

rapid spread through alveolar spaces and bronchioles causes acute inflammatory exudate into air spaces especially with Strep. pneumoniae (pneumococcus) or Klebsiella

Question 51

What develops from the spread of a tracheobronchial infection?

Answer 51

Bronchopneumonia

Question 52

What does atypical pneumonia cause?

Answer 52

predominantly interstitial inflammation

Question 53

different organisms cause community acquired types of pneumonia

Answer 53

most common is due to strep. pneumoniae

Question 54

What exposure of pneumonia is associated with Legionnaire disease and fungal pneumonias?

Answer 54

specific environmental exposure

Question 55

Aspiration pneumonia results in both

Answer 55

chemical and mixed infective damage to lungs

Question 56

What has opportunistic mycobacteria, viruses, fungi, and protozoa in the immunosupressed?

Answer 56

Pneumonia

Question 57

What causes loss of recoil in the lungs?

Answer 57

emphysema

Question 58

What is characterized by a chronic inflammatory response in airways, leading to reversible airways obstruction?

Answer 58

asthma

Question 59

What do muscle spasms, mucous plugging and mucosal edema cause?

Answer 59

airway obstruction

Question 60

What is is permanent dilation of the respiratory acinus, with destruction of tissue in the absence of scarring?

Answer 60

Generalized edema

Question 61

3 consequences of hypoxemia

Answer 61

pulmonary hypertension, polycythemia, hypercapnia

Question 62

What are the common organisms in lobar pneumonia?

Answer 62

strep pneumoniae and klebsiella