Respiratory Flashcards
(163 cards)
1
Q
What is the most common cause of rhinitis?
A
Rhinovirus
2
Q
What is a common cause of a nasal polyps in children? In adults?
A
children = Cystic fibrosis
adults = aspirin intolerant asthma
3
Q
What is the triad of Aspirin-Resistant Asthma?
A
asthma
aspirin induced bronchospasm
nasal polyps
4
Q
What is an angiofibroma? What is an angiofibroma composed of?
A
benign tumor of nasal mucosa
blood vessels and fibrous tissue
5
Q
What patient population is angiofibroma often seen?
A
adolescent males
6
Q
What virus is associated with nasopharyngeal carcinoma? Which lymph nodes does the commonly involve?
A
EBV
cervical
7
Q
Nasopharyngal carcinoma is classically seen in what two populations?
A
African children
Chinese adults
8
Q
What are the two histological characteristics of Nasopharyngeal Carcinoma seen on biopsy?
A
pleomorphic keratin positive epithelial cells
background of lymphocytes
9
Q
What is the most common cause of epiglottitis? Immunized, nonimmunized or both?
A
H. influenzae Type B
both
10
Q
What virus causes Croup?
A
Parainfluenzae
11
Q
What material composes a vocal cord nodule? Unilateral or bilateral? Why?
A
myxoid
bilateral
excessive use
12
Q
Which HPV isotypes would be found in Laryngeal Papilloma? How does this appear in adults? Children?
A
6 and 11
adults = single
children = multiple
13
Q
Where does a Laryngeal Carcinoma usually arise from? Arise from laryngeal papilloma?
A
epithelial tissue of vocal cord
no
14
Q
Which two bacteria make up the majority of Lobar Pneumonia? Which one is the stark majority?
A
Strep. pneumoniae (majority)
Klebsiella pneumoniae
15
Q
Which three bacterial Genus are most likely to cause Aspiration pneumonia?
A
Bacteroides
Fusobacterium
Peptococcus
16
Q
What is Secondary Pneumoniae? Which bug is most likely to cause Secondary Pneumonia?
A
bacterial pneumonia superimposed on viral pneumonia
S. Pneumoniae
17
Q
What is the most common mechanism by which Klebsiella pneumoniae can establish an infection in the lungs?
A
Aspiration
18
Q
Which patient population is most likely to be affected by Klebsiella pneumoniae?
A
alcoholics/elderly/debilitated
19
Q
What bacteria is the 2nd most common cause of Secondary Pneumonia?
A
S. aureus
20
Q
Patients with COPD are most likely to get pneumonia from what two bugs?
A
Haemophilus influenzae
Moraxella catarrhalis
21
Q
What bug causes pneumonia in CFTR patients?
A
P. aeruginosa
22
Q
Legionella pneumophilia requires what to infect people?
A
a water source
23
Q
Which pneumonia causing bug can be visualized with a silver stain?
A
Legionella pneumophilia
24
Q
What bug is the most common cause of atypical pneumonia? In what two patient populations?
A
Mycoplasma pneumonia
military recruits or college students
25
What bug is the second most common cause of atypical pneumonia in young adults?
Chlamydia pneumoniae
26
Which virus is most common to cause viral pneumonia is a post-transplant patient?
CMV
27
Where are the two sources for coxiella?
ticks or cattle placenta
28
In what two patient populations does Coxiella cause pneumonia?
farmers or veterinarians
29
Which lobe does aspiration pneumonia most often effect?
lower right
30
Where is the specific part of the brain where TB accumulates?
base of brain in meninges
31
Where in the lung does secondary TB most often effect?
apex
32
What are four sites of common TB systemic spread?
Meninges
cervical lymph nodes
kidney
lumbar spine
33
What hypertrophies during Chronic Bronchitis?
bronchial mucinous glands
34
What type of emphysema does smoking lead to? What lobe?
Centri-acinar
upper
35
What type of emphysema does α1AT deficiency lead to? What part of the lung?
panacinar
lower lobe
36
What is the normal α1AT allele? What is the mutant α1AT allele?
normal = PiMM
mutant = PiZZ
37
What three ILs do TH2 cytokines release during asthma?
IL4/IL5/IL10
38
What is the function of IL-4?
class type switch to IgE
39
What is the function of IL-5?
recruit eosinophils
40
What is the function of IL-10?
inhibit TH1 response
41
Does the first exposure or re-exposure to antigens result in degranulation of mast cells? What is the first cytokine released?
second exposure
histamine
42
Which leukotrienes are released during an asthma attack?
C4/D4/E4
43
Which protein mediates most of the damage/inflammation during asthma? What cell releases this protein?
major basic protein
eosinophils
44
What is bronchiectasis?
permanent dilation of bronchioles and bronchi
45
What causes Bronchiectasis?
Necrotizing Inflammation
46
What type of specific lung pathology is caused by Cystic Fibrosis?
bronchiectasis
47
What type of lung pathology is caused by Kartagener Syndrome?
bronchiectasis
48
What protein is defective during Kartagener Syndrome?
dynein arm
49
What is dynein important for?
motion of cilia
50
What are the three physical manifestations of Kartagener Syndrome?
sinusitis
infertility
situs inversus
51
What type of lung pathology can be created by Aspergillus? In what two patient groups?
Bronchiectasis
CF and asthmatics
52
Why can bronchiectasis produce amyloidosis?
chronic inflammation
53
What cytokine mediates the progression of pulmonary fibrosis?
TGF-β
54
What is pneumoconioses? What cell mediates this?
inhaled particles are engulfed by alveolar marophages and induce release of cytokines which mediate fibrosis
macrophages
55
Is sarcoidosis a caseating or non-caseating granuloma?
non-caseating
56
What is the race of the classic person to present with sarcoidosis?
african american, female
57
Would sarcoidosis be a restrictive or obstructive disease?
restrictive
58
What is the characteristic histological finding seen during Sarcoidosis?
asteroid body
59
What are the two classical lab findings during sarcoidosis?
elevated ACE
hypercalcemia
60
What is the Tx for sarcoidosis?
steroids
61
Coal Workers Lung is associated with what other disease?
Rheumatoid Arthritis
62
Does silicosis generally effect the upper lobe or lower lobe of the lung?
upper
63
What disease does silicosis carry an increased risk for developing? Why?
TB
silica impairs phagolysosome formation
64
Workers from what industry can present with berylliosis? What type of granuloma?
aerospace
beryllium = non-caseating granuloma
65
What disease does berylliosis mimmic?
Sarcoidosis
66
Does asbestos cause lung carcinoma or mesothelioma more often?
lung carcinoma
67
Asbestos Bodies contain what?
Iron
68
Primary Pulmonary HTN is clasically seen in what patient population?
young adult females
69
What gene can be implicated during Primary Pulmonary HTN? What is the result?
BMPR2
proliferation of smooth muscle
70
What are the three causes of Secondary Pulmonary HTN?
increased volume
hypoxemia
recurrent pulmonary embolism
71
What structure is damaged during Acute Respiratory Distress Syndrome?
Alveolar/Capillary Interface
72
Would Acute Respiratory Distress Syndrome feature exudate or transudate?
transudate
73
Which type of pneumocyte makes surfactant?
Type II
74
What is the main molecular component of surfactant?
Phosphatidylcholine
75
What is another name for phosphatidylcholine regarding surfactant?
Lecithin
76
What ratio is used to screen for neonatal respiratory distress?
Lecithin/Sphingomyelin
77
At what week of development does surfactant production begin? When is an adequate level reached?
28 = begin
34 = sufficient
78
What does the lecithin/sphingomyelin ratio need to be to ensure adequate surfactant production?
>2
79
What molecule increases the production of surfactant?
steroids
80
What molecule decreases the production of surfactant?
insulin
81
What keeps the PDA open? What causes a PDA to close?
open = hypoxemia
good oxygenation
82
What are the two particularly mutagenic carcinogens regarding lung cancer?
polycyclic aromatic hydrocarbons
arsenic
83
Radon is formed from the decay of what atom?
uranium
84
What are the two most common causes of a non-cancerous coin lesion in the lung?
Granuloma or Hamartoma
85
Which fungus is particularly notable for causing a lung granuloma? Where in the country can this be found?
Histoplasma
Midwest
86
What cell type does small cell lung cancer arise from? Also called?
Neuroendocrine
Kulchitsky
87
Which are three PNPs of small cell lung cancer?
ADH
ACTH
Eaton-Lambert
88
Eaton-Lambert Syndrome is associated with what specific lung cancer?
small cell
89
What two tissues compose a bronchial hamartoma? What often happens to this lesion?
lung tissue and cartilage
calcification
90
What are the two defining characteristics of squamous cell lung cancer on histology?
keratin pearls
intercelular bridges
91
What hormone may squamous cell carcinoma produce? Leading to?
PTHrp
hypercalcemia
92
Is squamous cell carcinoma more common in males or females?
males
93
What two populations present with adenocarcinoma of the lung?
females and nonsmokers
94
Which lung cancer often arises in a peripheral location?
adenocarcinoma
95
Does squamous cell cancer of the lung produce a central or peripheral lesion?
central
96
What type of lung cancer lacks any real defining characteristics on histology?
Large Cell Carcinoma
97
What is the definition for Bronchioloalveolar Carcinoma?
columnar cells that grow along pre-existing bronchioles and alveoli
98
What type of lung cancer arises from Club/Clara cells?
bronchoalveolar
99
Carcinoid tumors are derived from what cell?
neuroendocrine
100
What stain do carcinoid tumors stain for?
Chromogranin
101
What structure does a Carcinoid tumor usually present as in the lung?
polyp in bronchus
102
What two organs most often metastasize to the lungs?
breast and colon
103
Does pleural involvement occur more often with squamous cell or adenocarcinoma of the lung?
Adenocarcinoma
104
What are the three symptoms of Horner Syndrome?
Miosis
Ptosis
Anhydrosis
105
What is the unique site of spread of lung cancer?
adrenal glands
106
Which lung cancer encases the lung?
Mesothelioma
107
How does mesothelioma often present?
recurrent pleural effusion
108
Repeated bouts of rhinitis can give rise to what?
Nasal Polyp
109
What are the two most common risk factors for a Laryngeal Carcinoma?
alcohol and tobacco
110
Is interstitial pneumonia most often caused by virus or bacteria?
virus
111
What is a high-yield complication of Mycoplasma pneumonia infection?
autoimmune hemolytic anemia
112
Which specific lobe is most commonly affected during aspiration pneumonia?
right lower lobe
113
What are the two components of a Ghon complex?
fibrosis and calcification
114
Where in the brain can TB produce meningitis?
base of brain
115
What is the most common organ to be affected by spread of TB?
kidney
116
What is the first mechanism by which mast cells create inflammation? What is the 2nd phase?
1st = histamine
2nd = leukotrienes
117
What composes Charcot-Leyden crystals?
Major Basic Protein
118
Where in the lung does interstitial fibrosis most usually begin?
subpleural
119
Is sarcoidosis caseating or noncaseating?
non-caseating
120
What does non-caseating mean?
all cells of granuloma are alive
121
Hypersensitivity Pneumonitis features what two characteristics?
Granulomas
Eosinophils
122
How many mm of Hg counts as pulmonary HTN?
25 mm Hg
123
What is a plexiform lesion? When is a plexiform lesion seen?
close group of capillaries
pulmonary HTN
124
What patient population is most likely to present with pulmonary HTN?
young females
125
Which pneumocytes get damaged during ARDS? Protein rich or poor fluid?
Type I and Type II
protein rich
126
What are the two major complications of giving an infant with NRDS oxygen?
retinal damage
bronchopulmonary dysplasia
127
Which lung cancer is treated with surgery?
non-small cell
128
Which lung cancer is treated with chemotherapy?
small cell
129
What are the intercellular bridges of squamous cell carcinoma composed of?
desmosomes
130
If a lung cancer starts with an 'S', what are the three things it means?
smoking
central
(paraneoplastic) Syndromes
131
Are small cell lung cancers poorly differentiated or well differentiated? Carcinoid tumors poorly differentiated or well differentiated?
small cell = poorly
carcinoid = well
132
What is the name of a tumor that arises in the apex of the lung?
Pancoast tumor
133
What is Caplan Syndrome?
Rheumatoid Arthritis and coal workers pneumoconioses
134
What is another name for Croup?
Laryngotracheobronchitis
135
Does Croup present with inspiratory or expiratory stridor?
inspiratory
136
What causes gray hepitization?
degradation of red cells within exudate
137
Which two bacteria like to superimpose on top of viral pneumonia?
S. aureus
H. flu
138
Is Coxiella a rickettsial organism?
yes
139
Would a positive PPD occur during primary or secondary TB?
primary
140
What is the definition of bronchitis?
productive cough lasting three months over a two year period
141
What is the Reid Index?
thickness of mucus glands compared to bronchial wall thickness
142
Why does A1AT damage hepatocytes?
protein accumulation in ER
143
Are A1AT heterozygotes symptomatic?
no
144
What does IL10 due to TH2 cells? TH1?
stimulate TH2
inhibit TH1
145
What composes Curschmann Spirals?
mucus
146
Is dynein responsible for retrograde or anterograde?
retrograde
147
What is ABPA?
allergic bronchopulmonary aspergillosis
148
In what two groups is ABPA more common?
asthma or cystic fibrosis
149
Is sarcoidosis driven by CD4 or CD8 cells?
CD4
150
Which immune cell drives ARDS?
neutrophil
151
Which pneumonia causing bug is part of the enteric flora?
Klebsiella pneumoniae
152
What is the timeframe for bronchitis?
at least three months for at least two years
153
What does the Reid Index have to be do diagnose bronchitis?
> 50%
154
Which organelle does mis-folded A1AT get trapped?
endoplasmic reticulum
155
PiMZ heterozygotes shouldnt do what?
smoke
156
Which lung disease can produce amyloidosis?
Bronchiectasis
157
What is anthracosis?
build up of carbon in macrophages
158
What cancer does Berylliosis increase the risk of?
lung
159
What autoimmune disease can sarcoidosis mimmic?
Sjogren
160
What is a common enzyme of all non-caseating granulomas?
1-alpha-hydroxylase
161
Is BMPR2 activated or inactivated during pulmonary HTN?
inactivated
162
What type of membrane for ARDS?
hyaline
163
What structure of squamous cell carcinoma of the lung compose the intercellular bridges?
desmosomes
