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Flashcards in Respiratory Deck (163)
1

What is the most common cause of rhinitis?

Rhinovirus

2

What is a common cause of a nasal polyps in children? In adults?

children = Cystic fibrosis

adults = aspirin intolerant asthma

3

What is the triad of Aspirin-Resistant Asthma?

asthma

aspirin induced bronchospasm

nasal polyps

4

What is an angiofibroma? What is an angiofibroma composed of?

benign tumor of nasal mucosa

blood vessels and fibrous tissue

5

What patient population is angiofibroma often seen?

adolescent males

6

What virus is associated with nasopharyngeal carcinoma? Which lymph nodes does the commonly involve?

EBV

cervical

7

Nasopharyngal carcinoma is classically seen in what two populations?

African children

Chinese adults

8

What are the two histological characteristics of Nasopharyngeal Carcinoma seen on biopsy?

pleomorphic keratin positive epithelial cells

background of lymphocytes

9

What is the most common cause of epiglottitis? Immunized, nonimmunized or both?

H. influenzae Type B

both

10

What virus causes Croup?

Parainfluenzae

11

What material composes a vocal cord nodule? Unilateral or bilateral? Why?

myxoid

bilateral

excessive use

12

Which HPV isotypes would be found in Laryngeal Papilloma? How does this appear in adults? Children?

6 and 11

adults = single

children = multiple

13

Where does a Laryngeal Carcinoma usually arise from? Arise from laryngeal papilloma?

epithelial tissue of vocal cord

no

14

Which two bacteria make up the majority of Lobar Pneumonia? Which one is the stark majority?

Strep. pneumoniae (majority)

Klebsiella pneumoniae

15

Which three bacterial Genus are most likely to cause Aspiration pneumonia?

Bacteroides

Fusobacterium

Peptococcus

16

What is Secondary Pneumoniae? Which bug is most likely to cause Secondary Pneumonia?

bacterial pneumonia superimposed on viral pneumonia

S. Pneumoniae

17

What is the most common mechanism by which Klebsiella pneumoniae can establish an infection in the lungs?

Aspiration

18

Which patient population is most likely to be affected by Klebsiella pneumoniae?

alcoholics/elderly/debilitated

19

What bacteria is the 2nd most common cause of Secondary Pneumonia?

S. aureus

20

Patients with COPD are most likely to get pneumonia from what two bugs?

Haemophilus influenzae

Moraxella catarrhalis

21

What bug causes pneumonia in CFTR patients?

P. aeruginosa

22

Legionella pneumophilia requires what to infect people?

a water source

23

Which pneumonia causing bug can be visualized with a silver stain?

Legionella pneumophilia

24

What bug is the most common cause of atypical pneumonia? In what two patient populations?

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