Flashcards in Respiratory COPY Deck (78)
Do the typical TB related symptoms (Fever, night sweats, cough with hemptysis, weight loss) occur in primary or secondary TB?
In Primary TB it is rare to have symptoms. The only sign is usually a Ghon complex in the lower lobe
What are the most common causes of Lobar Pneumonia?
Lobar pneumonia is usually a bacterial infection
1.) Streptococcus pneumoniae (95%)
i.) Most common cause of community-acquired pneumonia (middle-aged adults & elderly)
2.) Klebsiella pneumoniae
i.) Enteric flora that is aspirated; nursing homes, alcoholics, diabetics
What are the complications associated with Mycoplasma pneumoniae infection?
1.) Hemolytic anemia (r/t cold agglutinin disease from elevated IgM antibody titers)
2.) Erythema multiforme
What is the most common organ to be affected by systemic tuberculosis (other than the lung)?
Kidney; causing sterile pyuria
A pathogen spread via pigeon droppings. This pathogen can cause pneumonia and meningitis; more commonly meningitis in immunocompromised people.
Cryptococcal neoformans (encapsulated yeast)
1.) Klebsiella-related pneumonia forms what type of pattern on chest xray?
2.) What patients are most likely to have Klebsiella pneumonia?
1.) Lobar Pneumonia with significant risk of abscess formation
2.) Elderly in nursing homes, alcoholics, and diabetics; because they are at an increased risk of aspiration. Klebsiella pneumoniae is an enteric bacteria that is aspirated
A tumour located in the apex of the lung that results in compression of the sympathetic chain causing:
ii.) Pinpoint Pupils
The most common lung cancer occurring in non-smokers and in female smokers. This classically occurs in peripherally in the lung
Why is it important to distinguish small cell carcinoma from non-small cell carcinoma?
Small cell carcinoma is treated with chemotherapy while non-small cell carcinoma is treated with surgery
What two lung cancers are associated with smoking, present centrally in the lung, and are associated with paraneoplastic syndrome?
Small Cell Carcinoma & Squamous Cell Carcinoma
Mnemonic = if the lung cancer starts with an S then it happens Sentrally (central) in Smokers and causes paraneoplastic Syndrome
Keratin pearls or intercellular bridges present on histology in this centrally occurring lung tumour
Squamous cell carcinoma
Poorly differentiated neuroendocrine cells found centrally in the lung. These cells may produce ADH or ACTH (Cushing's) and may cause Eaton-Lambert Syndrome
Small Cell Carinoma
Eaton-Lambert Syndrome (antibodies against presynaptic calcium channels resulting in muscle weakness)
Where does a mesothelioma neoplasm occur?
In mesothelial cells located between the parietal and visceral pleura.
Mesothelia cells are responsible for the production of a lubricating fluid that allows frictionless movement of the lung in relation to the chest wall
What are the major subtypes of Non-small Cell Carcinoma?
1.) Adenocarcinoma (40%)
i.) associated with glands & mucin
2.) Squamous cell carcinoma (30%)
i.) associated with keratin pearls & intercellular bridges
3.) Large Cell Carcinoma
i.) associated with the lack of keratin pearls, glands, mucin, or intercellular bridges
What is the next step after discovering a solitary nodule in the lungs of a patient with nonspecific symptoms?
To go back and compare the XRay with a previous XRay.
If the coin lesion (solitary nodule) has been present over a long time and remains unchanged then it is most likely benign.
If the coin lesion is new or growing, then biopsy is required to diagnose lung cancer
What are the symptoms of Woolsorter's disease (Pulmonary anthrax)?
1.) Pulmonary hemorrhage
What are the main pathogenic causes of pneumonia in children?
RSV, Mycoplasma, Chlamydia trachomatis, Streptococcus pneumoniae
Runts May Cough Sputum
What is Pneumoconioses?
Interstitial fibrosis (restrictive lung condition) caused by occupational exposure of small particles that are fibrogenic (caused by macrophages in the bottom of the lung)
Some examples include: coal worker's pneumoconiosis, silicosis, asbestosis
Restrictive lung condition with non-caseating granulomas
What is the most common consequence of a pulmonary contusion?
What are the main treatment interventions for a pulmonary contusion?
Acute Respiratory Distress Syndrome
Most contusions do not require specific therapy.
Large contusions may affect gas exchange and lead to hypoxemia (after 24-48 hours). Close monitoring of vitals and oxygen delivery may be required. Tracheal intubation may also be required.
What are the major causes of bronchiectasis?
1.) Infections that damage the airway (pneumonia, tuberculosis)
2.) Foreign object blocking off part of the airway
3.) Cystic Fibrosis
In what condition do you find plexiform lesions?
Long standing pulmonary hypertension (a tuft of capillaries)
Describe the pathophysiology of acute respiratory distress syndrome
1.) Damage (sepsis, infection, shock, trauma, aspiration, etc) to capillary interface of the alveoli.
i.) Results in leaking of protein-rich fluid
2.) The protein-rich fluid is then reorganized into a Hyaline Membrane
3.) The Hyaline membranes then cause the following complications:
i.) Thickened diffusion area for gases resulting in hypoxemia
ii.) Increased surface tension of the alveoli resulting in collapsed air sacs
What are the 2 major sequelae of neonatal respiratory distress syndrome?
1.) Persistence of the patent ductus arteriosus
2.) Necrotizing enterocolitis
Both are caused by hypoxemia in the neonate
What is the most common restrictive condition of the lungs?
What is a major consequence of respiratory distress syndrome?
Localized sharp pain made worse by inhalation, movement, or cough
What are the chances of a pulmonary embolism with DVT?
What COPD condition may result in secondary amyloidosis?