Respiratory System Diseases Flashcards
(84 cards)
1
Q
What is another name for infectious rhinitis?
A
The common cold
2
Q
What type of pathogen is the most common cause of infectious rhinitis?
A
Rhinoviruses
3
Q
Describe the clinical presentation of infectious rhinitis
A
- Nasal congestion with watery discharge
- Sneezing
- Scratchy, dry, sore throat
4
Q
What are some potential complications of infection rhinitis? (3)
A
- Bacterial infection due to swelling/fluid accumulation
- Middle ear infection (otitis media)
- Sinus infection (sinusitis)
5
Q
True or false. Viral infections can be secondary to bacteria causing pharyngitis/tonsilitis.
A
False. Bacterial infections are secondary to viral
6
Q
Which viruses most commonly cause pharyngitis and tonsilitis? (3)
A
- Rhinoviruses
- Echoviruses
- Adenoviruses
7
Q
What are the most serious consequences of untreated pharyngitis or tonsilitis? (3)
A
- Rheumatic fever
- Glomerulonephritis
- Chronic tonsillar enlargement
8
Q
What is atelectasis?
A
Collapse of a previously inflated lung
9
Q
What are the 3 subtypes of atelectasis? Which one is not reversible (***).
A
- Resorption: blockage of airway
- Compression: accumulation in pleural space
- ***Contraction: fibrosis restricts expansion
10
Q
What is a pulmonary embolism?
A
Something that blocks the vessels in the lung(s):
Ex: blood clot, air bubble, fatty deposit, other debris
11
Q
95% of pulmonary emboli are _____
A
blood clots from large leg veins
12
Q
Blockage in a vessel causes _____ downstream and _____ upstream.
A
- Ischemia
- Increased pressure
13
Q
Approximately 10% of pulmonary emboli result in _______
A
Pulmonary infarct
14
Q
What is cor pulmonale?
A
Right-sided heart failure
15
Q
Why do large blockages caused by pulmonary emboli kill quickly?
A
- Increased pressure damages the heart
- Leads to cor pulmonale
16
Q
Right-sided heart failure leads to ______, while left-sided heart failure leads to ______.
A
- Cor pulmonale
- Pulmonary hypertension
17
Q
Pulmonary embolism signals the body to lower _____ and in turn _____.
A
- Blood pressure
- Cardiac output
18
Q
What are some reasons for atelectasis with a pulmonary embolism? (2)
A
- Lack of surfactant
- Reduced movement in response to pain
19
Q
What are the treatment options for a pulmonary embolism?
A
- Anticoagulant (e.g. heparin)
- Thrombolytic (risky; only in hospitals)
20
Q
What vascular changes occur in pulmonary hypertension?
A
- Medial hypertrophy of muscular and elastic arteries in the lungs: intimal fibrosis
- Plexiform lesions (advanced) that cause dilated thin-walled arteries to rupture
21
Q
Pulmonary hypertension can be caused by? (6)
A
- Chronic obstructive or interstitial lung diseases
- Heart disease (left-sided)
- Recurrent emboli
- Autoimmune diseases
- Obstructive sleep apnea
- Idiopathic (80% have genetic basis)
22
Q
What are the symptoms of pulmonary hypertension?
A
- Dyspnea
- Fatigue
- End-stage: severe respiratory distress and cyanosis
23
Q
True or false. Chest pain is rarely seen in pulmonary hypertension.
A
True
24
Q
True or false. Pulmonary hypertension is only detectable when it’s advanced.
A
True
25
What are the potential treatments for pulmonary hypertension? (3)
1. If secondary: treatment of primary disease
2. If autoimmune or refractory (untreatable): vasodilators
3. Lung transplant
26
What is Goodpasture syndrome?
* Complex multigenetic disorder
* Pulmonary hemorrhage syndrome
* Autoimmune destruction of alveolar basement membranes
27
What are the potential treatment options for Goodpasture syndrome?
1. Plasmapheresis to remove autoantibodies
2. Immunosuppression
28
What does Goodpasture Syndrome look like histologically in the lungs?
* Intra-alveolar hemorrhage
* Focal necrosis in alveolar walls
* Macrophage accumulation
29
What is pulmonary edema?
Leakage of fluid into alveolar space
30
Hemodynamic pulmonary edema is most commonly the result of \_\_\_\_\_\_\_
* Left-sided congestive heart failure
* Increased pressure in LV → Increased pressure in lungs → fluid forced out of the capillaries
31
What is acute respiratory distress syndrome (ARDS)?
* Severe acute lung injury indicated by:
* Abrupt onset of hypoexemia
* Bilateral pulmonary infiltrates
* Bilateral edema throughout
32
Explain the pathogenesis of ARDS
1. Initiated by macrophages
2. Inflammatory mediators damage endothelium and pneumocytes
3. Neutrophils invade and debris accumulates (hyalinization)
4. Healing starts when macrophages produced TGFβ and PDGF
33
In ARDS, what are the consequences of damage to type I (squamous) vs type II (cuboidal) pneumocytes?
1. Increased permeability
2. Decreased surfactant and alveolar collapse
34
What are the symptoms of ARDS?
1. “Heavy” feeling lungs
2. Lungs filled with fluid (can be heard on auscultation)
3. Stiff lungs due to surfactant loss
4. Dyspnea/tachypnea
5. Cyanosis/hypoxemia
35
What are some potential treatments for ARDS?
1. 100% oxygen therapy
2. Mechanical ventilation
3. Treat underlying cause (such as sepsis)
36
Pneumonia can be caused by what?
1. Bacteria
2. Viruses
3. Mycoplasms
4. Fungi
37
Pneumonia is responsible for ____ of US deaths.
1/6
38
Does pneumonia cause pulmonary edema or does pulmonary edema cause pneumonia?
Either or both
39
What is a common risk factor for hospital-acquired pneumonia?
Mechanical ventilation
40
What typically causes aspiration pneumonia?
* Vomiting
* Markedly debilitated patients, stroke victims, etc.
* Abnormal gag/swallowing reflex
41
True or false. Chronic pneumonia only occurs in immunocompromised patients.
False. Immunocompetent\*
42
What are some causes of pneumonia? (5)
1. Cough reflex suppression/inhibition
2. Mucociliary apparatus damage
3. Accumulation of secretions
4. Decreased macrophage activity
5. Edema or congestion (mucus)
43
What form of pneumonia is often fatal?
Aspiration (necrotizing) pneumonia
44
What are the two ways bacterial pneumonia can present?
1. Bronchopneumonia: opaque spots
2. Lobar: entire lobe is opaque
45
Describe the clinical course of pneumonia
* **Rapid onset:** fever, chills, cough (mucous with signs of infection)
* **Fibrinosuppurative pleuritis**: Lung swelling, pleuritic pain, and pleural friction rub
46
Stage 2 (early red hepatization) of acute pneumonia is indicated by what histologically?
* Neutrophil infiltrate
* Congestion of septal capillaries
47
Stage 3 (gray hepatization) of acute pneumonia is indicated by what histologically?
Alveolar exudate in air spaces
48
Stage 4 (resolution) of acute pneumonia is indicated by what histologically?
* Fibromyxoid masses (attempts at rebuilding)
* Macrophages
* Fibroblasts
49
What virus is responsible for infecting pneumocytes and causing viral pneumonia?
* SARS-CoV
* FIrst time a coronavirus infected somewhere other than the upper respiratory tract
50
What are the initial symptoms of Severe Acute Respiratory Syndrome (SARS)? (5)
1. Malaise
2. Myalgia
3. Dry cough
4. Fever
5. Chills
51
What are some complications that are caused by SARS-CoV-2? (7)
1. Pneumonia and trouble breathing
2. Organ failure
3. New-onset cardiac issues
4. ARDS
5. Blood clots
6. Acute kidney injury
7. Additional viral and bacterial infections
52
Histoplasmosis is caused by what organism?
* *Histoplasma capsulatum*
* Dimorphic fungus
53
Describe the gross appearance of histoplasmosis
* Perihilar mass lesions
* Can look like lymphoma or leukemia
54
Describe the histology of histoplasmosis
* Macrophage aggregates filled with yeast
* Lymph node infiltration
* Granulomas with giant cells
* May develop fibrosis and calcifications
55
What are the differences between obstructive vs. restrictive diseases?
**Obstructive**
* Partial or complete obstruction at any level
* Increased resistance to airflow
**Restrictive**
* Reduced expansion of parenchyma
* Decreased total lung capacity
56
How are obstructive and restrictive diseases diagnosed in pulmonary function tests?
* **Obstructive:** decreased forced expiratory volume (FEV)
* **Restrictive:** decreased FEV and vital capacity
57
What is emphysema?
* Permanent enlargement of smaller airspaces
* No destruction of walls of smaller air spaces
* No fibrosis
58
\_\_\_\_\_ is a complex multigenic disease that increases airway responsiveness to stimuli
Asthma
59
What are some characteristics of asthma? (3)
1. Episodic bronchoconstriction
2. Bronchial wall inflammation
3. Increased mucus section (which exacerbates 1.)
60
What is atopic asthma?
Classic hypersensitivity reaction via IgE
61
What is non-atopic asthma?
Hyperirritability due to viral infection
62
What drugs are most likely to cause drug-induced asthma?
* Aspirin and other NSAIDS
* Affects balance of cyclooxygenase activity
63
What are some causes of occupational asthma?
Exposure to:
* Fumes
* Dust
* Gases
* Chemicals
64
What is chronic inflammatory airway disease?
* Recurrent episodes wheezing, breathlessness, chest tightness, and cough
* Bronchoconstriction (widespread but variable)
* Airflow limitations (partially reversible)
65
How does recurrent asthma alter airway structure?
* Increased mucus production
* Thickening of basement membrane and smooth muscle
* WBC infiltration
* Increase glandular tissue
66
What does asthma look like histologically?
1. Eosinophil infiltration
2. Goblet cell hyperplasia
3. Thick basement membrane
4. Smooth muscle hypertrophy
67
In cystic fibrosis, mutations in ______ result in viscous mucus that obstructs passageways
* Cystic fibrosis conductance regulator (CFTR)
* Chloride channel
68
What are some of the consequences of cystic fibrosis? (5)
1. Chronic lung disease
2. Pancreatic insufficiency (excess fecal fat)
3. Hepatic cirrhosis
4. Intestinal obstruction
5. Male infertility
69
\_\_\_\_\_\_ is caused by particles recognized the body as foreign, but cannot be eliminated
Pneumoconioses
70
What is black lung?
* Complicated coal workers pneumoconiosis
* Progressive, massive fibrosis
* Black pigment associated with fibrosis (coal)
71
What are some subtypes of pneumoconiosis?
1. Coal workers pneumoconiosis (CWP)
2. Silicosis
3. Anthracosis
4. Asbestosis
72
True or false. You cannot see silicosis or asbestosis on microscopic analysis.
True
73
What are some consequences of CWP? (3)
1. Pulmonary dysfunction
2. Pulmonary hypertension
3. Cor pulmonale
74
Asbestosis increases risk of what type of cancer?
Mesothelioma
75
What is allergic alveolitis?
* Type of granulomatous disease
* Hypersensitivity pneumonia
* Inflammation in alveoli
76
What are some consequences of allergic alveolitis? (3)
* Decreased diffusion capacity
* Decreased lung compliance
* Decreased total lung volume
77
Describe the histology of allergic alveolitis
* Patchy infiltrates in the interstitium
* Loos granulomas without necrosis
* Lymphocyte, plasma cell, and epitheloid macrophage infiltration
* Usually around bronchioles
78
What is Sarcoidosis?
* Type of granulomatous restrictive disease
* Unknown etiology
79
What are some histological characteristics of sarcoidosis?
1. Non-necrotizing granulomas
2. Frequent giant cells
3. When chronic, may become scar tissue
80
What are the possible clinical courses for Sarcoidosis?
1. Spontaneous remission
2. Steroid therapy
81
Accumulation of pleural fluid (pleural effusion) can be caused by? (5)
1. Incrased hydrostatic pressure (CHF)
2. Increased vascular permeability (pneumonia)
3. Decreased osmotic pressure (renal disease)
4. Decreased intrapleural negative pressure (atelectasis)
5. Decreased lymphatic drainage
82
What is a pneumothroax?
* Air or gas in the pleural space
* Collapsed lung
83
What causes a spontaneous pneumothorax?
* Idiopathic
* Rupture of alveolus, abscess cavity
84
What is a flap valve?
* Allows air in but out out
* In tension pneumothorax
