Flashcards in Respiratory System Pathology Deck (76)
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1
What is the function of type 1 pneumocytes
Gas exchange
2
What is the function of type 2 pneumocytes
Surfactant production
3
Respiratory failure could be a result of defects in what 3 main areas?
Ventilation, perfusion and gas exchange
4
What blood o2 concentration classifies as respiratory failure
PaO2
5
What O2 and CO2 concentrations class as type 1 respiratory failure
PaO2
6
What O2 and CO2 concentrations class as type 2 respiratory failure?
PaO26.3kPa
7
Proximal airway obstruction
Stridor
8
Distal airway obstruction
Wheeze
9
What would you find on examination, if someone has restricted opening of their small airways?
Crackles
10
What would you find on examination, if someone has narrowed small airways
Wheeze
11
Sound conduction through solid lung
Cronchial breathing
12
Lung consolidation or pleural effusion- what would you see on examination?
Dull percussion
13
What would you see on examination if someone had a pneumothorax or emphysema?
Hyperesonant
14
Benign, primary lung neoplasm
Adenochondroma
15
What are the 4 main type of lung cancer?
Small cell carcinoma, squamous carcinoma, adenocarcinoma and undifferentiated large cell carcinoma
16
Non small cell carcinomas account for what proportion of lung diseases?
85%
17
How do secondary tumours usually present?
Multiple bilateral nodules
18
Which lung cancers are more peripherally sited?
Adenocarcinomas
19
What type of lung cancer is often seen with hypercalcaemia due to parathyroid related peptide in the neoplasm?
Squamous carcinoma
20
What is the usualy (90%) cause of squamous carcinoma?
Iriitants e.g. smoke, cause the normal pseudostratified columnar epithelium to undergo a reversible metastatic change to stratified squamous- may keratinise (like skin)
21
1st metastatic cell undergoes irreversible genetic changes
Dysplasia
22
In which lung cancer is thyroid transcription factor expressed?
Adenocarcinoma
23
What is a type of adenocarcinoma that is typically termed 'adenocarcinoma in situ' that is the spread of well differentiated mucinous or non mucinous neoplastic cells on alveolar walls. Not invasive and mimic pneumonia.
Bronchioalveolar carcinoma
24
Low grade, benign tumours not associated with smoking
Carcinoid tumours
25
'Oat cell' carcinomas- metastasise early, poorly differentiated. Secreted ACTH and almost all in smokers.
Small cell carcinoma
26
What skin condition is a paraneoplastic effect of lung carcinoma?
Acanthosis nigricans
27
Hypertrophic pulmonary osteroarthropathy
Clubbing
28
What coagulopathy is common paraneoplastic effect of lung cancer?
Thrombophelbitis migrans
29
Name a new drug used for lung cancers, that target epidermal growth factor receptors
Epidermal growth factor receptor tyrosine kinase inhibitors e.g. gefitinib and erlotinib
30
Lymph in pleural space
Chylothorax
31
Pus in pleural space
Empyema
32
Benign pleural tumour
Fibroma
33
Most common malignant secondary pleural tumour
Adenocarcinoma
34
Primary malignant pleural tumour
Malignant mesothelioma
35
What risk factor is commonly associated with malignant mesothelioma?
Aspestos exposure
36
How does early malignant mesothelioma typically present?
Small plaques on parietal pleura, may produce significant pleural effusion
37
These are found on the lower thoracic wall and diaphraymatic parietal pleura- marker of aspestos exposure .No physiological effect, not pre-malignant.
Fibrous pleural plaques
38
Causative organism of bronchiolitis
RSV
39
Inflammatory exudate in alveoli and distal small airways consolidations
Pneumonia
40
2 anatomical types of pneumonia
Bronchopneumonia and lobar pneumonia
41
Which type of pneumonia is most often primary (previously healthy)?
Lobar pneumonia
42
Which type of pneumonia is often caused by strep.pneumoniae?
Lobar pneumonia
43
Which type of pneumonia is most common
bronchopneumonia
44
Which type of pneumonia is often patchy and bronchocentric?
Bronchopneukonia
45
Describe the appearance of lobar pneumonia
congestion- red then grey
46
Which pneumonia typically heals with scarring?
Bronchopneumonia
47
What autoimmune sydrome can present as pulmonary vasculitis- intra-alveolar haemorrhage and glomerulonephritis
Goodpasture's syndrome
48
Name 4 obstructive lung condiitons
Bronchiectasis, COPD (chronic bronchitis and emphysema), asthma and bronchiolitis
49
Permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue. Results from chronic nectrotizing infection
Bronchiectasis
50
Which obstructive lung condition presents as copious amounts of foul smelling sputum?
Bronchiectasis
51
Predisposing conditions of bronchiectasis
CF, primary ciliary dyskinesia (kartagener's syndrome), bronchial obstruction, rheumatoid arthritis, IBD
52
What is the histological presentation of COPD
Mucous gland hyperplasia and hypersecretion
53
Does emphysema occur with or without fibrosis?
Without
54
Differenct between emphysema and overinflation?
Both dilation of airspaces distal to terminal bronchioles, without obvious fibrosis. Emphysema- airspace wall destruction too.
55
3 classes of emphysema
Centrilobar (centriacinar)
Panlobar (panacinar)
Paraseptal (distal acinar)
56
Airspaces in the centre of lobules.
Centrilobar
57
Which type of emphysema is associated with smoking or coal dust?
Centrilobar
58
All airspaces distal to terminal bronchioles. Lower lobes mainly. Seen in 30-80% patients with alpha-1-antitrypsin deficiency
Panlobar
59
Airspaces at the periphery of lobules. Often adjacent scarring and fibrosis. Pneumothorax if ruptures.
Paraseptal
60
COPD with pred. bronchitis stereotype
Blue boater
61
COPD with pred. emphysema stereotype
Pink Puffer
62
Cor. pulmonale (dilated Right side of heart) seen in COPD patients with pred. bronchitis or pred. emphysema?
Pred. bronchitis
63
Conditions which presents as mucosal inflammation and oedema and hyperinflated lungs?
Asthma
64
What types of asthma are there?
Atopic, acute, aspirin induced, occupational
65
Which type of asthma is a type 1 hypersensitivity reaction in children/adults?
Atopic asthma
66
Is interstitial lung disease a restrictive or obstructive lung disease?
Restrictive
67
What are the 3 characteristics of interstitial lung disease?
Increase tissue in alveolar-capillary wall- ifnlammation and fibrosis
Reduced lung compliance
Increased gas diffusion distance
68
Diffuse alveolar wall damage caused by shock, trauma, infection etc. activated complement and results in a massive cytokine release, presenting as acute dyspnoea, tachypneoa and respiratory distress
Adult respiratory distress syndrome
69
honeycomb lung
Chronic interstitial lung disease
70
4 types of chronic interstitial lung diseases
Idiopathic pulmonary fibrosis
Pneumoconiosis
Sarcoidosis
Collagen vascular diseases- associated lung disease
71
Cobblestone pleural surface- contraction of interstitial fibrous tissue accenuates lobular architecture
Idiopathic pulmonary fibrosis
72
Multisystem inflammatory disorder, commonly involving mediastinal lymph nodes and lung.
Sarcoidosis
73
Discrete non-caseating granulomas with frequent lymph node involvement
Sarcoidosis
74
Inflammatory disorder presenting as chronic interstitial lung disease, commonly in young females
Sarcoidosis
75
'The dust diseases'
Pneumoconioses
76