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Flashcards in Respiratory System Pathology Deck (76):
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

Give 1 example of fibrous pneumoconiosis

Asbestosis