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Clinical Pathology > Respiratory System Pathology > Flashcards

Respiratory System Pathology Flashcards

1
Q

What is the function of type 1 pneumocytes

A

Gas exchange

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2
Q

What is the function of type 2 pneumocytes

A

Surfactant production

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3
Q

Respiratory failure could be a result of defects in what 3 main areas?

A

Ventilation, perfusion and gas exchange

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4
Q

What blood o2 concentration classifies as respiratory failure

A

PaO2

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5
Q

What O2 and CO2 concentrations class as type 1 respiratory failure

A

PaO2

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6
Q

What O2 and CO2 concentrations class as type 2 respiratory failure?

A

PaO26.3kPa

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7
Q

Proximal airway obstruction

A

Stridor

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8
Q

Distal airway obstruction

A

Wheeze

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9
Q

What would you find on examination, if someone has restricted opening of their small airways?

A

Crackles

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10
Q

What would you find on examination, if someone has narrowed small airways

A

Wheeze

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11
Q

Sound conduction through solid lung

A

Cronchial breathing

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12
Q

Lung consolidation or pleural effusion- what would you see on examination?

A

Dull percussion

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13
Q

What would you see on examination if someone had a pneumothorax or emphysema?

A

Hyperesonant

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14
Q

Benign, primary lung neoplasm

A

Adenochondroma

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15
Q

What are the 4 main type of lung cancer?

A

Small cell carcinoma, squamous carcinoma, adenocarcinoma and undifferentiated large cell carcinoma

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16
Q

Non small cell carcinomas account for what proportion of lung diseases?

A

85%

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17
Q

How do secondary tumours usually present?

A

Multiple bilateral nodules

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18
Q

Which lung cancers are more peripherally sited?

A

Adenocarcinomas

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19
Q

What type of lung cancer is often seen with hypercalcaemia due to parathyroid related peptide in the neoplasm?

A

Squamous carcinoma

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20
Q

What is the usualy (90%) cause of squamous carcinoma?

A

Iriitants e.g. smoke, cause the normal pseudostratified columnar epithelium to undergo a reversible metastatic change to stratified squamous- may keratinise (like skin)

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21
Q

1st metastatic cell undergoes irreversible genetic changes

A

Dysplasia

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22
Q

In which lung cancer is thyroid transcription factor expressed?

A

Adenocarcinoma

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23
Q

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.

A

Bronchioalveolar carcinoma

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24
Q

Low grade, benign tumours not associated with smoking

A

Carcinoid tumours

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25
Q

‘Oat cell’ carcinomas- metastasise early, poorly differentiated. Secreted ACTH and almost all in smokers.

A

Small cell carcinoma

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26
Q

What skin condition is a paraneoplastic effect of lung carcinoma?

A

Acanthosis nigricans

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27
Q

Hypertrophic pulmonary osteroarthropathy

A

Clubbing

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28
Q

What coagulopathy is common paraneoplastic effect of lung cancer?

A

Thrombophelbitis migrans

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29
Q

Name a new drug used for lung cancers, that target epidermal growth factor receptors

A

Epidermal growth factor receptor tyrosine kinase inhibitors e.g. gefitinib and erlotinib

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30
Q

Lymph in pleural space

A

Chylothorax

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31
Q

Pus in pleural space

A

Empyema

32
Q

Benign pleural tumour

A

Fibroma

33
Q

Most common malignant secondary pleural tumour

A

Adenocarcinoma

34
Q

Primary malignant pleural tumour

A

Malignant mesothelioma

35
Q

What risk factor is commonly associated with malignant mesothelioma?

A

Aspestos exposure

36
Q

How does early malignant mesothelioma typically present?

A

Small plaques on parietal pleura, may produce significant pleural effusion

37
Q

These are found on the lower thoracic wall and diaphraymatic parietal pleura- marker of aspestos exposure .No physiological effect, not pre-malignant.

A

Fibrous pleural plaques

38
Q

Causative organism of bronchiolitis

A

RSV

39
Q

Inflammatory exudate in alveoli and distal small airways consolidations

A

Pneumonia

40
Q

2 anatomical types of pneumonia

A

Bronchopneumonia and lobar pneumonia

41
Q

Which type of pneumonia is most often primary (previously healthy)?

A

Lobar pneumonia

42
Q

Which type of pneumonia is often caused by strep.pneumoniae?

A

Lobar pneumonia

43
Q

Which type of pneumonia is most common

A

bronchopneumonia

44
Q

Which type of pneumonia is often patchy and bronchocentric?

A

Bronchopneukonia

45
Q

Describe the appearance of lobar pneumonia

A

congestion- red then grey

46
Q

Which pneumonia typically heals with scarring?

A

Bronchopneumonia

47
Q

What autoimmune sydrome can present as pulmonary vasculitis- intra-alveolar haemorrhage and glomerulonephritis

A

Goodpasture’s syndrome

48
Q

Name 4 obstructive lung condiitons

A

Bronchiectasis, COPD (chronic bronchitis and emphysema), asthma and bronchiolitis

49
Q

Permanent dilation of bronchi and bronchioles caused by destruction of the muscle and elastic tissue. Results from chronic nectrotizing infection

A

Bronchiectasis

50
Q

Which obstructive lung condition presents as copious amounts of foul smelling sputum?

A

Bronchiectasis

51
Q

Predisposing conditions of bronchiectasis

A

CF, primary ciliary dyskinesia (kartagener’s syndrome), bronchial obstruction, rheumatoid arthritis, IBD

52
Q

What is the histological presentation of COPD

A

Mucous gland hyperplasia and hypersecretion

53
Q

Does emphysema occur with or without fibrosis?

A

Without

54
Q

Differenct between emphysema and overinflation?

A

Both dilation of airspaces distal to terminal bronchioles, without obvious fibrosis. Emphysema- airspace wall destruction too.

55
Q

3 classes of emphysema

A

Centrilobar (centriacinar)
Panlobar (panacinar)
Paraseptal (distal acinar)

56
Q

Airspaces in the centre of lobules.

A

Centrilobar

57
Q

Which type of emphysema is associated with smoking or coal dust?

A

Centrilobar

58
Q

All airspaces distal to terminal bronchioles. Lower lobes mainly. Seen in 30-80% patients with alpha-1-antitrypsin deficiency

A

Panlobar

59
Q

Airspaces at the periphery of lobules. Often adjacent scarring and fibrosis. Pneumothorax if ruptures.

A

Paraseptal

60
Q

COPD with pred. bronchitis stereotype

A

Blue boater

61
Q

COPD with pred. emphysema stereotype

A

Pink Puffer

62
Q

Cor. pulmonale (dilated Right side of heart) seen in COPD patients with pred. bronchitis or pred. emphysema?

A

Pred. bronchitis

63
Q

Conditions which presents as mucosal inflammation and oedema and hyperinflated lungs?

A

Asthma

64
Q

What types of asthma are there?

A

Atopic, acute, aspirin induced, occupational

65
Q

Which type of asthma is a type 1 hypersensitivity reaction in children/adults?

A

Atopic asthma

66
Q

Is interstitial lung disease a restrictive or obstructive lung disease?

A

Restrictive

67
Q

What are the 3 characteristics of interstitial lung disease?

A

Increase tissue in alveolar-capillary wall- ifnlammation and fibrosis
Reduced lung compliance
Increased gas diffusion distance

68
Q

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

A

Adult respiratory distress syndrome

69
Q

honeycomb lung

A

Chronic interstitial lung disease

70
Q

4 types of chronic interstitial lung diseases

A

Idiopathic pulmonary fibrosis
Pneumoconiosis
Sarcoidosis
Collagen vascular diseases- associated lung disease

71
Q

Cobblestone pleural surface- contraction of interstitial fibrous tissue accenuates lobular architecture

A

Idiopathic pulmonary fibrosis

72
Q

Multisystem inflammatory disorder, commonly involving mediastinal lymph nodes and lung.

A

Sarcoidosis

73
Q

Discrete non-caseating granulomas with frequent lymph node involvement

A

Sarcoidosis

74
Q

Inflammatory disorder presenting as chronic interstitial lung disease, commonly in young females

A

Sarcoidosis

75
Q

‘The dust diseases’

A

Pneumoconioses

76
Q

Give 1 example of fibrous pneumoconiosis

A

Asbestosis

Clinical Pathology (53 decks)

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