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D&T 3 test 2 > Saroj 1 > Flashcards

Saroj 1 Flashcards

1
Q

which bronchi is more susceptible to aspiration

A

right main stem due to vertical orientation

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2
Q

What does bronchioles not have

A

cartilage

submucosal glands

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3
Q

what is pathway for air

A

bronchi
bronchioles
terminal bronchioles
acinus

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4
Q

What does Acinus contain

A

respiratory bronchioles –> alveolar ducts –> alveolar sacs

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5
Q

almost entire respiratory tree is lined by what? exceptions?

A

ciliated pseudostratified tall columnar epithelium

- vocal cord: stratified squamous epithelium

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6
Q

what are 2 types of alveolar epithelium

A

Type I pneumocytes: alveolar surface majority

Type II pneumocytes: surfactant and repair

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7
Q

what supplies the lung

A

pulmonary and bronchial arteries

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8
Q

nasal clearnce

A

sneezing or blowing

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9
Q

tracheobronchial clearance

A

epithelial mucociliary action

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10
Q

alveolar clearance

A

phagocytosis in alveolar macrophages

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11
Q

how can alcohol and smoking impact clearance mechanism

A

interfere with phagocytic action of alveolar macrophages

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12
Q

what is restrictive pulmonary disease

A

reduced expansion of lung parenchyma

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13
Q

what numbers are impacted for restrictive pulmonary disease

A

decreased total lung capacity

normal FEV1

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14
Q

what are 2 categories for restrictive disease

A
  1. chest wall disorder with normal lungs

2. acute or chronic interstitial and infiltrative

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15
Q

define diffuse interstistial disease

A

inflammation and fibrosis of lung connective tissue or delicate alveolar septal interstitium

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16
Q

what is decreased in diffuse interstitial disease

A

diffusion capacity
lung volumes
compliance

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17
Q

clinical features of diffuse interstitial disease

A

dyspnea
tachypnea
cyanosis

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18
Q

what do advanced lesions on diffuse interstitial look like

A

honeycomb lung

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19
Q

name 2 granulomatous diseases

A

Sarcoidosis

Hypersensitivity pneumonitis

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20
Q

Idiopathic pulmonary fibrosis (IPF) is the same thing as

A

UIP

usual interstitial pneumonia

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21
Q

what is a probable cause for IPF UIP

A
  • repeated cycles of epithelial activation/injury

- fibroblastic/myofibroblastic proliferation = FIBROBLASTIC FOCI

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22
Q

What is a probable genetic cause of IPF and UIP

A

TERT and TERC gene

telomerase

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23
Q

What is a second mechanism of pathogenesis for IPF UIP

A
  • caveolin 1 inhibits TGF- beta1

decreased caveiolin-1 in IPF
- abnormal repair

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24
Q

idiopathic pulmonary fibrosis usually occurs where in the lung

A

subpleural regions in lower lobes

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25
microscopically what do you see in Idiopathic pulmonary fibrosis (IPF
- fibroblastic foci initially - later dense fibrosis and cystic spaces - HONEYCOMB - abrupt transition between fibrosis and normal lung - temporal heterogeneity
26
later clinical features of Idiopathic pulmonary fibrosis (IPF)
cyanosis and clubbing
27
microscopically what does nonspecific interstitial pneumonia look like
cellular - interstitial inflammation fibrosing patterns without temporal heterogeneity if UIP no fibroblastic foci or honeycomb lung
28
how is nonspecific interstitial pneumonia treated
steroids
29
another name for cryptogenic organizing pneumonia
Bronchiolitis obliterans organizing pneumonia (BOOP)
30
cryptogenic organizing pneumonia is associated with what
viral and bacterial pneumonias
31
what is the histo for cryptogenic organizing pneumonia
- polypoid plugs or loose organizing fibroconnective tissue ( MASSON BODIES) - connective tissue plugs all the same age
32
what does X-ray show for cryptogenic organizing pneumonia
- Subplerual or peribronchial area of consolidation
33
how is cryptogenic organizing pneumonia treated
steroid therapy for greater than 6 months
34
What are 3 pneumoconioses
coal worker silicosis asbestos
35
what does cigarette smoke affect? amplies?
- affects mucociliary apparatus | - amplies effect of all inhaled dusts in obstructive and restrictive diseases
36
what size are the most dangerous cigarette particles
1-5 um
37
Is there cellular reaction in anthracosis of coal workers
no
38
morphology of simple CW coal workers
- coal macules: composed of carbon laden macrophages | - coal nodules, larger, collagen fibers
39
where does simple CW coal workers occur in the lung
upper lobes | upper zones of lower lobes
40
for simple CW coal workers macules and nodules are adjacent to
respiratory bronchioles
41
what can simple CW coal workers cause
centrilobular emphysema
42
clinical presentation for coal workers pneumonia
usually benign | - milder forms of complicated CWP exist without lung function abnormalities
43
what is Caplan syndrome coal workers
pneumoconiosis plus rheumatoid arthritis
44
what is the most prevalent chronic occupational disease worldwide
silicosis
45
what causes silicosis
inhalation of crystalline silicon dioxide
46
when does disease present for silicosis
decades after exposure
47
what forms in the lung for silicoisis
- crystalline ( more fibrosis, quartz most common) and amorphous forms
48
Silica causes activation and release of what
mediators within macrophages | -IL1, TNF, derived free radicals, fibrogenic cytokines
49
what does histo look like for silicosis
discrete pale to dark nodules ' eggshell calcifications' - concentric layers of collagen
50
where does silicosis usually occur in lung
upper lung zones
51
Silicosis is associated with increased susceptibility to
tuberculosis
52
what are 2 forms of asbestos
serpentine amphibole both are fibrogenic
53
what is serpentine asbestos look like
soluble curly flexible fibers
54
compare serpentine and asmphibole
amphibole less prevalent but more pathogenic
55
describe amphibole
stiff brittle fibers
56
where does initial injury occur in asbetsosis
bifurcations of small airways and ducts
57
asbestosis can act as what? by what?
tumor promoter by free radical generation
58
what is seen in histo for asbestos
asbestos bodies: golden brown fusiform
59
what are asbestos fibers coated with
iron-containing proteinaceous material
60
where in the lung does asbestos occur
lower lobes
61
in asbestos what is a macro feature
honeycombing
62
what is the most common manifestation of asbestos ? what does it not have
pleural plaques | - does not contain asbestos bodies
63
when do symptoms occur for asbestois
20 years of more after exposure
64
asbestosis with lung or pleural cancer =
grim prognosis
65
Bleomycin
directly damage lung tissue
66
Amiodarone
causes penumonitis
67
radiation
pneumonitis occurs in 10-20% of patients 1-6 months after therapy

D&T 3 test 2 (14 decks)

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