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31 Cards in this Set
- Front
- Back
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Atelectasis: Definition and 3 methods of causing it |
Definition: loss of lung volume due to inadequate expansion of air spaces. It can be due to resorption, compression, or contraction.
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ARDS: definition and pathogenesis |
Definition: Acute Respiratory Distress Syndrome.
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Emphysema: definition |
permanent enlargement of air spaces distal to terminal bronchioles, with centriacinar patterns more closely associated with smoking, and panacinar emphysema associated with alpha-1 antitrypsin deficiency. |
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Asthma: definition & features |
Asthma is a chronic inflammatory disorder. There is reversible airway obstruction, with wheezing as a notable component, accompanied by chronic bronchial inflammation (with eosinophils) and increased mucus secretion. Note the role of Th2 cells to generate a IgE-focused response that leads to mast cell degranulation and eosinophil recruitment. Most asthmais commonly atopic with this type I hypersensitivity aspect. |
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Bronchiectasis: definition |
permanent dilation of bronchi/bronchioles secondary to chronic infections or obstruction; associated with production of purulent sputum. Caused by, for example, long standing infections and/or Cystic Fibrosis |
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Types of Interstitial Lung Disease |
1. Fibrosing i) Usual Interstitial Pneumonia (idiopathic pulmonary fibrosis) ii) Nonspecific interstitial pneumonia iii) cryptogenic organizing pneumonia iv) associated with collagen vascular disease v) pneumoconiosis vi) assoc. w/ therapies e.g. drugs, radiation 2. Granulomatous i) sarcoidosis ii) hypersensitivity pneumonia 3. Eosinophilic i) drug allergy related ii) idiopathic chronic eosinophilic pneumonia 4. smoking related i) desquamative interstitial pneumonia ii) respiratory bronchiolitis |
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Chronic Interstitial Lung Diseases: definition |
[They] generaterestrictive patterns, as they involve the alveolar interstitium. There isreduced compliance (increased elasticity), generating a dyspnea from increasedeffort of breathing, as well as decreased gas exchange from the interstitialfibrosis. |
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Idiopathic pulmonary fibrosis (IPF): Crone's definition |
Idiopathic pulmonary fibrosis (IPF) generatespatchy, progressive, and bilateral interstitial fibrosis. In contrast to normalepithelial repair, in IPF there is an abnormal activation of fibroblasts andrelated cells to generate a usual interstitialpneumonia (UIP) and fibroblastic foci that can lead to honeycombfibrosis and ultimately respiratory failure. |
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Pneumoconiosis: translate |
Pneumo - air/lung conio - dust Breathing in dust (particles) |
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Pneumoconiosis: Crone's definition |
A pneumoconiosis is a lung disease induced by particulates. The most common involve coaldust, silica, and asbestos. The problem involves particles that are 1 to 5micrometers across…small enough to reach distal airways, such as alveolarbifurcations, and thereby generate a response from local alveolar macrophages. |
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Asbestosis: Crone's definition |
1. asbestos fibers will 2. trigger a macrophage response that leads to 3. interstitial fibrosis, and notably, 4. pleural involvement. While parietal pleural plaques of asbestosis may be asymptomatic, a possible (rare) outcome is mesothelioma. |
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Mesothelioma: Crone's definition |
Mesothelioma is a slow-progressing but deadlydisease, as the asbestos fibers persist and will trigger ongoing damage andinflammatory response. |
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Hypersensitivity pneumonitis: Crone's definition |
Hypersensitivity pneumonitis (allergicalevolitis) will typically generate a restrictive lung disease (withcough)-type response to the allergen; note the interstitial granulomas.Thesecan either present as acute (< 8 hour) disease, or with ongoing exposure tothe allergen, a chronic condition. |
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Diffuse alveolar hemorrhage syndromes: Crone's definition |
Diffuse alveolar hemorrhage syndromes areimmune-mediated conditions that have a triad of hemoptysis, anemia, and diffusepulmonary infiltrates. These can run the gamut from Goodpasture syndrome, wherethere is a type II hypersensitivity from antibodies formed against basementmembrane collagen in the lungs and kidneys, to granulomatosis with polyangiitis(GPA; Wegener granulomatosis) of a medium-to-small vasculitis started by cell-mediated (type IV) hypersensitivity,and “complemented” with ANCAs (anti-neutrophil cytoplasmic antibodies) oncepreviously hidden antigens from the neutrophils are exposed. Note thehemosiderin-laden macrophages in the alveoli following the hemorrhage. |
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Sarcoidosis: Crone's definition |
SARCOIDOSIS is a multisystem disease in which there isgeneration of NONCASEATING GRANULOMAS in affected organs (lungs in 90% ofpatients). While the underlying etiology is still unknown, the presence ofgranulomas and the widespread other effects suggest immunological activitiesdriven by Th1 cells. Granulomasare formed (giant cell, epith cells, T1 lymph cheering on macrophages inmiddle…)Noproduction of TNF to break down center of granuloma. Hence, caseating. Can Alsoget uviitis, erethema nodosum (hypersens. To fat cells. Results in subQ lumpy. |
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Pulmonary HTN: Primary vs Secondary |
Primary: inappropriate proliferation of endothelial cells ("nexus") Secondary: Response to other Dz. endothelial activation (e.g. from Lung Dz, Recurrent Emboli, or HF) causes increased inward layering and intrusion, obstructing blood flow. |
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Lung defense mechanisms |
1. MECHANICAL turbinates, nose hairs 2. INNATE cilia & mucus ladder, entrapping mucus glands, macrophages 3. ADAPTIVE Antibodies IgG most common in blood&tissues; enters through permeable endothelium-- & IgA enters via secretions; aggregates pathogens to facilitate expulsion i.e. coughing |
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Pneumonia: definition and two major patterns of bacterial pneumonias |
Definition: lung inflammation caused byinfection. bronchopneumonia: patchy distribution as bronchi/bronchioles get infected and the infection extends to alveoli lobar pneumonia: exudate fills the alveoli of a segment/lobe *Pneumococcus respects anatomical structure |
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Lung access: Crone definition |
Localized suppurative necrosisgenerating a cavity, e.g., from aspiration of mixed oral flora or fromdestructive bacteria such as staph or the Gram negative rod Klebsiella pneumoniae. *Abcess is a protease, and proteases don't respect anatomical structure (i.e. distorts) |
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TB: 1. Pathology 2. Recurrence Imaging patterns 3. Buzzwords |
1. Pathology: Mycobacterium tuberculosis. Aprimary infection notes how the TB organism can proliferate in thephagolysosome of a macrophage, and only with the help of Th1 cells can anappropriate type IV hypersensitivity (delayed-typehypersensitivity, a major example of cell-mediatedimmunity) response be generated to activate the macrophage sufficientlyto kill the pathogen and in the process, lead to the caseating granuloma. 2. Withloss of immunity, e.g., age, malnutrition, AIDS, the TB may reactivate andprogress. Miliary TB is the term used forwidespread hematogenous spread of TB. 3. Caseating: Think TB. Non-Caseating: Think granulomas |
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PCP |
Pneumocystis jiroveci is alsoclassified as a fungus, although it behaves more like a protozoan. Inimmunocompromised individuals with low Th1(CD4) counts (ie <200 cells/mL), thereis an ineffective (non-eliminating) immune response, triggering the “GROUND GLASS” appearance of an exudative alveolitis on chest x-ray. "Ground glassappearance" == buzzword! |
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Most common type of lung cancer |
95% ofprimary lung cancers are carcinomas(malignant neoplasms derived from epithelia). Lung canceris the number one cause of cancer death for both men and women in the US. |
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Differences b/w Small Cell carcinoma and Non-small cell carcinomas |
Small cell (SCLC):
Non-small cell carcinomas (NSCLC)
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Apical tumor: nickname and presentation |
Apical (Pancoast) tumors involve brachial plexus or sympathetic trunk and generate an ipsilateral Horner's Syndrome. |
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Laryngeal papillomas |
benign neoplasms caused by HPV (Human papillomavirus) and can typically recur. |
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laryngeal carcinoma |
almost always squamous cell carcinoma with smoking and drinking as significant riskfactors. The tumor location matters: if in the glottis, then will develophoarseness early, whereas the supraglottic tumors have more lymphatic chancesto spread, and the subglottic tumors can become extensive before presentingsymptomatically. |
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Examples of inflammation of the larynx that cause hoarseness |
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Examples of lesions of the vocal cords that cause hoarseness |
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Pulmonary Arterial Hypertension: Classes & causes |
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Cor Pulmonale: definition, features |
Cardiac changes related to pull hypertension from lung Dz (Non-Group 2)
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Pulm HTN: |
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