First Aid Resp - Path

Front 1

What is the hallmark PFT in obstructive lung disease?

Back 1

Decreased FEV1/FVC ratio

Front 2

What is the general pathophys behind emphysema?

Back 2

Enlargement of air spaces and decreased recoil resulting from destruction of alveolar walls.

Front 3

What happens to lung compliance in emphysema?

Back 3

Increases

Front 4

What is done to compensate for emphysema?

Back 4

Exhale through pursed lips to increase airway pressure and prevent airway collapse during exhalation

Front 5

Features of centriacinar emphysema?

Back 5

Distension of respiratory broncholes only; caused by smoking

Front 6

Features of panacinar emphysema?

Back 6

Distension of entire respiratory unit; caused by a1-antitrypsin deficiency (also liver cirrhosis)

Front 7

What is paraseptal emphysema?

Back 7

Localized emphysema in subpluera targeting alveolar ducts and alveoli. Not an obstructive airway disease

Front 8

What is paraseptal emphysema associated with, can it result in, and who is it most common in?

Back 8

Assoc with bullae that can rupture and result in spontaneous pneumothroax. Often occurs in young, otherwise healthy males

Front 9

What is the criteria to dx Chronic Bronchitis?

Back 9

Productive cough for > 3 consecutive months in > or equal to 2 years.

Front 10

Pathogenesis of chronic bronchitis

Back 10

Hypertrophy of mucus secreting glands in the bronchioles. Causes: cigarettes and cystic fibrosis

Front 11

What is the Reid index?

Back 11

Gland depth / total thickness of bronchial wall; in COPD, Reid index > 50%

Front 12

Early/late onset hypoxemia or dyspnea: Chronic bronchitis vs. emphysema

Back 12

Chronic bronchitis: early onset hypoxemia due to shunting, late onset dyspnea; Emphysema: early onset dyspnea, late onset hypoxemia (due to eventual loss of alveolar walls and eventual loss of capillary beds)

Front 13

What are Curschmann's spirals?

Back 13

Shed epithelium from spiral shaped mucous plugs that are found in asthma

Front 14

What is bronchiectasis?

Back 14

Destruction of cartilage and elastic tissue in lungs from chronic necrotizing infection of bronchi leading to permanently dilated airways, cupfuls of purulent sputum, hemptysis

Front 15

What are the findings of PFTs in restrictive lung diseases?

Back 15

Decreased lung volumes (dec FVC and TLC) and FEV1/FVC ratio > .8

Front 16

Surfactant is made by type II pneumocytes most abudnantly when?'

Back 16

35th week of gestation\

Front 17

What are the risk factors for neonatal respiratory distress syndrome?

Back 17

Prematurity, maternal diabetes (elevated insulin), cesarean delivery (decrease release of fetal glucocorticoids)

Front 18

What are the treatments for neonatal respiratory distress syndrome?

Back 18

Maternal steroids before birth; artificial surfactant for infant

Front 19

Is ARDS responsive to O2 therapy?

Back 19

No

Front 20

What are the 2 most common causes of ARDS?

Back 20

G- sepsis (40%) and Gastric aspiration (30%)

Front 21

What is the pathogenesis of ARDS?

Back 21

Acute injury to alveolar cause alveolar macrophages and other cells to release cytokines that are chemotactic to neutrophils --> increase alveolar capillary permeability --> protein rich leakage into alveoli. Reuslts in formation of intra-alveolar hyaline membrane. Initial damage due to neutrophilic substances toxic to alveolar wall, activation of coagulation cascade, or oxygen derived free radicals.

Front 22

In abestosis, what is the histopathologic finding and how do they form?

Back 22

Ferruginous bodies in lung (abestos fibers coated with hemosiderin) - Macrophages phagocytose abestos and coat fibers with ferritin; Ivory white plaques in pleura and dome of diaphragm

Front 23

What does abestosis increase the risk of?'

Back 23

Increase risk of bronchogenic cancer (smoking increases risk further) + Increase risk of mesothelioma (smoking does not add to risk)

Front 24

What type of tracheal deviation is seen in bronchial obstruction?

Back 24

Towards the side of the lesion

Front 25

Resonance and fremitus in lobar pneumonia

Back 25

Resonance: dullness. Increased fremitus

Front 26

Resonance and fremitus in tension pneumothorax

Back 26

Hyperresonant. Absent fremitus

Front 27

Which lung cancer is most common in smokers?

Back 27

Squamous cell carcinoma

Front 28

Which lung cancer releasese PTHrP?

Back 28

Squamous cell caqrcinoma

Front 29

What are the histologic features of squamous cell carcinoma?

Back 29

Keratin pearls and intercellular bridges

Front 30

What is the location and characteristics of squamous cell carcinoma?

Back 30

Central location; Hilar mass arising from bronchus; cavitation; clearly linked to smoking

Front 31

What is the location of adenocarcinoma of the lung?

Back 31

Peripheral

Front 32

What are the characteristic differences between bronchial and bronchioloalveolar adenocarcinomas of the lung?

Back 32

Bronchial: develops in site of prior pulmonary inflammation or injury (most common lung cancer in nonsmokers and females) Bronchioalveolar: not linked to smoking; grows along airways; can present like pneumonia

Front 33

What lung cancer is the most common in nonsmokers and females?

Back 33

Bronchial adenocarcinoma

Front 34

What is the xray finding for adenocarcinoma of the lung?

Back 34

Multiple densities

Front 35

Which lung cancer may lead to Lambert-Eaton syndrome?

Back 35

Small cell (oat cell) carcinoma

Front 36

What lung cancer is associated with ectopic production of ACTH or ADH?

Back 36

Small cell (oat cell) carcinoma

Front 37

what is the location of Small cell carcinoma of the lung? What is it's growth characteristics?

Back 37

Central; undifferentiated and very aggressive

Front 38

What are Kulchitsky cells?

Back 38

Small dark blue neuroendocrine cells that are found in small cell carcinomas of the lung

Front 39

Which lung cancer is responsive to chemotherapy?

Back 39

Small cell carcinoma (oat cell)

Front 40

What is the location of large cell carcinomas of the lung?

Back 40

Peripheral

Front 41

What are the characteristics of large cell carcinoma of the lung?

Back 41

Highly anaplastic undifferentiated tumor; poor prognosis; less responsive to chemo.

Front 42

How are large cell carcinomas of the lung treated?

Back 42

Remove surgically

Front 43

Histology of large cell carcinoma

Back 43

Pleomorphic giant cells with leukocyte fragments in cytoplasm

Front 44

What are the three signs of Horner's syndrome and what neoplasia is it associated with?

Back 44

Ptosis, miosis, anhidrosis: Pancoast's tumor

Front 45

Organism responsible usually for lobar pneumonia

Back 45

Pneumococcus

Front 46

S. aureus, H. flu, Klebsiella, S. pyogenes are responsible for which type of pneumonia?

Back 46

Bronchopneumonia

Front 47

What organisms are responsible for atypical pneumonia?

Back 47

Viruses (RSV, adenoviruses), Mycoplasma, Legionella, Chlamydia

Front 48

What are the three types of pleural effusions?

Back 48

Transudate, exudate, lymphatic

Front 49

What causes transudate pleural effusions?

Back 49

CHF, nephrotic syndrome, or hepatic cirrhosis (decreased protein content)

Front 50

What causes exudative pleural effusions?

Back 50

Malignancy, pneumonia, collagen vascular disease, trauma (Increased protein content, in states of increased vascular permeability)

Front 51

Which of the three pleural effusions must be drained becuase of risk of infection:;

Back 51

Exudative

Front 52

Whcih of the three pleural effusions has increased triglyceride content?

Back 52

Lymphatic

Front 53

In asthma, which are louder, expiratory or inspiratoyr wheezes?

Back 53

Expiratory (obstructive)

Front 54

What are charcot-leyden crystals?

Back 54

Crystalline granules in eosinophils that are histologically found in asthma