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119 Cards in this Set
- Front
- Back
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What is the most common polyp in adults?
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Allergic nasal polyp
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What is obstructive sleep apnea?
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Excessive snoring with periods of apnea
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What does obstructive sleep apnea cause (2)?
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1) respiratory acidosis
2) hypoxemia |
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What are people with obstructive sleep apnea at increased risk for developing?
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Cor pulmonale
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In sinus infections, the _____ sinus is most commonly affected in adults, whereas the ____ sinus is more commonly affected in children.
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a) maxillary
b) ethmoid |
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What type of organism is the most common cause of sinusitis?
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Viruses
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What is the most common bacterial cause of sinusitis?
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Streptococcus pneumoniae
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What is the most sensitive way to test for sinusitis?
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CT
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What is nasopharyngeal carcinoma associated with?
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EBV
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What is the most common cause of laryngeal carcinoma?
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Smoking cigarettes.
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What type of cancer is laryngeal cancer?
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Squamous cell carcinoma
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Where do laryngeal cancers typically occur?
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On true vocal cords
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What is atelectasis?
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Loss of lung volume due to inadequate expansion of the airspaces.
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Where is surfactant synthesized?
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Type II pneumocytes
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Surfactant synthesis is stimulated by _____ and inhibited by _____.
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a) cortisol
b) insulin |
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What is the major function of surfactant?
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To decrease surface tension in small airways
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What is the most common cause of pulmonary edema?
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Left-sided heart failure
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(True/False) Acute respiratory distress syndrome (ARDS) is a form of noncardiogenic pulmonary edema resulting from acute alveolar-capillary damage.
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True
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What is the most common cause of ARDS?
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Sepsis
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In ARDS, what cell type causes damage to type I and type II pneumocytes?
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Neutrophils
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What is the most common cause of typical community-acquired penumonia?
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Streptococcus pneumoniae
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What is bronchopneumonia?
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Acute bronchitis with local extension into parenchyma.
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The typical sign of pneumonia is ______, which is due to an alveolar exudate.
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Consolidation
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What is the gold standard for diagnosing pneumonia?
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CXR
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(True/False) A positive gram stain is more useful than a culture.
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True
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What is the most common cause of atypical community-acquired pneumonia?
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Mycoplasma pneumoniae
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What is the major distinction between typical and atypical penumonia?
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There are no signs of consolidation in atypical pneumonia.
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What is an important cause of nosocomial pneumonia which can be contracted from respirators?
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Pseudomonas aeruginosa
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What is the most common pathogen causing pneumonia in AIDS patients?
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Pneumocystis jiroveci
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What stain can be used to detect TB?
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Acid-fast
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Does PPD distinguish between active and non-active TB?
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No
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Common locations of primary TB (2).
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1) upper part of lower lobes
2) lower part of upper lobes |
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What is a Ghon complex?
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A calcified focus of pulmonary infection and an involved hilar lymph node.
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Where does reactivation TB usually occur?
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Upper lobe cavitary lesions.
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What is the most common extrapulmonary site for TB?
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Kidneys
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Adrenal involvement of TB may result in _______ disease.
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Addison's
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What is the most commmon form of mycobacterium infection in patients with AIDS?
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Mycobacterium avium-intracellulare complex (MAC)
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How will lung abscesses appear on a CXR?
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Cavitation with air/fluid level
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What is the most common cause of a lung abscess?
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Aspiration of oropharyngeal material.
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What is the most common sight for a lung abscess?
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Superior segment of the right lower lobe b/c it is most common site for aspiration.
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Why are lungs relatively protected from infarction by thromboemboli?
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Because of redundant blood supply from bronchial arteries.
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Where do bronchial arteries arise (2)?
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1) Aorta
2) Intercostal arteries |
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What type of thromboembolus may cause sudden death?
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Saddle embolus
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What are the main causes of secondary pulmonary hypertension (2)?
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1) respiratory acidosis
2) hypoxemia |
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What is the most common symptom of patients with pulmonary hypertension?
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Dyspnea on exertion
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What two findings are present in patients with cor pulmonale?
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1) pulmonary hypertension
2) right-ventricular hypertrophy |
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Hemoptysis followed by renal failure is most likely associated with what?
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Goodpasture's syndrome
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What may alveolitis eventually lead to?
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Interstitial fibrosis
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In restrictive lung diseases, compliance _______ and elasticity _______.
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a) decreases
b) increases |
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In restrictive lung disease, what happens to the FEV1/FVC ratio?
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It remains unchanged b/c both FEV1 and FVC decrease proportionally.
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What causes pneumoconiosis?
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Inhalation of mineral dust
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What type of pigment accumulates in interstitial tissue and hilar nodes of patients with coal worker's pneumoconiosis?
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Anthracotic pigment
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What are dust cells?
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Alveolar macrophages with anthracotic pigment.
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What may coal worker's pneumoconiosis progress to?
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Black lung disease
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(True/False) Patients with black lung disease are not at increased risk for developing lung cancer or TB.
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True
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What is the most common occupational lung disease?
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Silicosis
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Opacities in biopsies of patients with silicosis contain _____ and _____.
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a) collagen
b) quartz |
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What does silicosis cause in the hilar lymph nodes?
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"egg-shell" calcification
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(True/False) Patients with silicosis are not at increased risk for developing lung cancer or TB.
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False
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What are ferruginous bodies?
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Iron-coated asbestos fibers
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(True/False) Benign pleural plaques are the most common lesions seen in asbestosis.
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True
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What two diseases may arise from asbestosis?
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1) Malignant mesothelioma
2) Bronchogenic carcinoma |
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What does berylliosis predispose to?
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Lung cancer
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What is the most common non-infectious granulomatous disease of the lung?
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Sarcoidosis
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What causes sarcoidosis?
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CD4 t-cells interacting with unknown antigen
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What is a characteristic microscopic finding of sarcoidosis?
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Non-caseating granulomas
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What organ systems manifest lesions due to sarcoidosis (4)?
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1) lung
2) skin 3) eyes 4) liver |
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(True/False) Sarcoidosis is a diagnosis of exclusion.
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True
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What is a common growth appearance of the lung in patients with idiopathic pulmonary fibrosis?
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Honeycomb lung
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What are three causes of collagen vascular disease with interstitial fibrosis?
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1) Systemic sclerosis
2) SLE 3) Rheumatoid arthritis |
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What is the major antigen responsible for farmer's lung?
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Thermophilic actinomyces in moldy hay
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What types of hypersensitivity are associated with farmer's lung (2)?
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1) Type III (immune complex-mediated)
2) Type IV (granulomatous inflammation) |
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What causes silo filler's disease?
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Inhalation of gasses (nitrogen oxides) derived from plant material.
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List four drugs which may cause interstitial fibrosis.
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1) amiodarone
2) bleomycin 3) cyclophosphamide 4) methotrexate |
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What is the most common cause of emphysema?
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Cigarette smoking
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In emphysema, lung compliance ______ (increases/decreases) and elasticity ______ (increases/decreases).
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a) increases
b) decreases |
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Cigarette smoke is chemotactic to _______.
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neutrophils
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What type of tissue is damaged in emphysema?
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Elastic tissue
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What is affected in centriacinar emphysema?
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Distal terminal bronchioles and respiratory bronchioles.
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What is affected in panacinar emphysema?
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Distal terminal bronchioles and the entire respiratory unit.
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What are some common CXR findings for patients with emphysema (4)?
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1) hyperlucency
2) increased AP diameter 3) vertically oriented heart 4) depressed diaphragms |
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What happens to the total lung capacity in patients with emphysema?
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It increases.
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What happens to the FEV1/FVC in patients with emphysema?
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It decreases (~33%)
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What happens to the arterial CO2 in patients with emphysema?
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It decreases causing respiratory alkalosis.
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What is the most common cause of chronic bronchitis?
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Smoking cigarettes.
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Definition of chronic bronchitis?
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Productive cough for at least 3 months for 2 consecutive years
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What is the major pathology found in people wit chronic bronchitis?
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Hypersecretion of mucous glands
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What ABG abnormalities are usually seen with chronic bronchitis patients (2)?
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1) respiratory acidosis
2) hypoxemia |
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What causes extrinsic asthma?
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Type I hypersensitivity reaction
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What happens to the anteroposterior diameter of patients with asthma?
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It increases.
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What can be heard on auscultation of patients with asthma?
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Wheezes
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What is bronchiectasis?
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Permanent dilation of bronchi and bronchioles
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What is the most common cause of bronchiectasis in the US? Worldwide?
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1) Cystic fibrosis
2) TB |
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What are two clinical findings in patients with bronchiectasis?
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1) productive cough
2) hemoptysis |
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What is the mode of inheritance for cystic fibrosis?
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Autosomal recessive
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What is the most common geneotype for patients with cystic fibrosis?
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Deletion of F508 in the CFTR gene
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What is the cellular defect in CF?
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Defective CFTR Cl- transporter is degraded in the golgi
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What changes occur in sweat (1) and luminal secretions (2) in patients with CF?
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1) Loss of NaCl in sweat
2) Loss of NaCl in luminal secretions |
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What is the most common cause of death in patients with CF?
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Respiratory infections
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What happens to the pancreas in patients with CF?
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Pancreatic exocrine deficiency causing malabsorption and chronic pancreatitis causing type 1 diabetes
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What is may happen in newborns with CF?
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Meconium ileus leading to rectal prolapse.
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What is the diagnostic test for CF?
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Sweat test
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What is the most common cause of lung cancer?
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Cigarette smoking
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What cancers are centrally located in the lung (2)?
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1) squamous cell carcinoma
2) small cell carcinoma |
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What cancer is located peripherally?
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Adenocarcinoma
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What is the most common lung cancer?
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Metastatic cancer from a primary breast cancer
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Eaton-lambert syndrome. Symptom? Pathology?
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1) muscle weakness
2) antibody against calcium channel |
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What is the most common site for mediastinal masses?
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Anterior compartment
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The most common primary mediastinal masses are ______ tumors, and are located in the ______ mediastinum.
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a) neurogenic
b) posterior |
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The majority of thymomas express systemic symptoms of ______ ______.
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Myasthenia gravis
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What is the most common overall cause of pleural effusions?
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Congestive heart failure
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A pleural fluid exudate indicates what underlying condition?
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Acute inflammation
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Provide three examples of conditions that can lead to pleural fluid exudates.
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1) infarction
2) pneumonia 3) metastasis |
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What are the characteristics of pleural effusion on CXR (2)?
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1) blunting of the costophrenic angle
2) obscuration of the diaphragm |
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What may cause a secondary spontaneous pneumothorax?
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Emphysema
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What are the clinical findings in a patient with a spontaneous pneumothorax (2)?
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1) sudden onset of dyspnea
2) pleuritic chest pain |
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What is the most common cause of a tension pneumothorax?
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Penetrating trauma to the lungs.
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Why does the pressure build up so high in a tension pneumothorax?
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Because the trauma creates a pleural tear that acts like a one way valve, opening during inspiration and flapping closed on expiration.
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What is a clear physical finding on a patient with a large pneumothorax?
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Deviation of trachea to contralateral side.
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