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41 Cards in this Set
- Front
- Back
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What is the most common cause of secondary pneumonia?
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S. aureus
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What is a common cause of pneumonia superimposed on COPD?
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H influenza
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Which bacteria is often associated with pneumonia in Cystic Fibrosis patients?
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Pseudomonas aeruginosa
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What is the most common cause of CAP?
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Streptococcus pneumoniae
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What is a common complication of pneumonia caused by Mycoplasma pneumonia?
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Autoimmune haemolytic anemia. IgM is produced against MHC I on RBC causing cold haemolytic anemia.
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What is the most common cause of atypical pneumonia in infants?
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RSV
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Which virus is associated with pneumonia in post-transplant immunosuppressed patients?
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CMV
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What is the differentiating symptom of Coxiella burnetti in regards to pneumonia?
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Causes Q fever (high fever). Usually atypical pneumonias cause low-grade fevers.
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Where is the most likely site of infection with aspiration pneumonia?
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Right lower lobe.
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T/F: Smoking causes panacinar emphysema?
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False - smoking causes centriacinar emphysema that is most severe in the upper lobes
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How is liver cirrhosis a potential consequence of emphysema?
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A1AT (misfolded protein) accumulates in the endoplasmic reticulum of hepatocytes.
PiZZ homozygotes are at significant risk of panacinar emphysema and cirrhosis. |
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Why are emphysema patients known as pink puffers?
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Increases the back pressure to keep airways open. Cartilage and air sacs prevent the sacs from collapsing as the air accelerates through the tree. As the elasticity, and thus the number of air sacs, decreases there is a tendency for the bronchioles to collapse.
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Asthma is usually associated with?
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Allergic rhinitis, ecxema and a family history of atopy.
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Describe the role of:
IL4 IL5 IL10 |
IL 4 = class switch to IgE
IL 5 = attracts eosinophils IL10 = stimulate Th2; inhibits Th1 |
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What are:
Kurshmann spirals? Charcot-Leyden crystals? |
K = spiral-shaped mucus plug
C = Eosinophil derived crystals |
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Describe Kartagener's Syndrome. What is it associated with?
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Inherited defect of the DYNEIN ARM which is necessary for ciliary movement.
Sinusitis Infertility Situs Inversus |
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What does ABPA stand for?
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Allergic BronchoPulmonary Aspergillosis. A hypersensitivity reaction to Aspergillus leading to chronic inflammatory damage, usually seen in asthma and CF.
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Describe the clinical features of pulmonary fibrosis.
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Progressive dyspnea and cough
Fibrosis on lung CT; initially seen in subpleural patches, but eventually results in diffuse fibrosis with end-syage 'honeycomb' lung |
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What are pneumoconiosis?
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Interstitial fibrosis due to occupational exposure. Alveolar macrophages engulf foreign particles and induce fibrosis.
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A systemic disease characterized by noncaseating granuloma in multiple organs.
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Sarcoidosis
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How does sarcoidosis present in the lungs?
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Granulomas most commonly involve the hilar lymph nodes and lung leading to restrictive disease.
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What are often within giant cells of sarcoid granulomas?
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Stellate inclusion (asteroid) bodies
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Which disease is associated with an increased risk of TB and why?
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Silicosis. Silica impairs phagolysosome formation by macrophages.
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Which disease also presents with noncaseating granulomas in the lung, hilar nodes, and systemic organs.
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Berylliosis - HISTORY IS IMPORTANT.
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Which is more common in patients exposed to asbestosis: lung carcinoma or mesothelioma?
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LUNG CARCINOMA!
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What confirms exposure to asbestosis?
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Asbestos bodies: long, golden-brown fibres with associated iron
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What is considered pulmonary hypertension?
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Mean arterial pressure > 25mmHG (normal is 10 mmHg)
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Primary pulmonary HTN is classically seen in:
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Young adult females
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What are the etiologies of secondary pulmonary HTN?
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1. Hypoxemia (COPD + interstitial lung disease)
2. Fluid overload (CHF) 3. Recurrent pulmonary embolism |
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What type of membrane are classically seen in ARDS?
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Hyaline membranes: Protein rich fluid leads to edema and hyaline membranes in the alveoli.
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On CXR, how can you determine with someone is in ARDS?
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White-out
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How do you treat ARDS?
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Treat underlying cause, Ventilation with PEEP (BiPaP)~
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What does a coin lesion indicate?
What is the next step after you find a coin lesion on CXR? |
A coin lesion (solitary nodule) indicates a tumour. The next step is to check previous CXR to determine if lesion is stable or not; new or growing. Biopsy for cancer.
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What are 2 benign presentations of a coin lesion?
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1. Granuloma: TB or fungus (Hittoplasma)
2. Bronchial Hamartoma: benign tumour composed of lung tissue and cartilage |
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SSC is associated with the following three conditions...
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ADH
ACTH (Cushings) Eateon-Lambert syndrome - muscle weakness due to antibodies against calcium channels |
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Which lung cancer is associated with hypercalceuria?
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Squamous cell carcinoma
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What stain do you use to differentiate neuroendocrine cells?
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Chromagranin
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Which lung cancer presents with pneumonia-like consolidation on imaging?
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Bronchioalveolar carcinoma - columnar cells that grow along pre-existing bronchioles and alveoli.
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True or False -
SCC are poorly differentiated on histology |
True!
SCC = poorly differentiated Carcinoid = Well differentiated |
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On histology, which cancer has prominent desmosomes?
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Squamous cell carcinoma - Intercellular bridges (desmosomes)
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What is a common site of metastasis from lung cancer?
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Adrenal gland
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