Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
173 Cards in this Set
- Front
- Back
|
Where are aspirations more likely to occur in the bronchus?
|
Right main bronchus because it's straighter
|
|
|
What does the trachea have that allows it to provide structure and support?
|
C-rings of catilage
|
|
|
Is catilage present in the bronchioles?
|
No cartilage but does have an incomplete ring of smooth muscle
|
|
|
What structure contains cartilage and submucosal glands?
|
The bronchus
|
|
|
What structure contains columnuar and cuboidal epithelium and smooth muscle?
|
Bronchioles
|
|
|
What structure contains pneumocytes?
|
Alevolus
|
|
|
What type of pneumocytes does the alveolus contain
|
Type 1 and Type 2
|
|
|
Where does gas exchange take place in the lung?
|
Alveolus
|
|
|
What are the cellular components of the alveolus?
|
Surface alveolar lining cells (Type 1 and Type 2 pneumo)
Capillary endothelial cells Occassional intersitial cells and alveolar macrophages |
|
|
What is the most common type of tracheoesphageal fistula?
|
Blind esophagus with a distal tracheoesophageal fistula
|
|
|
What is a Congenital Foregut cyst?
|
Detached section of maldeveloped foregut
|
|
|
Where is the congenital foregut cyst located?
|
At the mediastinal and hilar location
|
|
|
Is a congenital foregut cyst connected to the airways?
|
No
|
|
|
What is a congenital foregut cyst usually lined with?
|
Respiratory epithelium
|
|
|
How does a congenital foregut cyst typically present?
|
As a mass or incidental finding--possibly in adulthood
|
|
|
What is a congenital cystic adenomatoid malformation (CPAM)?
|
Hamartomatous lesion--abnormal bronchiolar structure
|
|
|
Is a Bronchopulmonary sequestration connected to the airway?
|
No
|
|
|
Where does the blood supply come from in a bronchopulmonary sequestration?
|
Systemic arteries
|
|
|
What are the two types of bronchopulmonary sequestrations?
|
Extralobar and Intralobar
|
|
|
What is extralobar?
|
Found in thorax or mediastinum external to the lung--usually diagnosed as mass lesions
|
|
|
What is intralobar?
|
Within the lung and associated with recurrent local infection and or bronchiectasis--Most likely an acquired lesion
|
|
|
What side is bronchopulmonay sequestration usually seen on?
|
The left side
|
|
|
Which type of bronchopulmonary sequestration do we see later in childhood or adulthood?
|
Intralobar
|
|
|
What is atelectasis?
|
A collapsed lung
|
|
|
What are the types of atelectasis?
|
Acquired collapse (adult) or incomplete expansion (neonatal)
|
|
|
What are the 3 type of acquired collapse in the adult?
|
Resorption
Compression Contraction |
|
|
What is a resportion collapse usually caused by?
|
Airway obstruction--mucus, foreign body, or tumor
|
|
|
Which way is the mediastinal shift in a resporption collapse?
|
Mediastinal shift towards
|
|
|
What is a compressions collapse usually caused by?
|
Secondary to external pressure--usually in the pleural cavity or elevated diaphragm
|
|
|
Which was is the mediastinal shift in a compression collapse ?
|
Mediastinal shift away
|
|
|
What is a contraction collapse usually caused by?
|
Fibrosis--irreversible and bilateral
|
|
|
What type of collapse is a tension pneumothorax?
|
Compression atelectasis--usually due to trauma
|
|
|
What are the two types of pulmonary edema?
|
Hemodynamic (most common) and microvascular (alveolar) injury
|
|
|
What is hemodynamic pulmonary edema usually caused by?
|
Increased hydrostatic pressure due to left sided heart failure
|
|
|
What are heart failure cells?
|
Marcophages with iron in them
|
|
|
What is microvascular injury pulmonary edema usually caused from?
|
Fluid leaking into alveolar space--infection, toxin, etc.
|
|
|
Which type of pulmonary edeam is more likely to lead to ARDS?
|
Microvascular injury
|
|
|
What is the hydrostatic and oncotic pressures in pulmonary edema?
|
Increased and decreased respectively
|
|
|
What is the vasuclar permeability in pulmonary edema?
|
Increased
|
|
|
What is coal worker's pneumoconiosis also referred to?
|
"Black lung"
|
|
|
What is Silicosis?
|
Slowly progressive--Silica ingested by macrophages and kills; inflammatory response with release of TNF
|
|
|
What is the most prevalent chronic occupational disease in the world?
|
Silicosis
|
|
|
Who is affected by silicosis?
|
Sandblasters and miners
|
|
|
If a fibrotic nodule is found in the lung, what should you do?
|
Look under light microscopy--silica particles light up
|
|
|
What is asbestos related disease?
|
Fibrotic lung disease that begins in the lower lobe
|
|
|
What is the typical finding in asbestos related disease?
|
Pleural plaque
|
|
|
What does a biopsy of an asbestos exposed lung typically reveal?
|
Amphibole fibers--accumulation of iron
|
|
|
What do you need to see to be able to diagnose asbestos related disease?
|
Asbestos (iron) bodies--looks like a baton
|
|
|
What is Sarcoidosis?
|
Systemic disease--mostly pulmonary--of unknown origin characterized by the formation of numerous non-caseating granulomas
|
|
|
How should sarcoidosis be diagnosed?
|
By exclusion--rule out everything that can cause granulomas
|
|
|
What is a common finding in sarcoidosis?
|
Bilateral pulmonary lymphadnopathy
|
|
|
Who is mostly affected by sarcoidosis?
|
Women
|
|
|
What is the CD4 and IL-2 count in sarcoidosis?
|
Increased CD4 and Increased IL-2
|
|
|
What organs are affected in sarcoidosis?
|
Lung, lymph nodes, spleen, liver, bone marrow, skin, eyes, salivary glands, muscle
|
|
|
What is a better prognosis for sarcoidosis?
|
Hilar lymph node involvement only--much better than lung and lymph node involvement
|
|
|
What bodies are characteristic of sarcoidosis?
|
"Asteroid and Schaumann body"
|
|
|
What is hypersensitivity pneumonitis?
|
Hypersensitivity reaction to offending agent--OCCURS AT THE ALVEOLAR LEVEL
|
|
|
Why is it critical to take a good history on a patient with hypersensitivity pneumonitis?
|
Because removal of an envirnomental agent can spare serious fibroitc lung disease
|
|
|
What type of granulomas are seen in hypersensitivity pneumonitis?
|
Noncaseating granulomas in distal lung
|
|
|
What is desquamative interstitial pneumonia (DIP)?
|
Large collections of macrophages in alveoli--minimal fibrosis
|
|
|
Who is more affected by DIP?
|
Males greater than 50
|
|
|
What is DIP usually caused by?
|
Smoking
|
|
|
Is DIP treatable?
|
Yes--steroids and cessation of smoking
|
|
|
What is Histiocytosis?
|
Proliferation of dendritic cells in response to smoking
|
|
|
What type of cell is histocytosis full of?
|
Eosinophils
|
|
|
What is pathognomonic for histiocytosis?
|
Birbeck granule
|
|
|
What is RBILD?
|
Pigmented macrophages in bronchioles--common in smokers
|
|
|
What is Pulmonary Alveolar Proteinosis?
|
Accumulation of acellular surfactant in the intra-alveolar and bronchiolar spaces
|
|
|
Who is usually affected by PAP?
|
Middle aged (20-50)
|
|
|
What is the treatment for PAP?
|
Pulmonary lavage
|
|
|
What is the most common type of PAP?
|
Acquired--idiopathic--variable course
|
|
|
What is a pulmonary embolism?
|
A thrombus that most often originates in the lower leg that becomes mobile
|
|
|
What is a pulmonary embolus most often a cause of?
|
Sudden death
|
|
|
What increases the risk of a pulmonary embolus?
|
Sitting for a long time
Hypercoaguable states BCP |
|
|
What are other types of emboli?
|
Fat
Air Nitrogen Tumor Amniotic Fluid |
|
|
What is a fat embolus most often a result of?
|
Trauma
|
|
|
What is pulmonary hypertension?
|
Increased pressure in a low pressure system--can be primary or secondary
|
|
|
What causes primary pulmonary hypertension?
|
Idiopathic--94% of the time
(6% familial) |
|
|
What is the mutation in primary pulmonary hypertension?
|
BMPR2--normally codes for inhibition of smooth muscle
|
|
|
Is there a mutation involved with secondary pulmonary hypertension?
|
No--caused by a normal reaction of pulmonary arteries to increased pressure
|
|
|
What is Good Pasture Syndrome?
|
Autoimmune--antiboides to basement membrane
|
|
|
What type of symptoms do patients with Goodpasture's have?
|
Pulmonary and renal symptoms--Hemoptosis and Hematuria
|
|
|
What is the most common cause of death in Goodpasture's patients?
|
Renal failure
|
|
|
What 3 things need to be present for a diagnosis of Wegener granulomatosis?
|
Granulomas of lung arteries
Inflammation of URT Glomerulonephritis |
|
|
Who is typically affected by Goodpasture's syndrome?
|
Young patients--Males more than females
|
|
|
Who is typically affected by Wegener's?
|
Males in the 5th decade
|
|
|
What are the two types of bacterial pneumonia?
|
Bronchopneumonia and lobar pneumonia
|
|
|
What is the predominate type of bacterial pneumonia?
|
Bronchopneumonia
|
|
|
What part of the lung does Bronchopneumonia involve? Lobar pneumonia?
|
Broncho--involves whole lung bilaterally
Lobar--only involves one lobe |
|
|
What is the typical cause of lobar pneumonia?
|
Strep pneumo
|
|
|
What is the most important thing to determine first in bacterial pneumonia?
|
What is the organism
|
|
|
What are the stages of pneumococcal lobar pneumonia?
|
Congestion--hyperemia
Red hepatization Gray hepatization Fibrosis |
|
|
What is a pulmonary abcess?
|
A collection of neutrophils
|
|
|
What is the most common cause of a pulmonary abcess?
|
Staph aureus and many gram negatives
|
|
|
What is the #1 sequelae of pulmonary abcess?
|
Aspiration
|
|
|
What is seen in TB primary infection?
|
Gohn complex--located at the hilum of the lung
|
|
|
What is a Gohn complex called once it is healed?
|
A Ranke complex
|
|
|
Where does TB go in a reactivation or secondary TB?
|
Apical because of the high O2 content
|
|
|
What is almost always present in secondary TB?
|
Granulomas
|
|
|
What is miliary TB?
|
Occurs when tubercle erodes into a vessel
|
|
|
Where is miliary TB classically seen?
|
In the kidney and the lung
|
|
|
In what population may TB seen without granuloma formation?
|
HIV--M. avium common causative organism
|
|
|
What chronic pneumonia presents with a coin like lesion and is seen in the Ohio River Valley?
|
Histoplasma
|
|
|
Where is coccidiodes immitus often seen?
|
Southwest US
|
|
|
Where is blastomycosis typically seen?
|
Central southeast
|
|
|
How does blastomycosis look histologically?
|
Broad budding yeasts
|
|
|
Who is at risk for contracting PCP, CMV, Aspergillus and Candida?
|
HIV and immunocompromised patients
|
|
|
How does aspergillus typically appear histologically?
|
Fungal balls
|
|
|
What type of tumors occur very commonly in the lung?
|
Mestatic tumors
|
|
|
What is the most common cause of death?
|
Primary lung tumors
|
|
|
What is the leading cause of cancer deaths in men and women?
|
Lung cancer
|
|
|
What is the second most common cancer in both genders in the US?
|
Lung cancer
|
|
|
What are the risk factors for lung cancer?
|
SMOKING--accounts for up to 90% of all lung cancer deaths
Environmental Genetics |
|
|
What are the signs and symptoms of lung cancer?
|
Pain
Hemoptysis Weight loss Underlying chronic lung disease symptoms |
|
|
Where do most lung cancers develop?
|
Centrally
|
|
|
What is the most common lung cancer with a high correlation to smoking?
|
Squamous Cell Carcinoma
|
|
|
Where is SCC of the lung located?
|
Central, endobronchial growth
|
|
|
What are the precursor lesion to SCC of the lung?
|
Metaplasia
Dysplasia CIS |
|
|
What is frequently seen in SCC of the lung?
|
Keratinization--Kertain pearls
|
|
|
What paraneoplastic effect does SCC of the lung have?
|
Hypercalcemia
|
|
|
What type of lung cancer has blue cells all clumped together on a histological slide?
|
Small cell carcinoma of the lung
|
|
|
What type of carcinoma has keratin pearls?
|
Squamous cell carcinoma of the lung
|
|
|
What type of lung cancer involves glandular tissue?
|
Adenocarcinoma
|
|
|
What type of lung cancer involves "a complete mess?"
|
Large cell carcinoma
|
|
|
What is the most common lung cancer in women and non-smokers?
|
Adenocarcinoma
|
|
|
Where is adenocarcinoma of the lung located?
|
Peripherally
|
|
|
What is a common product of Adenocarcinoma?
|
Mucin
|
|
|
What can predispose you to a risk of developing Adenocarcinoma of the lung?
|
Scar formation--"Scar Carcinoma"
|
|
|
What is a subtype of adenocarcinoma that can be confused with other pulmonary diseases?
|
Bronchioalveolar Carcinoma
|
|
|
Where is brochioalveolar carcinoma usually found in the lung?
|
Peripheal--may be multifocal/lobar and diffuse
|
|
|
Where do bronchioalveolar carcinomas like to grow?
|
Along the alveolar septa
|
|
|
Where are most smoking related tumors located?
|
Centrally
|
|
|
How does large cell carcinoma appear histologically?
|
Undifferentiated--a big mess
|
|
|
What percentage of large cell carcinomas are neuroendocrine?
|
A small percentage
|
|
|
What is small cell carcinoma most likely a cause of?
|
SMOKING!!!! (99% are smokers)
|
|
|
What is the first step of management of small cell carcinoma of the lung?
|
Chemotherapy--very aggressive--poor prognosis--assume metastisis
|
|
|
What origin is small cell carcinoma of the lung?
|
Neuroendocrine origin
|
|
|
Do small cell carcinomas have paraneoplastic effects?
|
Yes
|
|
|
What mutations are common in small cell carcinoma?
|
p53, RB, bcl-2
|
|
|
Where do small cell carcinomas frequently arise?
|
Just under the epithelium--need a full thickness biopsy
|
|
|
What is a T1 stage?
|
<3 cms
No pleura/main stem |
|
|
What is a T2?
|
>3 cms or main stem
|
|
|
What is a T3?
|
Local extension
|
|
|
What is a T4?
|
Regional extension, malignant pleural effusion
|
|
|
What is N1?
|
Ipsilateral hilar/peribronchial node involvment
|
|
|
What is N2?
|
Ipsilateral mediastinal/subcarinal
|
|
|
What is N3?
|
Contralateral
|
|
|
What is M1?
|
Distant metastisis
|
|
|
What is stage 1?
|
T1 or T2
No nodal involvement No metastisis |
|
|
What is stage 2?
|
T1, 2, or 3
N0, 1 No metastisis |
|
|
What is stage 3?
|
T1, 2, or 3
N2 No metastisis OR Any T N3 No metastisis OR T4 Any nodes No metastisis |
|
|
What is stage 4?
|
Any T
Any nodes Distant metastisis |
|
|
What type of lung cancer has the worst prognosis?
|
Small cell carcinoma--very small amount make it 2 years
|
|
|
What is type of cancer has the best 5 year survival rate?
|
Non small cell carcinoma, Stage 1 (47%)
|
|
|
What are the types of non small cell carcinoma?
|
Adenocarcinoma
Squamous cell carcinoma Large cell carcinoma |
|
|
Where are common site of metastisis of lung cancer?
|
Regional nodes
Adrenal glands Liver Brain Bone |
|
|
Where does the lung receive metastisis from?
|
Breast
GI Sarcomas Melanoma |
|
|
What are the most common type of pleural neoplasms?
|
Metastatic--especially lung and breast
|
|
|
What is an example of a pleural neoplasm?
|
Malignant Mesothelioma
|
|
|
What is N2?
|
Ipsilateral mediastinal/subcarinal
|
|
|
What is N3?
|
Contralateral
|
|
|
What is M1?
|
Distant metastisis
|
|
|
What is stage 1?
|
T1 or T2
No nodal involvement No metastisis |
|
|
What is stage 2?
|
T1, 2, or 3
N0, 1 No metastisis |
|
|
What is stage 3?
|
T1, 2, or 3
N2 No metastisis OR Any T N3 No metastisis OR T4 Any nodes No metastisis |
|
|
What is stage 4?
|
Any T
Any nodes Distant metastisis |
|
|
What type of lung cancer has the worst prognosis?
|
Small cell carcinoma--very small amount make it 2 years
|
|
|
What is type of cancer has the best 5 year survival rate?
|
Non small cell carcinoma, Stage 1 (47%)
|
|
|
What are the types of non small cell carcinoma?
|
Adenocarcinoma
Squamous cell carcinoma Large cell carcinoma |
|
|
Where are common site of metastisis of lung cancer?
|
Regional nodes
Adrenal glands Liver Brain Bone |
|
|
Where does the lung receive metastisis from?
|
Breast
GI Sarcomas Melanoma |
|
|
What are the most common type of pleural neoplasms?
|
Metastatic--especially lung and breast
|
|
|
What is an example of a pleural neoplasm?
|
Malignant Mesothelioma
|
