Pathology Respiratory System

Front 1

What tumor-derived hormones are secreted in paraneoplastic syndrome associated with bronchogenic carcinoma?

Back 1

Parathyroid-like polypeptide (hypercalcemia); ACTH-producing tumor (overstimulation of adrenals-->cushings syndrome); ADH-producing (water retention)

Front 2

Sarcoidosis can affect any organ, but what does it affect especially, according to lecture (according to carranza….blah blah blah)

Back 2

Especially Lungs, thoracic/neck lymph nodes, the skin, salivary glands, and lacrimal gland (dryness)

Front 3

Which chronic lung disease is caused by inhalation of fumes, dust, or particulate matter (inorganic)?

Back 3

Pneumoconioses

Front 4

What is usually the etiology of URTI's (common cold)?

Back 4

Viruses (ie rhinoviruses, coronavirus, RSV, parainfluenza, etc.

Front 5

Moderate hypertension, angina pectoris, congestive heart failure are what ASA type?

Back 5

III

Front 6

Chronic Hypersensitivity pneumonitis is _______ ________, as opposed to acute which is mediated by antigen-antibody complexes.

Back 6

Cell mediated

Front 7

What disease is associated with amyloidosis and recurrent pneumonias?

Back 7

Bronchiectasis

Front 8

What is this process: Airless lung parenchyma due to incomplete expansion of lungs or collapse of previously infiltrated lung

Back 8

Atelectasis

Front 9

Bacterial URTI's are not as common as viral, but when present exhibit what characteristics?

Back 9

PMN's and exudate formation; whitish yellow membranes in throat

Front 10

T or F: a patient with latent TB is not infectious

Back 10

TRUE

Front 11

The type of emphysema caused by Alpha 1-antitrypsin deficiency is called _________ emphysema.

Back 11

Panacinar

Front 12

Dyspnea, Cachexia, Barrel Chest, Cor Pulmonale, Congestive Heart Failure are clinical signs of what disease?

Back 12

Emphysema

Front 13

Bronchitis, Emphysema, or Both: Minimal Sputum

Back 13

Emphysema

Front 14

"Barrel Chest" is a result of what?

Back 14

attempt to increase ventilation

Front 15

Coccidiomycosis, Aspergillosis, or Zygomycosis: Deep fungal lung disease

Back 15

All of them (that better not have tricked you)

Front 16

Coccidiomycosis, Aspergillosis, or Zygomycosis: Especially in diabetics

Back 16

Zygomycosis

Front 17

Bronchitis, Emphysema, or Both: Severe Dyspnea

Back 17

Emphysema (Puffer=dyspnea)

Front 18

The _______ cavity is the space between viseral pleura and parietal pleura (separated by thin layer of fluid)

Back 18

Pleural

Front 19

Cor pulmonale causes _________ heart failure due to __________.

Back 19

Right-sided; Pulmonary hypertension caused by lung disease

Front 20

T or F: Chronic Bronchitis at times is not easily distinguished from Emphysema.

Back 20

True; sometimes they go hand in hand

Front 21

What is the most significant congenital respiratory disease?

Back 21

Tracheo-esophageal fistula

Front 22

What are four examples of congenital respiratory diseases?

Back 22

Tracheo-esophageal fistula, Bronchiogenic cysts, hypoplasia, vascular anomalies

Front 23

What is the name of the disease caused by URTI's?

Back 23

common cold

Front 24

Who is most susceptible to deep fungal lung diseases?

Back 24

Immunosuppressed, AIDS pts, uncontrolled diabetics, transplant pts, etc.

Front 25

Bronchitis, Emphysema, or Both: Hypoxia, Cyanosis, polycythemia (increased rd blood cells)

Back 25

Bronchitis

Front 26

What 3 types of atelectasis are there?

Back 26

Deficiency of surfactant; External compression of lung; resorption of air in lung, distal to an obstruction

Front 27

What is the most common complication of chronic bronchitis?

Back 27

Bronchiectasis

Front 28

In obstructive lung disease, Total lung capacity/forced vital capacity is _______ to ________.

Back 28

Normal to Increased

Front 29

Coccidiomycosis, Aspergillosis, or Zygomycosis: Often in a hospital setting

Back 29

Aspergillosis

Front 30

T or F: Tumors can be associated with bronchiectasis

Back 30

TRUE

Front 31

T or F: Asthma is a reversible airway obstruction.

Back 31

TRUE

Front 32

In obstructive lung disease, there is a _________ in expiratory flow rate.

Back 32

Decrease

Front 33

Cavitary lesions filled with pus.

Back 33

Lung Abscess

Front 34

T or F: Cystic fibrosis can be associated with bronchiectasis

Back 34

TRUE

Front 35

________ obstruction (in obstructive lung disease) is due to narrowing of airway (what disease) or loss of elastic recoil (what disease).

Back 35

Expiratory; asthma; emphysema

Front 36

What is the key element of the massive lung fibrosis that causes pneumoconioses?

Back 36

Alveolar Macrophages

Front 37

In restrictive lung disease, total lung capacity is __________.

Back 37

decreased

Front 38

T or F: A patient with Bronchiectasis presents with bronchi (and/or bronchioli) filled with mucopurulent material; this mucous can be cleared by coughing.

Back 38

First statement true, second statement false

Front 39

Restrictive lung disease is due primarily to either _________ abnormalities or __________ damage.

Back 39

chest wall; parenchymal

Front 40

Bronchitis, Emphysema, or Both: Weight loss

Back 40

Emphysema (cachexia)

Front 41

What two body systems does the ASA (MED) classification emphasize?

Back 41

Cardiovascular and Respiratory

Front 42

A particle that is less than ______ microns in size can enter alveoli, contributing to what disease?

Back 42

5; Pneumoconioses

Front 43

What 2 components of the bronchial wall are primarily involved in asthma? (undergo hyperplasia)

Back 43

Mucous glands (goblet cells); Smooth muscle

Front 44

T or F: Chronic inflammation is part of asthma.

Back 44

TRUE

Front 45

What Antibody is involved in extrinsic asthma?

Back 45

IgE

Front 46

T or F: Sarcoidosis can affect any organ, not just the lungs.

Back 46

TRUE

Front 47

What ASA classification would a patient with mild to moderate systemic disease that does not interfere with day-to-day activity?

Back 47

ASA II

Front 48

What are the 3 main Middle Respiratory tract infections?

Back 48

1. Croup; 2. Epiglottitis, 3. Bronchiolitis

Front 49

What bronchodilators are used to treat asthma?

Back 49

Beta2-agonists; theophyline

Front 50

What clinical significance does multiple asthma medications have?

Back 50

More medications means more severe asthma

Front 51

Is Asthma a restrictive or obstructive lung disease?

Back 51

Usually Obstructive

Front 52

Is asthma considered acute or chronic?

Back 52

Acute (although the underlying process is more chronic)

Front 53

What disease is associated with low grade fever, malaise, fatigue, and clubbing of the fingers?

Back 53

Bronchiectasis

Front 54

What types of medications might patients with bronchitis or emphysema be on? List 5

Back 54

Bronchodilators, corticosteroids, diuretics, alveolar surfactants, antibiotics

Front 55

Greater than __ emergency room visits in the past year are a risk factor for treating a patient with asthma.

Back 55

3

Front 56

3 general types of lesions of the pleura:

Back 56

Inflammatory, traumatic, neoplastic

Front 57

Use of greater than __ beta-agonist canisters per month is a risk factor for asthma patients.

Back 57

2

Front 58

T or F: current use of systemic corticosteroids is a risk factor for asthma pts.

Back 58

TRUE

Front 59

Bronchitis, Emphysema, or Both: Peribronchial fibrosis

Back 59

Bronchitis

Front 60

Sepsis, shock, trauma, pneumonia, toxic lung injury, aspiration of fluids, and blood transfusions can all cause what disease?

Back 60

Acute respiratory distress syndrome

Front 61

What bacteria predominantly causes Lung abscess?

Back 61

S. Aureus

Front 62

Which MRTI is characterized by: acute viral illnes of larynx, especially affects ages 3-5 yrs., loud cough, barking seal (like chase in the mornings)

Back 62

Croup

Front 63

What is the major asthma medication which can cause complications with long term use?

Back 63

Corticosteroids

Front 64

T or F: Anthracosis increases incidence of Tuberculosis.

Back 64

TRUE

Front 65

What four complications can long term use of corticosteroids have?

Back 65

Osteoporosis, immunosuppression, addisonian crisis (secondary adrenal insufficiency), diabetes

Front 66

What fungal disease do all our professors like to talk about since it is widespread in the midwest?

Back 66

Histoplasmosis

Front 67

Increased responsiveness of bronchial tree to various stimuli is ________.

Back 67

asthma

Front 68

If a dental patient with asthma has had no attacks for several years, they are what ASA/MED?

Back 68

II

Front 69

If a dental patient with asthma has occasional attacks managed by bronchodilators they are what ASA?

Back 69

III

Front 70

T or F: In Cor Pulmonale, The Right Ventricle hypertrophies due to congestion in the lungs.

Back 70

TRUE

Front 71

If a dental patient with asthma has many/severe attacks they are what ASA?

Back 71

IV

Front 72

What % of patients with sarcoidosis have elevated ACE (angiotensin Converting Enzyme)?

Back 72

60 % (another percentage baby)

Front 73

T or F: Aspirin is involved in Intrinsic asthma.

Back 73

TRUE

Front 74

Mild hypertension, some forms of diabetes melitus are characteristic of what ASA type?

Back 74

II

Front 75

What medications should you avoid prescribing to asthma patients?

Back 75

Beta blockers, aspirin, sulfites

Front 76

T or F: Croup is extremely life-threatening.

Back 76

FALSE

Front 77

________ abscesses have a fibrous capsule

Back 77

chronic

Front 78

What are the three major chronic obstructive pulmonary diseases (COPD)?

Back 78

Emphysema, Chronic Bronchitis, Bronchiectasis

Front 79

T or F: Many times COPD is a combination of chronic bronchitis and emphysema, not just pinned down to one systemic problem.

Back 79

TRUE

Front 80

Why do patients with bronchiectasis have clubbing of the fingers?

Back 80

It is related to chronic hypoxia.

Front 81

T or F: All patients affected with Acute Respiratory Distress Syndrome die during the acute stage.

Back 81

False. 70% die during this stage, but the remainder progress to a chronic stage, where 10% may survive, and 20% eventually die from interstitial fibrosis

Front 82

T or F: COPD is a reversible condition

Back 82

FALSE

Front 83

T or F: Most histoplasmosis infections go on to become chronic.

Back 83

False; most are acute and then resolve

Front 84

Among patients with COPD in the US, the vast majority have __________ (14 million) and the remainder have __________ (2 million)

Back 84

Chronic Bronchitis; Emphysema

Front 85

Name the 5 factors that are considered in susceptibility to Pneumoconioses.

Back 85

1. Size/shape of particle (<5 microns); 2. Composition of particles; 3. Duration of exposure; 4. Patients clearance mechanism; 5. Other irritants (ie smoking)

Front 86

What is the only acute, restrictive lung disease?

Back 86

Acute respiratory distress syndrome

Front 87

Acute Respiratory Distress Syndrome is caused by a mechanism of either 1. Injury to the _________ _______ in pulmonary capillaries or 2. Injury to the ________ _________ _______.

Back 87

1. Endothelial cells; 2. Alveolar lining cells

Front 88

What disease: Enlargement of airspaces distal to terminal bronchioles; destruction of alveolar walls; loss of elastic recoil; collapse of unsupported, enlarged air spaces on expiration; obstruction on expiration

Back 88

Emphysema

Front 89

Name the ASA class: Severe systemic disease that limits activity but not incapacitating

Back 89

ASA III

Front 90

T or F: Silicosis can lead to bronchogenic carcinoma.

Back 90

TRUE

Front 91

What is the characteristic difference of air sacs between healthy air sacs and air sacs with emphysema?

Back 91

Emphysema: weakened and collapsed air sacs with Excess mucous

Front 92

This disease was first widely recognized during the vietnam war (Da Nang Lung).

Back 92

Acute respiratory distress syndrome

Front 93

What are lung abscesses a complication of?

Back 93

Staphylococcal pneumonia; aspiration of foreign material (swallowing a crown, poor dental hygiene, etc.)

Front 94

Bronchitis, Emphysema, or Both: Pulmonary hypertension

Back 94

Both

Front 95

What is the major cause of emphysema?

Back 95

Cigarettes

Front 96

T or F: It is necessary to consult with a physician prior to treating a ASA II patient.

Back 96

FALSE

Front 97

In extremely rare cases (1%) what can cause emphysema?

Back 97

hereditary alpha1-antitrypsin deficiency (which protect the tissue from leukocyte proteases)

Front 98

In the Protease-antiprotease mechanism of emphysema, what 2 things does smoking do?

Back 98

1. Inhibits antielastase; 2. favors recruitment of leukocytes and release of elastase (causing elastic damage to the tissue)

Front 99

Which MRTI is characterized by: acute, severe, life-threatening disease, presents as a child w/ fever +/- sore throat, clinical triad of drooling, dysphagia, distress

Back 99

Epiglottitis

Front 100

Other than the protease-antiprotease mechanism, what else does smoking do to cause emphysema?

Back 100

Oxidant/antioxidant imbalance (free radicals released, induce cell damage)

Front 101

The type of emphysema caused by smokers is called _________ emphysema.

Back 101

Centrilobular

Front 102

Which type of bronchogenic carcinoma has the worst prognosis, most aggressive, and not usually amenable to surgery?

Back 102

Small Cell (oat cell)

Front 103

Bronchitis, Emphysema, or Both: Frequent Upper Respiratory infections

Back 103

Bronchitis

Front 104

Name the types of Pleural Lesions:

Back 104

Mesothelioma, Pleural effusions and plueritis, Pneumothorax, Hemothorax, Chylothorax

Front 105

What disease: Excessive production of tracheobronchial mucous causing cough.

Back 105

Chronic Bronchitis

Front 106

What 3 diseases included in COPD (chronic obstructive pulmonary disease)?

Back 106

Emphysema, Chronic Bronchitis, Bronchiectasis (just a reminder)

Front 107

What disease: erodes bronchial wall, eric-smelling sputum, chest pain, weight loss, chronic cough, fever, clubbing of fingers and toes

Back 107

Lung Abscess *note, bronchiectasis also has clubbing of toes--the difference here is eroding of bronchial wall. Bronchiectasis is permanent dilatation of bronchial wall.

Front 108

N2O (increases/supresses) pH as a stimulus to respiration, because N2O has a high O2 content.

Back 108

supresses

Front 109

T or F: ASA III patients can withstand most dental procedures with appropriate modifications.

Back 109

TRUE

Front 110

Anthracosis, Silicosis, or Asbestosis, all three, or none: Increased risk of TB

Back 110

Anthracosis and Silicosis

Front 111

_____ % of Chronic Bronchitis cases are caused by _________.

Back 111

90%; Smoking (I know we all love percentages)

Front 112

What organism causes Epiglottitis?

Back 112

Haemophilus Influenzae

Front 113

T or F: N2O can diffuse into closed spaces

Back 113

TRUE

Front 114

Bronchitis, Emphysema, or Both: Acute disease

Back 114

Neither (trick question!)

Front 115

What are the risk factors for contracting histoplasmosis (other than living in this hell hole we call omaha….j/k)

Back 115

exposure to soil contaminated with bird poo, preexisting COPD, compromised immunity

Front 116

What disease: Thickening of bronchial walls, mucous gland hyperplasia, chronic inflammation, fibrosis, mucous plugging.

Back 116

Chronic Bronchitis

Front 117

The presence of transudate in the pleural space is called ________

Back 117

hydrothorax; caused by CHF and Left-sided heart failure especially

Front 118

T or F: Chronic Bronchitis results in Restriction.

Back 118

False; leads to obstruction

Front 119

What are the main differences in the pathways for chronic bronchitis and emphysema?

Back 119

Bronchitis: bronchiolar injury, hypersecretion of mucous; emphysema: destruction of alveolar walls early (bronchitis does it later)

Front 120

What ASA type is a patient with COPD and NO congestive heart failure?

Back 120

ASA/MED III

Front 121

What ASA type is a patient with COPD WITH congestive heart failure?

Back 121

ASA/MED IV

Front 122

Which acute disease exhibits severe dyspnea, cyanosis, and hypoxia?

Back 122

Acute respiratory distress syndrome

Front 123

One of the main characteristics (underlined in the notes) of chronic Bronchitis is ________.

Back 123

Fibrosis

Front 124

What is ectasia?

Back 124

dilatation or distension of hollow organs

Front 125

Anthracosis, Silicosis, or Asbestosis, all three, or none: Can lead to mesothelioma

Back 125

Asbestosis (this is the #1 characteristic of asbestosis)

Front 126

What disease: Permanent dilatation of bronchi, can be secondary to persisting infection or obstruction

Back 126

Bronchiectasis

Front 127

T or F: Asthma is more common in females.

Back 127

FALSE (males 2:1)

Front 128

What process takes place in pulmonary fibrosis or tuberculosis?

Back 128

Cavitation

Front 129

What is the first step in treatment for bronchitis and emphysema?

Back 129

Quit smoking

Front 130

________ occurs as a result of an exudate (protein rich)

Back 130

Pleuritis

Front 131

The two chronic restrictive lung diseases caused by occupational/environmental exposure are: 1.____, 2._________

Back 131

Hypersensitivity Pneumonitis; Pneumoconioses (ie asbestosis)

Front 132

In this disease, fibrin is deposited along damaged alveolar lining , which leads to diffuse alveolar damage.

Back 132

What is Acute respiratory distress syndrome? (jeopardy style baby)

Front 133

Anthracosis, Silicosis, or Asbestosis, all three, or none: increases risk of cancer 5 fold

Back 133

Asbestosis

Front 134

Chronic Restrictive lung diseases are diseases of _________ ________.

Back 134

Lung parenchyma

Front 135

Anthracosis, Silicosis, or Asbestosis, all three, or none: runs a benign course

Back 135

Anthracosis

Front 136

What term means: Labored Breathing

Back 136

Dyspnea

Front 137

T or F: Now epiglottitis is more prevalent in children than adults.

Back 137

False. Other way around.

Front 138

90% of all lung cancers are caused by smoking (150,000 deaths/yr). What are the other 10% caused by? (hint-variety of things)

Back 138

Radon (radioactive gas=2nd leading cause--.20,000 deaths/yr); Air pollution; Radiation exposure; Asbestos exposure; Nickel and chromate exposure

Front 139

The end result of chronic restrictive lung diseases is _________.

Back 139

Diffuse pulmonary fibrosis

Front 140

Anthracosis, Silicosis, or Asbestosis, all three, or none: shows pleural plaques

Back 140

Asbestosis

Front 141

T or F: Chronic Bronchitis gives you the "pink puffer."

Back 141

False; gives you "Blue Bloater" (B for Bronchitis, Blue Bloater)

Front 142

Anthracosis, Silicosis, or Asbestosis, all three, or none: Leads to Fibrosis

Back 142

All Three

Front 143

What causes pleural effusion?

Back 143

Microbial infection, cancer, pulmonary infarction, viral pleuritis

Front 144

Which chronic restrictive lung disease has no known cause?

Back 144

Idiopathic pulmonary fibrosis

Front 145

Histoplasmosis infection symptoms include: fever, chills, weight loss, cough (with/without) mucus or pus

Back 145

WITH

Front 146

In asbestosis, what sets off a fibrogenic reaction?

Back 146

Macrophages ingesting an asbestos fiber

Front 147

What immune cells are primarily involved in asthma?

Back 147

mast cells

Front 148

Neutrophil/complement defects (humoral defects) result in increased incidence of ___________ ________.

Back 148

Bacterial pneumonia

Front 149

What disease invovles extrinsic allergic alveolitis caused by exposure to organic dust?

Back 149

Hypersensitivity Pneumonitis

Front 150

Cell-mediated immune defects result in increased incidence of (intracellular/extracelluar) ___________.

Back 150

Intracellular parasites (ie TB, HSV, pneumocystis carinii)

Front 151

What are the two types of asthma?

Back 151

Extrinsic and Intrinsic

Front 152

What MRTI is characterized by: acute infectious disease of lower respiratory tract (bronchi/bronchioles, not alveoli), mostly in young infants 2-24 mos.,

Back 152

Bronchiolitis

Front 153

What disease presents commonly following URTI, absent splenic function, chills, pleuritic chest pain, productive cough.

Back 153

Pneumonia

Front 154

What ways can pneumonia be spread?

Back 154

Inhalation of pathogens, aspiration of infection, aspiration of gastric contents, hematongenous spread (IV, septic emboli)

Front 155

What disease: Multi-system granulomatous disease of unknown etiology (presumably immune mediated)

Back 155

Sarcoidosis

Front 156

What are the possible complications of pneumonia?

Back 156

Abscess formation; Plueritis, empyema (collection of pus); fibrosis--> chronic Dx

Front 157

T or F: in a patient older than age 40, in the absence of systemic infection, lung complications should be assumed it is cancer until proven otherwise.

Back 157

TRUE

Front 158

What term means: Physican wasting with loss of weight and musche mass caused by disease

Back 158

Cachexia

Front 159

T or F: Emphysema gives you the "pink puffer."

Back 159

True (emphysema=pink puffer)

Front 160

What is the definition of Pneumonia?

Back 160

Any infection in the lung (acute or chronic)

Front 161

Pneumonia is of Bacterial, viral, or fungal origin?

Back 161

Any of the above.

Front 162

In Asthma, which is more difficult, expiration or inspiration?

Back 162

Expiration

Front 163

T or F: Pneumoconioses is caused by exposure to organic dust particles.

Back 163

False; inorganic particles (organic--Hypersensitivity Pneumonitis)

Front 164

What are the 2 main subclasses of pneumonia?

Back 164

Lobar Pneumonia and Bronchopneumonia

Front 165

________ asthma is associated with young-onset asthma.

Back 165

Extrinsic

Front 166

What is main cause of Bronchiolitis?

Back 166

Viral infection (80%--esp. respiratory synctial virus)

Front 167

Bronchopneumonia or Lobar Pneumonia: Consolidation of multiple respiratory units surrounding individual bronchial branches

Back 167

Bronchopneumonia

Front 168

Bronchopneumonia or Lobar Pneumonia: Consolidation of entire Lobe of Lung

Back 168

Lobar Pneumonia

Front 169

What are the 2 main pathways of pathogenesis for Acute Respiratory Distress Syndrome?

Back 169

Damage to alveolar lining cells or damage to alveolar capillary endothelium--leads to interstitial edema, high protein exudation (hyaline membranes)

Front 170

What treatment difference is there for bronchitis?

Back 170

Use bronchodilators and antibiotics.

Front 171

What organisms cause community acquired acute pneumonias?

Back 171

Haemophilus Influenzae; Moraxella catarrhalis; Staph Aureus; Klebsiella Pneumoniae; Legionella Pneumoniae

Front 172

What organism causes Pneumococcus?

Back 172

Streptococcus pneumoniae

Front 173

How can histoplasosis be diagnosed?

Back 173

sputum test, chest x-ray, biopsy of granulomatous tissue, complement fixation, urinary antigen test, immunodiffusion test

Front 174

What organisms cause community acquired atypical pneumonias?

Back 174

Mycoplasma Pneumoniae, Chlamidia sp., Viruses

Front 175

What type of asthma is associated with Type I hypersenistivity, allergens, atopic dermatitis and hay fever?

Back 175

Extrinsic

Front 176

T or F: Hypersensitivity pneumonitis is only an acute disease.

Back 176

False. It can also be a chronic disease.

Front 177

What is the death rate for SARS?

Back 177

10% die

Front 178

Give an example of a community acquired atypical pneumonia caused by a virus.

Back 178

SARS

Front 179

What immune related chronic restrictive lung disease affects blacks 10:1 and women 2:1?

Back 179

Sarcoidosis

Front 180

What organism causes nosocomial pneumonia (according to lecture notes)?

Back 180

Pseudomonas Aeruginosa

Front 181

What is the primary cause for aspiration pneumonia?

Back 181

Markedly debilitated; unconscious patients; abscesses frequent

Front 182

Fibrothorax, Pneumothorax, Empyema, Hemothorax, or chylothorax: encasement of lungs with fibrous tissue that obliterates pleural cavity.

Back 182

Fibrothorax

Front 183

T or F: Lung cancer usually has a poor prognosis with a 5 yr survival rate of 10-15%.

Back 183

TRUE

Front 184

Cytomegalovirus primarily affects who?

Back 184

Immunosuppressed (AIDS), bone marrow transplant

Front 185

Pneumocystis pneumonia affects who?

Back 185

Immunosuppressed (AIDS)

Front 186

What organism causes tuberculosis?

Back 186

Mycobacteria Tuberculosis (causes chronic bacterial infection)

Front 187

What chronic lung disease is associated with caseating granulomatous inflammation?

Back 187

Tuberculosis

Front 188

T or F: Anthracosis usually leads to bronchogenic carcinoma.

Back 188

False; Most=benign course

Front 189

How is histoplasmosis treated?

Back 189

Antifungals

Front 190

What types of cells are associated with TB?

Back 190

epitheliod macrophages, multinucleated giant cells, lymphocytes

Front 191

approximately how many of the world's population are infected with TB?

Back 191

one-third

Front 192

T or F: Intrinsic asthma is immune-mediated.

Back 192

False

Front 193

What disease: purulent cough, dyspnea, hypoxia, cyanosis, peribronchial fibrosis, pulmonary hypertension, cor pulmonale, congestive heart failure.

Back 193

Chronic Bronchitis

Front 194

Fibrothorax, Pneumothorax, Empyema, Hemothorax, or chylothorax: Entry of air or gas into pleural cavity; may cause atelectasis, compression, collapse of lung.

Back 194

Pneumothorax (spontaneous vs trauma)

Front 195

What is the "Ghon Complex"?

Back 195

associated with localized lung inflammation in primary tuberculosis

Front 196

Acute hypersensitivity pneumonitis is of _______ onset and is mediated (or affected) by _________ ________.

Back 196

Sudden; antigen-antibody Complexes

Front 197

T or F: Primary TB usually heals spontaneously

Back 197

TRUE

Front 198

Define Consolidation as it refers to the lungs.

Back 198

Process of becoming solid (ie when lung becomes firm as air spaces are filled with exudate in pneumonia)

Front 199

What treatment is there for the rare form of emphysema?

Back 199

alpha 1-antitrypsin infusion

Front 200

T or F: In primary TB, viable organisms can still persist after healing and calcification

Back 200

TRUE

Front 201

T or F: Bronchiolitis usually resolves in 7-10 days.

Back 201

TRUE

Front 202

T or F: Histoplasmosis ususally responds poorly to antifungal meds.

Back 202

False; responds well

Front 203

The "ghon Complex" forms in which part of the lung and enlarges which lymph nodes?

Back 203

lower part of upper lobe, upper part of lower lobe (right in the middle); enlarges hilar lymph nodes

Front 204

T or F: Sarcoidosis exhibits caseating granulomas

Back 204

False; exhibit non-caseating granulomas

Front 205

Anthracosis, Silicosis, or Asbestosis, all three, or none: Increased risk of bronchogenic carcinoma

Back 205

Silicosis (maybe asbestosis too, but mesothelioma is the characteristic sign of asbestosis

Front 206

Granulomas in TB can produce cavities in the lungs which can cause hemoptysis. What is hemoptysis?

Back 206

coughing up blood

Front 207

T or F: The primary TB infection is more damaging than the secondary infection.

Back 207

False (other way around)

Front 208

What disease: non-specific mild pulmonary disease, low grade fever, 95% undiagnosed, ghon complex

Back 208

Primary TB

Front 209

What disease: Non-productive cough, low grade fever, malaise, night sweats, weight loss, hemoptysis

Back 209

Secondary TB

Front 210

One of the MAIN causes (that he underlined) of INTRINSIC asthma is _______

Back 210

Psychological stress

Front 211

What can be seen in a sputum test for TB?

Back 211

Acid fast bacilli

Front 212

How long after a Mantoux skin test should you be examined?

Back 212

48-72 hrs.

Front 213

What Middle Respiratory Tract Tumor did we mention in class? (only one)

Back 213

SCCA (squamous cell carcinoma) of Larynx

Front 214

What are 3 specific examples of Pneumoconioses?

Back 214

1. Coal worker's lung (anthracosis); 2. Silicosis; 3. Asbestosis

Front 215

T or F: the erythema around the indurated area of a PPD test is measured.

Back 215

False. Only the induration is measured (normal = <10 mm)

Front 216

What potential complication arises from using N2O sedation on a patient with emphysema?

Back 216

They can be dependent on LOW O2 levels as a primary stimulant to respiration; N2O has high concentration of O2 so it can lead to cease of respiration.

Front 217

T or F: After treating histoplasmosis, fibrotic changes may still remain.

Back 217

TRUE

Front 218

Fibrothorax, Pneumothorax, Empyema, Hemothorax, or chylothorax: Pockets of pus surrounded by fibrous tissue; caused by infection that spreads from the lung.

Back 218

Empyema

Front 219

Bronchitis, Emphysema, or Both: Productive cough

Back 219

Bronchitis

Front 220

What can be done in the dental office to prevent an attack of dyspnea during treatment?

Back 220

Treat in semi-upright position; always have inhaler

Front 221

T or F: Asthma is more common in children.

Back 221

TRUE. 10% of children get it, while 5% of adults get it.

Front 222

What disease: widespread hematogenous seeding of bacteria; numerous granulomas in lungs or other organs (ie spleen)

Back 222

Miliary TB

Front 223

T or F: Sarcoidosis is typically a fatal disease.

Back 223

False; 10% mortality, 70% spontaneous recovery, 50% asymptomatic

Front 224

T or F: Disseminated TB can cause granulomas on pluera (causing pleuritis) and extrapulmonary TB

Back 224

TRUE

Front 225

Where are the most common sites of metastasis of lung cancers?

Back 225

Brain and Liver mostly, occasionaly bone (mandible), rarely oral soft tissue

Front 226

Premature infants commonly have respiratory problems due to insufficient pulmonary __________.

Back 226

surfactant

Front 227

What is the main cause of SCCA of the larynx?

Back 227

Smoking and chronic alcohol use

Front 228

What is by far the most common type of lung cancer?

Back 228

Bronchiogenic Carcinoma (90-95% of lung cancers)

Front 229

Two of the causes of Hypersensitivity Pneumonitis (as stated in the notes) are: __________ Lung and _______ _________ Lung.

Back 229

Farmer's Lung (moldy hay/grain); Pigeon Breeder's Lung (pigeon serum protein in droppings)

Front 230

T or F: Pulmonary Histoplasmosis progression to Disseminated Histoplasmosis is common.

Back 230

FALSE; happens, but rarely

Front 231

If N2O diffuses into large gas-filled blebs in patients with COPD, what can happen?

Back 231

They can rupture

Front 232

Fibrothorax, Pneumothorax, Empyema, Hemothorax, or chylothorax: Collection of blood in space between chest wall and lung (pleural cavity).

Back 232

Hemothorax (trauma vs. rupture of intrathoracic aortic aneurysm)

Front 233

List the 4 types of Bronchiogenic carcinomas.

Back 233

1. SCCA (30%) 2. Adenocarcinoma (30%) 3. Large Cell undifferentiated (10%) 4. Small Cell (oat cell-20%)

Front 234

Coccidiomycosis, Aspergillosis, or Zygomycosis: Southwest

Back 234

Coccidiomycosis

Front 235

What type of lung cancer arises from the terminal bronchioles?

Back 235

Bronchioalveolar cancer

Front 236

What is a type of lung cancer that is a neuroendocrine tumor of low malignancy?

Back 236

Carcinoid

Front 237

What ASA type(s) is it mandatory to consult with the physician first?

Back 237

IV (III is wise, but not necessary)

Front 238

What type of lung cancer is associated with asbestos exposure, takes 25-40 yrs to develop, is pluera-derived, and has a poor prognosis?

Back 238

Mesothelioma

Front 239

What disease: persisten hoarseness, change in voice, stridor (high pitched crowing sound), rare under age 40

Back 239

SCCA of larynx

Front 240

Bronchitis, Emphysema, or Both: Cor Pulmonale

Back 240

Both

Front 241

What do small (oat) cells arise from?

Back 241

Neuroendocrine cells

Front 242

T or F: Metastatic lung tumors are more common than primary lung tumors (single site)

Back 242

TRUE

Front 243

What is the treatment and survival rate for SCCA of the larynx?

Back 243

Radiation w/ or w/out surgery; 75% survival rate if early Dx.

Front 244

What type of hormones do small (oat) cell (bronchogenic carcinoma) express?

Back 244

polypeptide hormones

Front 245

Fibrothorax, Pneumothorax, Empyema, Hemothorax, or chylothorax: Presence of lymphatic fluid in pleural space; secondary to leakage/obstruction of thoracic duct or main tributaries

Back 245

Chylothorax (causes: lymphoma, surgical trauma)

Front 246

What chronic lung disease is associated with elevated ACE?

Back 246

Sarcoidosis