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;
110 Cards in this Set
- Front
- Back
|
When do the lungs first develop? From where?
|
Weeks 4-6. Tracheobronchial bud divides to form proximal airways up to segmental bronchi
|
|
|
When do the acinus and vascular system develop?
|
Between weeks 17-28
|
|
|
When do the alveoli develop?
|
begin to 34-36 weeks and finish in the first two years of life.
|
|
|
What are the Kulchitsky cells?
|
Neuroendocrine cells in the tracheobronchial mucosa that secrete polypetides and vasoactive amines
|
|
|
The last purely conducting pathway of the lungs _______
|
Respiratory Bronchiole
|
|
|
What is a Clara cell?
|
Nonciliated columnar cells which accumulate and detoxify many inhaled agents.
|
|
|
What is a ACINUS?
|
A unit of gas exchange in the lung consist of respiratory bronchioles, alveolar ducts, alveoli.
|
|
|
There are lymphatics in what part of the lungs?
|
Alveolar Walls
|
|
|
The pleural lymphatics drain towards the _________
|
Hilus through the brochovascular lymphatics
|
|
|
What are the three major causes of pulmonary hypoplasia?
|
Compression of lung
Oligohydramnios Decreased Respiration |
|
|
What is Congenital Cystic Adenomatoid Malformation?
|
Abnormal brochiolar structure of varying size or distribution
|
|
|
What are the most common symptoms Congenital Cystic Adenomatoid Malformation?
|
RDS and cyanosis
|
|
|
What is extralobar sequestration?
|
A mass of lung tissue that is not connected to the brochial tree and is located outside the visceral pleura and supplied abnormal artery
|
|
|
What is the Intralobar sequestration?
|
A mass of lung tissue inside the visceral pleura, supplied by systemic artery
|
|
|
Where are intralobar sequestration found in the lung?
|
Lower lobe in almost all cases
|
|
|
What does the intralobar sequestration look like on gross examination?
|
Appears like chronic reccurent pneumonia, end-stage fibrosis and honey-comb cystic changes.
|
|
|
What are the clinical symptoms for intralobar sequestration?TX?
|
Cough, sputum, recurrent pneumonia
Surgical removal |
|
|
What are brochiocentric granulomatosis?
|
a non-specific granulamatous inflammation centered in the bronchi or bronchioles.
|
|
|
Histologically speaking, are you able to diagnosed based on brochiocentric granulomatosis ?
|
No, not a distinct entity b/c many diseases causes this: asthmatics and nonasthmatics.
|
|
|
What is the treatment for both types of brochiocentric granulomatosis ?
|
Corticosteroids, they respond well
|
|
|
What is constrictive bronchiolitis?
|
An uncommon disorder where initial inflammatory brochiolitis is followed by bronchiolar scarring and fibrosis, narrowing of the airway
|
|
|
A 30 year old with a recent kidney transplant presents with dyspnea and wheezing. Has a normal chest x-ray.Biopsy shows mural inflammation with focal submucosal fibrosis. What is the Dx?
|
Constritive Bronchiolitis
|
|
|
What are some causes of the fibrosis seen in constrictive bronchiolitis?
|
1.GVH
2. Lung transplant chronic rejection 3. Collagen vascular diseases: RA 4. Postinfectious disorders 5.Inhaled toxins 6. Drugs; Penicilamine |
|
|
What usually causes Atelectasis?
|
Bronchial obstruction, or direct compression of lung; hydrothorax or pneumothorax
|
|
|
What is Atelectasis?
|
Collapse of the lung tissue
|
|
|
What is brochiectasis?
|
It is permanent dilation of the lung tissue.
|
|
|
What is Right Middle Lobe syndrome?
|
It is atelectasis of the bronchus to the right middle lobe
|
|
|
What is obstructive brochiectasis?Some causes
|
A segment of the lung distal to a mechanical obstruction of a central bronchus, tumors foreign objects, Asthma mucus plugs, lymphadenopathy compression.
|
|
|
What is nonobstructive brochiectasis?
|
A complication of respiratory infections or defects in defense mechanisms that protect the airway.
|
|
|
What causes localized non-obstructive brochiectasis in children?
|
RSV and Adenovirus
|
|
|
A inherited impairment in host defense mechanisms or acquired conditions that permit introduction of infections into the airways is ________
|
Generalized brochiectasis
|
|
|
What are some of the acquired disorders that predispose to brocheicstasis?
|
1.Neurologic diseases: unconsciousness, swallowing, respiratory
2. LES incompetence 3. Nasogastric intubation |
|
|
What are the inherited conditions that cause brochiecstasis?
|
Cystic firbrosis
Dyskinetic ciliary syndromes Hypogammaglobulinemias IgG deficiences |
|
|
What is Kartagener syndrome?
|
Immotile cilia with dextrocardia, brochiectasis, and sinusitis.
|
|
|
What deficiency does Kartagener's syndrome have?
|
Absence of inner or outer dynein arms of cilia
|
|
|
The absence of radial spoke in cilia is known as ________
|
Sturgess syndrome
|
|
|
Why do patients with hypogammaglobulinemia present with lung infections?
|
B/c they usually lack IgA or IgG that protect against viruses or bacteria
|
|
|
What are the symptoms of bronchiectasis?Complication?In long standing?
|
Chronic productive cough
Severe production of mucopurulent sputum,Hemoptysis,Dyspnea, Pneumonia is a complication Long standing are at risk of chronic hypoxia and pulmonary hypertension |
|
|
How do you diagnose bronchiectasis?
|
CT of the lung, the bronchi will appear dilated with thickened walls
|
|
|
What is the difference between lobar pneumonia and brochopenumonia?
|
Older terms, lobar = consolidation of an entire lobe
Brochopneumonia= a scattered solid foci in the same or several lobes. |
|
|
How do you characterize asbestosis pathology in the lungs?
|
Bilateral diffuse interstitial fibrosis and asbestos bodies in the lung.
|
|
|
What type of lung disease does asbestosis cause?
|
Restrictive and Obstructive, b/c it deposits in respiratory bronchioles and alveolar ducts causing fribrosis.
|
|
|
A honey-comb lung, histologically, describes what disease?
|
Asbestosis
|
|
|
A clear thin fiber surrounded by beaded iron-protein coat ______
|
Asbestosis fibers in the alveolar macrophages.
|
|
|
In this disease, the macrophages engulf the fiber partially and coat it with protein, proteoglycans, and ferritin.
|
Asbestosis
|
|
|
After long-term lung exposure to asbestosis, what are some common lung problems?
|
Pleural effusion
Pleural Plaques Diffuse pleural fibrosis Rounded Atelectasis Mesothelioma Carcinoma of the lung |
|
|
A smooth, pearly white, nodular plaque on the dome of the diaphragm is caused by ________
|
Asbestosis
|
|
|
When is diffuse pleural fribrosis usually detected in person exposed to asbestosis?
|
10 years
|
|
|
A rounded appearance on the chest X-ray, at the pleural base and 2.5-5.0 cm shawdow at the posterior surface of the lung is caused by _______
|
Asbestosis
|
|
|
Berryllium exposure is indistinguishable from ________
|
Sarcoidosis
|
|
|
Multiple noncaseasting granulomas along the pleura, septa or brochovacular bundles in aerospace worker is _________
|
Berylliosis
|
|
|
Describe the mirco pathology of berylliosis
|
A noncaseating granuloma with nodular collection of epitheloid macrophages and multinucleated giant cells in an aerospace engineer
|
|
|
A known iv drug user would present with what type of lung disease?
|
Talcosis, develop vascular and interstitial granulomas in the lung and variable fibrosis.
|
|
|
What is the definition of restrictive lung diseases?
|
Characterized by decreased lung volume and decreased oxygen diffusing capacity.
|
|
|
A neutrophilic infiltrate in alveoli and respiratory bronchioles
|
Acute hypersensitivity pneumonitis
|
|
|
A mononuclear cells and granulomas with interstitial lymphocytic infiltrate _______
|
Chronic hypersensitivity pneumonitis
|
|
|
The prototypical hypersensitivity pneumonitis _______
|
Farmer's lung
|
|
|
The cause of farmer's lung ________
|
Inhaled thermophilic actinomyctes form moldy hay
|
|
|
The pulmonary function studies of a person with chronic farmer's lung would show;
|
Restrictive pattern
Decreased compliance Reduced diffusion capacity Hypoxemia |
|
|
The predominant lymphocyte involved in Farmer's lung is
|
CD8+ suppressor/cytotoxic cells
|
|
|
What is sarcoidosis?
|
A granulomatous disease of the lung but also skin, lymph, and eye can be affected.
|
|
|
The lymphocytes involved in sarcoidosis is ______
|
CD4+ 10:1 ratio to CD8+
|
|
|
How can you determine if a person has active Sarcoidosis?
|
Nonspecific polyclonal B activation of B-cells by helper T cells leads to hyperglobulinemia.
|
|
|
Multiple non-caseating granulomas present along the bronchovascular interstitium
|
Sarcoidosis
|
|
|
A bronchoscopic biospy of the bronchial yields a granuloma in the submucosa, diagnosis
|
90% Sarcoidosis
|
|
|
Asteroid bodies and Schauamn bodies are found in granulomas =
|
Sarcoidosis, not specific but commonly found
|
|
|
An asteroid body is
|
star-shaped crystal
|
|
|
Schaumann bodies are
|
small calcifications with lamellar bodies
|
|
|
The most common type of interstitial pneumonia is _______
|
Usual interstitial pneumonia, unknown etiology
|
|
|
Retraction scars in lobular septa with an external hobnail appearance, reminiscent of cirrhosis liver
|
UIP
|
|
|
A patchy inflammation and interstitial fibrosis with areas of normal lung tissue __________
|
UIP, usual interstitial pneumonia
|
|
|
A fibrosis of temporal heterogeneity, ie different ages.
|
UIP, usual interstital pneumonia
|
|
|
A gradual onset of dyspnea on excertion, dry cough, over 1-3 years. Chest X-ray diffuse lateral infilitrates in lower lobes and reticular pattern with Clubbing of the fingernails.
|
UIP
|
|
|
A _________ pneumonia is exlcusively associated with cigarette smoking in the fourth and fifth decades.
|
DIP, desquamated intersitial pneumonia
|
|
|
Another common pneumonia associated with cigarette smoking is
|
Respiratoy bronchiolitis-interstitial ling disease, RB-ILD
|
|
|
What is the histological difference between DIP and RB-ILD in the lungs?
|
DIP, Desquamted interstitial pneumonia is diffuse in RB the lesion is patchy.
|
|
|
What are the grading systems for pulmonary tension?Based on?
|
based on if cardiac surgery would correct the pulmonary hypertension
Grades 1, 2, 3, reversible Grade 4 and above irreversible |
|
|
What is col pulmonale?
|
Hypertrophy of right ventricle b/c of increased pressure
|
|
|
What are some causes of precapillary hypertension?
|
Left-Right cardiac shunts
Primary pulmonary hypertension thromboembolic pulmonary hypertension Hypertension do to Fibrotic lung disease |
|
|
What are some causes of postcapillary hypertension?
|
Pulmonary veno-occlusive dusease
Left-sided heart disorders; mitral stenosis |
|
|
What is the most common cause of cancer death worldwide and in the US?
|
Lung Carcinoma
|
|
|
What lung cancers are strongly associated with smoking?
|
Squamous cell carcinoma
Small cell carcinoma |
|
|
What mutations is found in 80% of small cell carcinoma?
|
p53 and Rb 80% each
|
|
|
What mutation is found oncogene is overexpressed in small cell carcinomas?
|
Myc oncogene
|
|
|
What is the single most important predictor for prognosis of lung cancers?
|
Tumor staging
|
|
|
What are the common sites for lung carcinomas metastatsis?
|
Hilar lymph and mediastinal nodes
Brain, bone, liver |
|
|
The most common extranodal lung carcinoma metastases is
|
Adrenal gland
|
|
|
What is the most common lung cancer found in women?
|
Adenocarcinoma
|
|
|
The most common extranodal lung carcinoma metastases is
|
Adrenal gland
|
|
|
What is the most common lung cancer found in women?
|
Adenocarcinoma
|
|
|
What are the four subtypes of adenocarcinoma? The most common?
|
1. Acinar *
2. Papillary 3. Solid mucus formation 4. Bronchioalveolar |
|
|
How do you histologically distinguish a solid adenocarcinoma from large cell carcinoma?
|
Solid adenocarcinoma contain mucin
|
|
|
What is the 5 year survival rate for a pt with stage I adenocarcinoma?
|
50-80% have a 5 year
|
|
|
What is the distinctive feature of bronchioloalveolar carcinoma?
|
grows along the preexisting alveolar walls
|
|
|
What lung carcinoma is associated with copious mucin sputum, bronchorrhea?
|
Bronchioloalveolar carcinoma, occurs ~ 10% but when it does its a distinctive sign
|
|
|
A majority of tumors in this lung carcinoma are coin lesions?
|
Bronchioloalveolar carcinoma
|
|
|
In bronchioloalveolar carcinoma, 2/3 of tumors are non-mucinous which means they contain what type of cells?
|
Clara cells and Type II pneumocytes
The other 1/3= mucinous = goblet |
|
|
A highly maglinant epithelial lung tumor that exhibits neuroendocrine features.
|
Small Cell Carcinoma
|
|
|
What is the definition of paraneoplastic syndromes?
|
Disorders associated with lung tumors
|
|
|
What are some of paraneoplastic syndromes associated with small cell carcinoma?
|
SiADH
Diabetes Insipidus ACTH Eaton-Lambert syndrome |
|
|
Where do small cell carcinoma usually appear in the lung?
|
perihilar mass with extensive lymph node metastases
|
|
|
Histologically describe SCC of the lung
|
Sheets of small, round, oval or spindle-shaped cells with scant cytoplasm
|
|
|
How are the nuclei of SCC distinct?
|
Finely granular nuclear chromatin and absent nucleoli
|
|
|
What is a useful rule of thumb for measuring the size of SCC?
|
Diameter of three small lymphocytes.
|
|
|
This is a diagnoses based on exclusion and is a poorly differentiated tumor that does not show features of squamous or glandular differentiation.
|
Large cell carcinoma
|
|
|
_______ are thought to arise from resident neuroendocrine cells normally found in bronchial epithelium and comprise two subtypes of neuroendocrine neoplasm
|
Carcinoid Tumor
|
|
|
Pathologically speaking, where are the carcinoid tumors found in the lung?
|
1/3 central
1/3 peripheral 1/3 midportion of lung |
|
|
Histologically speaking, Carcinoid tumors show what type of pattern? Describe
|
Organoid growth pattern uniform cytology
eosinophilic, finely granular cytoplasm and nuclei with finely granular chromatin |
|
|
What is the growth rate of carcinoid tumors?
|
Very slow, pt's present with no symptoms, but discovered as a mass on X-ray
|
|
|
What are the most common lung tumors in children?
|
Bronchial carcinoids
|
