Pulmonary Pathology: Vascular Lung Disease

Front 1

Define Embolus?

Back 1

Detached intravascular mass carried by the blood to a site distant from its point of origin

Front 2

What is a Pulmonary Thromboembolus?

Back 2

Arises from a thrombus in a deep leg vein, travels to the heart, through IVC, RA, RV and into pulmonary arteries...then kills you

Front 3

What is the most common preventable cause of death?

Back 3

PE's

Front 4

how many PE's arise in large deep leg veins?

Back 4

95%

Front 5

Risk factors for DVT--> PE?

Back 5

Prolonged bed rest
Surgery on legs
CHF

Front 6

Significance of thrombus being banded?

Back 6

It is indicative of the organization in layers or RBC's and Fibrin/Platelets

Front 7

Morphology of a Thromboembolus?

Back 7

Granular Layered Outer Surface
Twisted back on itself (indicates movement and tumbling)
Reddish/Purple (freshness)

Front 8

Where is a Saddle thromboembolus located?

Back 8

main PA bifurcation

Front 9

Type of emboli that cause pulmonary infarcts?

Back 9

Peripheral (small)

Front 10

What part of lungs is most often affected by Pulmonary Infarct?

Back 10

Lower Lobes

Front 11

Character of Infarct?

Back 11

Wedge-Shaped
Hemorrhagic (not pale)
Coagulative Necrosis

Front 12

Clincal Course (%'s) of Pulmonary thromboemboli?

Back 12

60-80% silent
5% sudden death, acute cor pulmonale, shock
10-15% infarction

Front 13

To cause sudden death, cor pulmonale, or shock, how much occlusion must occur?

Back 13

at least 60%

Front 14

What role do the lungs play in shunting blood through the ductus arteriosus?

Back 14

The pulmonary arterial walls are extra thick--> high pressure--> shunts RV output through DA

Front 15

Increased Pulmonary Arterial Pressure = ???

Back 15

mean pressure > 25 mmHg

Front 16

Systemic HTN is often idiopathic (90%). How often is pulmonary HTN idiopathic?

Back 16

5%

Front 17

What is Pulm HTN usually secondary to?

Back 17

Cardiac stuff (left to right shunt)
Vasculitis
Chronic Interstitial Lung Disease
Recurrent PE

Front 18

What are PHTN morphologies that are reversible?

Back 18

Medial Hypertrophy
Intimal Hyperplasia

Front 19

What are PHTN morphologies that are irreversible?

Back 19

Occlusive changes
Dilatation
Plexiform Lesions
Acute Necrotizing Arteritis

Front 20

Results of Pulmonary Edema?

Back 20

Decreased Gas Exchange
Hypoxia
Hypercapnia

Front 21

Most common general cause of Pulmonary Edema?

Back 21

Hemodynamic Alterations in Heart (CHF)

Front 22

What is seen w/ chronic elevated pulmonary venous pressure?

Back 22

Hemosiderin laden intraalveolar macrophages

Front 23

What is Good Pasture Syndrome characterized by?

Back 23

Diffuse Alveolar hemmorhage
Glomerulonephritis

Front 24

Pathogenesis of Good Pasture Syndrome?

Back 24

Circulating Cytotoxic Autoantibody to basement membranes

Front 25

Characteristic Good Pasture presentation?

Back 25

Young
Male
Hemoptysis
Renal Involvement in 3 months

Front 26

Good Pasture's Fluorescence Pattern?

Back 26

Linear

Front 27

SLE's fluorescence pattern?

Back 27

granular

Front 28

Wegener's Granulomatosis' pattern on fluorescence?

Back 28

Negative

Front 29

General Characteristics of Wegener's?

Back 29

Aseptic, Necrotizing, Granulomatous Inflammation and vasculitis

Affects lungs and kidneys

Front 30

Lung morphology in wegener's?

Back 30

Bilateral Nodules and CAVITATION

Large area of necrosis with SERPIGINOUS borders

Front 31

Wegener's kicker w/ vasculitis on histo?

Back 31

Destruction of inner and outer elastic laminae