Respiratory Pathology

Front 1

What is the mechanism of bronchiectasis?

Back 1

Chronic necrotizing infection of the bronchi reulsting in permanently dilated airways

Front 2

Disease: Purulent sputum, recurrent infections, can develop aspergillosis

Back 2

Bronchiectasis

Front 3

What are the causes of bronchiectasis?

Back 3

Bronchial obstruction, cystic fibrosis, poor ciliary motility, Kartagener's syndrome

Front 4

List examples of obstructive lung disease.

Back 4

Asthma, bronchiectasis, chronic bronchitis, emphysema

Front 5

What are the typical pulmonary function test results for restrictive lung disease?

Back 5

Decreased: lung volumes, FVC, TLC; FEV1/FVC > 80%

Front 6

There are two broad categories of restrictive lung diseases. What are they and give examples of each.

Back 6

Poor breathing mechanics: myasthenia gravis, obesity, polio, scoliosis; Interstitial lung diseases: adult respiratory distress syndrome, neonatal respiratory disease syndrome (hyaline membrane disease), pneumoconioses, sarcoidosis, idiopathic pulmonary fibrosis, Goodpastures's syndrome, Wegener's granulomatosis, eosinophillic granuloma, drugs (bleomycin, busulfan, amiodarone)

Front 7

What is the lecithin to sphingomyelin ratio in neonatal respiratory distress syndrome?

Back 7

<1.5

Front 8

How do you treat neonatal respiratory distress syndrome?

Back 8

maternal steroids before birth, artificial surfactant for infant

Front 9

What are the causes of adult respiratory distress syndrome?

Back 9

trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, amniotic fluid embolism

Front 10

What is the mechanism of adult respitory distress syndrome?

Back 10

neutrophillic substances, acivation of coagulation cascade, or oxygen-derived free radicals cause diffuse alveolar damage resulting in increased alveolar capillary permeability and exudate

Front 11

What is the definition of sleep apnea? What are the two types?

Back 11

Person stops breathing for at least 10 seconds repeatedly during sleep; Central: no respiratory effect and Obstructive: respiratory effort against airway obstruction.

Front 12

What are the associations and sequalae of sleep apnea?

Back 12

obesity, loud snoring, systemic/pulmonary hypertension, arrhythmias, sudden death, chronic tiredness

Front 13

Asbestosis and smoking greatly increase the risk of _________________ but not________________.

Back 13

bronchogenic cancer; mesothelioma

Front 14

Which lobes do asbestosis usually affect? How about the other pneumoconioses?

Back 14

Lower lobes; upper lobes

Front 15

Absent or decreased breath sounds over the affected area, decrease resonance, decreased fremitus, and tracheal deviation towards side of lesion usually indicates…

Back 15

Bronchial obstruction

Front 16

Decreased breath sounds over affected areas, dullness, decreased fremitus can indicate…

Back 16

Plerual effusion

Front 17

Bronchial breath sounds over lesion (but not always), dullness, increased fremitus is typically caused by…

Back 17

Pneumonia

Front 18

Decreased breath sounds, hyperresonance, absent fremitus, and trancheal deviations away from lesion of lesion indicate…

Back 18

Pneumothorax

Front 19

Disease: cough, hemoptysis, bronchial obstruction, wheezing

Back 19

Lung cancer

Front 20

List the complications of lung cancer

Back 20

SPHERE: Superior vena cava syndrome, Pancoast's tumor, Horner's syndrome, Endocrine (paraneoplastic), Recurrent laryngeal symptoms (hoarseness), Effusions (pleural or pericardial)

Front 21

Centrally located lung cancers are likely to be….?

Back 21

Squamous cell carcinoma or small cell carcinoma

Front 22

Peripherally located lung cancers are likely to be…?

Back 22

Adenocarcinoma (bronchial or bronchioalveolar) or large cell carcinoma

Front 23

Which lung cancer(s) are associated with smoking?

Back 23

Squamous cell carcinomas, adenocarcinomas (bronchial, not bronchioloalveolar), small cell carcinoma

Front 24

Which lung cancer? Cavitation, keratin pearls, parathyroid-like activity, hilar mass, and intracellular bridges.

Back 24

Squamous cell carcinoma

Front 25

Which lung cancer(s) can have paraneoplastic activity?

Back 25

Squamous cell carcinomas: PTHrP; Small cell carcinoma: ectopic ACTH or ADH production; Carcinoid tumor: serotonin.

Front 26

Which lung cancer and cell type? Nonsmoking female, multiple densities on x-ray, develops in site of prior pulmonary inflammation or injury.

Back 26

Adenocarcinoma: bronchial or bronchioalveolar; clara cells --> type II pneumocytes

Front 27

Which lung cancer and cell type? Very aggressive but responsive to chemotheraphy, ectopic ACTH or ADH, can cause Lambert-Eaton syndrome

Back 27

Small cell carcinoma; Kulchitsky cells

Front 28

Which lung cancer and why the symptoms? Flushing diarrhea, wheezing, salivation

Back 28

Carcinoid tumor; serotonin --> carcinoid syndrome

Front 29

Which pneumonia and organism(s)? Intra-alveolar exudate, consolidation; can involve entire lung.

Back 29

Lobar; Pneumococcus

Front 30

Which pneumonia and organism(s)? Patchy distribution of consolidation involving one or more lobes.

Back 30

Bronchopneumonia; S. aureus, H. influenzae, Klebsiella, S. pyogenes

Front 31

Which pneumonia and organism(s)? Diffuse patchy inflammation localized to interstiltal areas at alveolar walls, consolidation involves one or more lobes.

Back 31

Interstitial (atypical) pneumonia; Viruses (RSV, adenovirus), Mycoplasma, Legionella, Chlamydia

Front 32

What causes lung abscesses?

Back 32

Bronchial obstruction, aspiration, S. aureus or anaerobes

Front 33

Causes of transudate pleural effusion?

Back 33

CHF, nephrotic syndrome, hepatic cirrhosis.

Front 34

Causes of exudate pleural effusion?

Back 34

Malignancy, pneumonia, collagen vascular disease.