Respiratory Pathology - Pulmonary Vascular Diseases

Front 1

What can be causes of Pulmonary edema?

Back 1

Hemodynamic or increase capillary permeability

Front 2

What is the most common cause of hemodynamic pulm edema?

Back 2

increase in hydrostatic pressure

Front 3

What are you referring to saying "heart failure cells"?

Back 3

hemosiderin-laden macrophages

Front 4

What would you see in the Pulmonary Thromboembolus in micro?

Back 4

alternating pale pink and red lines = lines of Zahn, which are layers of RBC, Platelets, fibrin

Front 5

If patients survives, what happens to thromboembolus?

Back 5

It will undergo organization

Front 6

Sudden death and RHF are caused when...

Back 6

60% or more pulmonary obstruction

Front 7

Embolic obstruction of medium sized arteries ->

Back 7

pulmonary hemorrhage but NOT INFARCTION

Front 8

Obstruction of small end-arteriolar branches ->

Back 8

Associated with INFARCTION

Front 9

Multiple emboli ->

Back 9

Pulmonary HTN and RHF

Front 10

What is pulmonary infarction?

Back 10

ischemic necrosis of a portion of a lung d/t lack of perfusion

Front 11

What is defined as pulmonary hypertension?

Back 11

if the pressure is 1/4 of systemic level in pulmonary system

Front 12

What causes familial form of pulmonary hypertension?

Back 12

mutation in bone morphogenetic protein receptor type 2 signaling pathway

BMPR1

Front 13

What is normal BMPR2 signally perform?

Back 13

inhibition of proliferation and favors apoptosis

Front 14

What is seen in advance hypertensive pulmonary arteries in micro?

Back 14

Plexogenic lesions

Front 15

What is secondary form of PH?

Back 15

endothelial cell dysfunction , which increases shear and mechanical injury with L-to-R shunt associations or biochemical injury produced by fibrin in thromboembolism

Front 16

Besides the endothelial cell dysfunction, what else can induce PH?

Back 16

Crotalaria sepctabilis - in bus tea

appetite depressant - aminorex

adulterated olive oil

anti-obesity drugs - fenfluramine and phentermine

Front 17

What is the normal amount of fluid b/w pleura and chest cavity?

Back 17

< 15 ml of serous paucicellular (exfoliated mesothelial cells) clear fluid

Front 18

What would you see in CXR with bilateral pleural effusion?

Back 18

Loss of costophrenic angles

Front 19

Name some of the causes of pleural effusion

Back 19

Increased hydrostatic pressure - CHF

Increased vascular permeability - pneumonia

Decreased osmotic pressure - nephrotic syndrome

Increased intrapleural negative pressure - atelectasis

Decreased lympathic drainage - mediastinal carcinomatosis

Front 20

What are the types of pleural effusion?

Back 20

Inflammatory and non-inflammatory

Front 21

Name some of inflammatory pleural effusion causes

Back 21

inflammatory disease w/in the lung (serous, serofibrinous, fibrinous pleuritis)

TB, pneumonia, lung infarcts, lung abscess, RA, disseminated SLE, etc.

Emphysema = a purulent pleural exudate

Hemorrhagic pleuritis = sanguineous inflammatory exudate/ look for tumor cells

Front 22

Name some of non-inflammatory pleural effusion causes

Back 22

Hydrothorax - Cardiac failure

Hemothorax - aortic aneursyms, vascular trauma - fatal

Chylothorax - more on the left side - lymphatic fluid (more on the left possibly because of the hemiazogous vein)

Front 23

Exudate

Back 23

inflammatory extravascular fluid

high protein conc. (> 3 micrograms) and cellular debris

sp. gravity > 1.020

Front 24

Transudate

Back 24

fluid with low protein content (mostly albumin)

sp. gravity <1.012

Front 25

What 3 criteria defines exudate?

Back 25

1. pleural fluid protein divided by serum protein > 0.5

2. pleural fluid LDH divided by serium LDH > 0.6

3. pleural fluid LDH > 2/3's of upper limit of normal serum LDH (LDH = 50-150 units/L)