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77 Cards in this Set
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- Back
- 3rd side (hint)
Cause of common cold
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Adenovirus
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Croup
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Acute laryngotracheobronchitis
Acute inflammation of larynx, trachea, and epiglottis Potentially life-threatening in infants Harsh cough and inspiratory stridor Caused by parainfluenza virus, most commonly |
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Main cause of epiglottitis
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H. influenza
Can be life-threatening |
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Nasopharyngeal carcinoma
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Most common in adults (SE Asia) and children in East Africa
Caused by EBV |
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Squamous cell carcinoma of the nose
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most frequently occurring malignant nasal tumor
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adenocarcinoma of the nose/throat
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responsible for 5% of all the nose/throat malignancies
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Plasmacytoma
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plasma cell neoplasm that in its extraosseous form, produces tumros in the upper respiratory tract
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Singer's nodules histology
cause location symptoms |
Benign laryngeal polyp
Associated with overuse of the voice and smoking Localized to true vocal cords Hoarseness |
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Laryngeal papilloma
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In adults: single lesion, can turn malignant
In children: caused by HPV 6 and 11; multiple lesions, recurs after resection |
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Squamous cell carcinoma of the larynx
Epidemiology Presentation |
most common malignant tumor of the larynx
Seen in men older than 40 Associated with smoking and alcoholism (combined) Present with persistent hoarseness |
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What is glottic carcinoma?
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Most common type of laryngeal carcinoma
Has best prognosis |
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What is supraglottic ad subgglottic carcinoma?
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less common laryngeal carcinoma
poorer prognosis |
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Extrinsic asthma
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asthma associated witeh chronic bronchitis, exercise induced, and cold-induced asthma
Begins in adult life Not assocaited with hx of allergy |
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clinical Characteristics of asthma
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Episodic dyspnea and wheezing on expiration
Narrowing of the airways |
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Histology of asthmatic airways
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Bronchial smooth muscle hypertrophy
Hyperplasia of goblet cells Thickening and hyalinization of BM Proliferation of eosinophils Intrabronchial mucous plugs containing whorl-like accumulations of epithelial cells Crystalloids of eosinophil-derived proteins |
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What are Curschmann spirals
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Whorl-like accumulations of epithelial cells seen in asthma
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What are Carcot-Leyden crystals?
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Crystalloids of eosinophil-derived proteins
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Complications of asthma?
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Superimposed infection
Chronic bronchitiis Pulmonary emphysema Status asthmaticus |
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Definition of chronic bronchitis
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Productive cough lasting 3 consecutive weeks over 3 consecutive years
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Causes of chronic bronchitis
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Cigarette smoking
pollution infection genetics |
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What can chronic bronchitis lead to?
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cor pulmonale
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Histology of chronic bronchitis
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Hypersecretion of mucus d/t marked hyperplasia of mucus secreting submucosal glands
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What composes a respiratory acinus?
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respiratory bronchiole
alveolar duct alveoli |
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Characteristics of centrolobular emphysema
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Dilation of respiratory bronchioles
In apex/upper part of pulmonary lobes |
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Characteristics of panacinar emphysema?
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Dilation of the entire acinus, starting in the alveoli and alveolar duct, then respiratory bronchiole
Most commonly occurs in the lower basal zones |
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Characteristics of paraseptal emphysema
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Alveoli and alveoar ducts are dilated
Localizes subjacent to pleur interlobar septa |
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Which type of emphysema is associated with alpha-1 anti-trypsin deficiency
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Panacinar emphysema
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What are complications of emphysema
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Chronic bronchitis
Interstitial emphysema Rupture of a surface bleb with resulting pneumothorax |
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What is interstitial emphysema
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air escapes into the interstitial tissue of chest from a tear in the airways
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Pathogenesis of emphysema?
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Cigarette smoke causes recruitment of neutrophils and macrophages, which release elastase
Elastase destroys elastin unless neutralized alpha-1 anti-trypsin Cigarettes inactivate alpha-1 anti-trypsin |
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What is the PiZ allele
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structural alteration in alpha-1 anti-trypsin, which interferes with the hepatic secretion of it
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What is alpha-1 anti-trypsin deficiency associated with?
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panacinar emphysema
hepatic cirrhosis cholestasis hepatocellular carcinoma in 1-2% of homozygous adults |
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What is bronchiectasis?
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Permanent abnormal bronchial dilation
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What causes bronchiectasis
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Chronic infection wiht inflammation and necrosis of the bronchial wall
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What are predisposing factors for bronchiectasis?
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Bronchial obstruction (often by tumor)
CF necrotizing bacterial, viral or fungal pneumonai RA GVHD chronic sinusitis with post nasal drip Kartagener syndrome |
autoimmune dzs?
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Manifestations of Kartagener syndrome
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sinusitis
bronchiectasis situs inversus (left-right reversal of thoracic viscera) hearing loss immotile sperm |
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Cause of Kartagener syndrome
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structural defect in dynein arms, impairing ciliary activity
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Where in the respiratory tract does bronchiectasis most commonly appear?
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Lower lobes of both lungs
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Manifestations of bronchiectasis
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copious purulent sputum
hemoptysis recurrent pulmonary infection --> lung abscess |
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Complications of bronchiectasis
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cor pulmonale
metastatic abscess systemic amyloidosis |
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Characteristics of interstitial lung diseases
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interstitial accumulations of cells or noncellular material within the alveolar walls that restrict expansion and interfere with gaseous exchange
(increased A-a gradient... V/Q mismatch) |
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EXamples of interstitial lung disease
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ARDS
Neonatal respiratory distress syndrome Pneumoconiosis Sarcoidosis Idiopathic pulmonary fibrosis SLE Scleroderma Goodpasture syndroem Wegener granulomatosis |
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How does pulmonary fibrosis lead to cardiac failure?
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Pulmonary fibrosis --> repeated cycles of cellular injury --> abnormal wound healing b/c of excessive fibroblast proliferation --> cor pulmonale, pulmonary insufficiency and cardiac failure
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Pathogenesis of ARDS?
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diffuse alveolar damage --> increased capillary permeability --> leakage of protein rich fluid (exudate) into alveoli
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Histology of ARDS
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intra-alveolar hyaline membrane made of fibrin and cellular debris
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Clinical result of ARDS
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impairment of respiratory gas exchange with severe hypoxia
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Causes of ARDS
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toxic agents
shock sepsis trauma uremia aspiration of gastric contents acute pancreatitis O2 toxicity OD of heroin or bleomycin SARS |
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Relationship between SARS and ARDS
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SARS (a coronavirus) destroys type II pnemocytes --> diffuse alveolar damage
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Things that influence ARDS
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Neutrophils that release substances toxic to alveolar wall
Activation of coagulation cascade O2 toxicity from free radicals |
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Causes for neonatal respiratory distress syndrome
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Surfactant deficiency, from premature birth/premature lungs
seen in diabetic mom, poor glucose control, c-section |
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Clinical manifestations of neonatal respiratory distress syndrome
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Dyspnea
Cyanosis Tachypnea |
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Component of surfactant
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dipalmitoyl lecithin
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Way to determine fetal pulmonary maturity
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measure ratio of surfactant lecithin to sphingomyelin in amniotic fluid
[Lecithin] increases from 33rd week of pregnancy, while sphingomyelin remains stable L:S 2:1 or higher = pulmonary maturity |
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Factors predisposing to neonatal respiratory distress syndrome
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Prematurity
Materal DM C-section |
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Pathologic findings of neonatal RDS
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lungs are heavier than normal
Areas of atelectasis alternating with dilated alveoli/alveolar ducts Small pulmonary BV are engorged witeh blood, with leakage of blood products into alveoli Formation of hyaline membranes within alveoli |
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Components of hyaline membranes in neonatal RDS
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fibrin and cellular debris
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Complications/associated conditions with neonatal RDS
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Bronchopulmonary dysplasia
PDA Intraventricular brain hemorrhage Necrotizing enterocloitis (inflammation of large and small intestines) |
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Morphology of necrotizing enterocolitis
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mucosal edema
hemorrhage necrosis of terminal ileum and entire gut |
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Components of coal dust
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carbon and silica
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markings of simple coal workers' pneumoconiosis
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Coal macules around bronchioles
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What can progresive massive fibrosis from coal workers' pneumoconiosis lead to?
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bronchiectasis
pulmonary HTN death from respiratory failure cor pulmonale |
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Careers associated with silicosis
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miners
glass manufacturers stone cutters |
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dangers of silicotic nodules
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enlarge and obstruct airways and BV
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risks associated with silicosis
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increased TB risk
can also be concurrent (silicotuberculosis) |
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Pathogenesis of asbestosis
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asbestos fibers are taken up by alveolar macrophages
fibroblast-stimulating GF by macrophages likely released --> diffuse interstitial fibrosis in lower lobes |
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Ferruginous bodies
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seen in asbestosis
yellow-brown rod shaped bodies with clubbed ends that stain for Prussian blue |
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Complications of asbestosis
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bronchogenic carcinoma
malignant mesothelioma |
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Pathologic changes associated with sarcoidosis
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interstitial lung disease
enlarged hilar lymph nodes anterior uveitis erythema nodosum of skin polyarthritis |
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Immunologic phenomena associated with sarcoidosis
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reduced sensitivity to skin test antigens
polyclonal hyperglobulinemia |
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Clinical abnormalities seen with sarcoidosis
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bilateral hilar lymphadenopathy
interstitial lung disease manifest as diffuse reticular densities |
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Lab findings associated with sarcoidosis
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hypercalcemia
hypercalciuria hypergammaglobulinemia increased ACE |
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Way to make definitive dx of sarcoidosis
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biospy showing non-casseating granuloma
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Progression of idiopathic pulmonary fibrosis
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chronic inflammation and fibrosis of alveolar wall
begins with alveolitis --> ibrosis --> distorted fibrotic lung filled with cystic spaces |
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Honeycomb lung
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typical of idiopathic pulmonary fibrosis
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Prognosis for idiopathic pulmonary fibrosis
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poor
death often within 5 yrs |
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morphologic changs of eosinophilic granuloma
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histiocytic cells closely related ot Langerhans cells of skin
have cytoplasmic inclusions (Birbeck granules) resembling tennis rackets Prominent monocytes-macrophages, lymphocytes, and eosinophils |
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Location of eosinophilic granulomata
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lung or bony sites (i.e. ribs)
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