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43 Cards in this Set
- Front
- Back
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What are three clinical signs of asthma?
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(1) Airway hyper-responsiveness
(2) Acute, usually reversible diffuse bronchial narrowing (3) Wheezing, dypsnea |
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What are common triggers of asthma?
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(1) Antigens
(2) Excercise (3) Drugs (4) Infections (5) Stress |
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What are the radiological signs of asthma?
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(1) Alternating atelectasis
(2) Overexpansion |
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What is the pathology of asthma?
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(1) Edema
(2) Smooth muscle thickneing (3) Basal membrane thickening (4) hyperplasia of mucous cels (5) Increased submucousal eosinophils (6) Thickened intralumenal mucous (7) Sometimes see charcot-leyden crystals |
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What are the clinical signs for children and adults with aspiration or aspiration pneumonia?
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(1) Children - foreign bodies
(2) Adults - gastric acid, food, foreign bodies - lipids in nasal drops |
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What radiological signs are found in aspiration or aspiration pneumonia?
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(1) Foreign object or resulting pneumoia
This is usually found in the Right lower lobe |
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What is the pathology for aspiration pneumonia?
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The pathology includes foreign material which leads to a foreign body giant cell reaction with exogenous material.
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What are the clinical signs of emphysema?
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Clincially, there is increased elastase activity. The individual is usually a cigarrette smoker and has a alpha1-antitrypsin deficiency.
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What is the radiological sign of emphysema?
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There is increased lung volumes and there is a flat diaphragm.
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What is the pathology of emphysema?
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Dilation of distal airspaces with septal destruction.
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What are three types of inflammatory responses?
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(1) Neutrophils - usually bacterial and usualy in alveoli
(2) Lymphocytes - usually viral, usually in interstitium/septae (3) Granulomatous Inflammation - usually mycobacterial or fungal |
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What are two patterns associated with bacterial pneumonia?
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(1) Bronchopneumonia - scattered foci of consolidation in either a single lobe or multpile lobes
(2) Lobar - complete consolidation of a lobe |
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Individuals with bronchopneumonia are...
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terminally ill patients. Bronchopneumonia is a common ultimate cause of death.
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Is TB bronchopneumonia or lobar pneumonia?
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Lobar pneumonia - it is an encapsulated organsim.
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What are some examples of community acquired Bacterial Pnuemonia agents?
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(1) S. pneumoniae
(2) Klebsiella (3) Hemophilus Basically agents with capsules |
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What are some hospital acquired or "nosocomial" bacterial agents?
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Drug resistant strains such as MRSA - Methicillin resistant Staph. aureus
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What patient aquires bacterial pneumonia infections?
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Immunocompromised Patients
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What is the pathogenesis of bacterial pneumonia?
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Most bacteria are normal inabitants of the nasopharynx or oropharynx. They reach the alvoli by mostly aspiration, inhalation, hematogenous seeding. Direct spread from adjacent site is rare.
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Define the early and late stages of pathogenesis.
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(1) Early: Pulmonary edema and proliferation of bacteria, intra-alveolar accumulation of neutrophils and erythrocytes - so called "red hepatization"
(2) Later stage - serum and fibrinous exudates, intra-alveolar organization, macrophages - so called "gray hepatization" |
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What is the prototype of bacterial pneumonia?
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The prototypical bacterial pneumonia is Pneumococcal pneumonia or Streptococcus pneumonia. It is encapsulated, gram positive cocci, diplococcus, a normal resident of the nasopharynx, often preceded by a viral infection,may alter bronchial secretions.
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What are three complications of bacterial pneumonia?
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(1) Abscesses (relatively unusual) - anaerobic oral bacteria
(2) Pyothorax/empyema (3) Bacteremia(about 25%) |
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Describe mycoplasma.
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Mycoplasma pneumoniae lack a cell wall and are slow-growing. The culture is very difficult and is diagnosed with a serum antibody test. It results in acute pneumonia and trache-bronchitis, which is milder than usual bacterial pneumonia. It is termed "walking pneumonia." It is highly transmissable through airborne droplets. LYMPHOCYTIC infiltrate, usually of the lower lobes.
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Describe viral pneumonias. Who is most susceptible?
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Those who are imune compromised (i.e IV, organ transplants) and infants ay get CMV. Lymphocytes are in the intrstitium. It results in distict cytologica inclusions - cytomegalovirus, Herpes
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What fungus is responsible for tuberculosis?
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Mycobacterium tuberculosis is a small, acid-fast bacllus, slo growng. It is re-emerging as a result of HIV and drug resstant strais.
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Describe the primary infection of tuberculosis.
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Primary infection results in infection by inhalation of aerosolized droplets containin organisms. A caseous graulomatous inflammation results. Ghon complex also forms. 90% of these exposures are asymptomatic.
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Describe secondary TB.
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Secondary TB is reactivation of primary TB or new infection in a previously sensitized patient. It results in caseating granulomas again and apex and posteior segments of upper lobes. May erode into a bronchus, creating a cavity - often in the apex of lung which is the future home for Aspergillus.
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What are three complications of TB?
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(1) Miliary TB- multiple small granulomas in many organs - results from hematogenous dissemination
(2) Hemoptysis - inflammatory response erodes into pulmonary artery (3) Aspergilloma in cavities |
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Do most exposures to fungi result in infection?
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No - because body temperature arrests growth, phagocytosis by netrophils and macrophages.
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Who is at reisk for fungal infections?
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(1) Chemo
(2) Steroids (3) T-cell deficiencies |
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What type of inflammation does fungus result in and what staining is used?
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(1) Usually results in granulomatous inflammation
(2) silver stains demonstrate organisms. |
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A. niger, A. fumigatus, and septate hyphae result in what type of infection?
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Aspergillosis. They live in soild and decaying plant material.
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What types of disease does aspergillosis cause?
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(1) Invasive Aspergillosis
(2) Aspergilloma (3) Allergic aspergillosis |
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Describe invasive aspergillosis.
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Organisms invade blood vessels. Infarction of lung, dissemination, exsanguination, immunocompromised.
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Describe mycetoma or fungus ball.
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Often exists within an existing cavity - such as a TB cavity. It results in a tangled mat of hyphae, non-invasive.
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Describe allergic aspergillosis.
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Susceptible patients develop immunologic reation to Aspergillus, especially in asthma patients.
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What is the major risk factor for tobacco mortality and morbidity?
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Premature atherosclerosis but other risk factors include - premature atherosclerosis, emphysema, chronic bronchitis, and carcinoma.
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What are the three major types of cancer?
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(1) Squamous
(2) Adeno (3) Small Cell |
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What cancers are mostly related to smoking?
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ALL types!
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What is the most common cancer related to non-smokers?
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Adenocarcinoma
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Which cancers are present in central location?
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(1) Squamous Cell Carcinoma
(2) Small cell carcinoma |
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Which cancer is found peripherally?
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Adenocarcinoma
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Which cancers can you treat with surgery?
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Squamous cell carcinoma and adenocarcinoma
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Which cancer can you not txt with surgery?
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Small cell carcinoma
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