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100 Cards in this Set
- Front
- Back
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What type of emphysema is associated with aging and alpha1-antitrypsin deficiency?
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Panacinar (Panlobular)
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A form of chronic obstructive pulmonary disease that involves damage to the air sacs (alveoli). The air sacs are unable to completely deflate (hyperinflation) and are therefore unable to fill with fresh air to ensure adequate oxygen supply to the body. Patient has labored breathing and is more susceptible to infection
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Emphysema
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What are the two basic problems for people with emphysema?
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1. Lungs are fixed in inspiration
2. Respiratory lung surfaces have deteriorated so that they can no longer do gas exchange. |
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Obstruction of the lungs is a result of what?
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Tissue changes rather than mucus production
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What diseases of the lungs causes mucous production?
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Asthma
Chronic bronchitis |
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The volume change per unit of pressure change across an elastic structure.
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Compliance
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What is the distinguishing characteristics of emphysema?
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Limited air flow due to limited elastic recoil in the lungs
Also causes an increase in compliance |
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What are the three types of emphysema?
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Panacinar (panlobular)
Paraseptal (distal acinar) Centriacinar (centrilobular) |
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Emphysema that destroys alveoli and alveolar ducts; lower lobes of lungs mostly affected; associated with aging and alpha1-antitrypsin deficiency
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Panacinar (panlobular)
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Emphysema that commonly causes spontaneous pneumothorax in young adults
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Paraseptal (distal acinar)
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Emphysema that is associated with chronic bronchitis and smoking; destroys respiratory bronchioles; upper lobes of the lungs mostly are affected.
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Centriacinar (centrilobular)
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What is the most common cause of emphysema?
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Smoking
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What is a naturally occurring substance in the lungs which may prevent emphysema?
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Alpha1-antitrypsin
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Emphysema and chronic bronchitis frequently co-exist together to comprise what?
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Chronic obstructive pulmonary disease (COPD)
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Hyperplasia of bronchial submucosal glands is the characteristic pathologic change in what?
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Chronic Bronchitis
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A disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema, in most cases these occur together.
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COPD
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Disease defined clinically as the presence of a chronic productive cough for _____ months during each of _____ consecutive years.
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Chronic bronchitis
3 2 |
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What diseases does COPD often overlap with?
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Asthma
Bronchiectasis |
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bronchial smooth muscle hypertrophy; hyperplasia of bronchial submucosal glands and goblet cells; airways are plugged by viscid mucus containing Curschmann spirals, eosinophils, and Charcot-Leyden crystals
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Bronchial Asthma
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What are the key features of Bronchial asthma?
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Expiratory wheezing
Extrinsic (triggered by allergen) Intrinsic (triggered by cold, exercise) |
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Hyperplasia of bronchial submucosal glands, leading to increased Reid index
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Chronic Bronchitis
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What is the Reid index
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The ratio of the thickness of the gland layer to that of the bronchial wall
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What are the key features of chronic bronchitis?
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Blue bloaters
Chronic Irritation |
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What is an abnormal dilation of air spaces with destruction of alveolar walls, reduced lung elasticity.
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Emphysema
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What are the key features of emphysema?
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Pink puffers
Barrel chest |
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Abnormally dilated bronchi filled with mucus and neutrophils; inflammation and necrosis of bronchial walls and alveolar fibrosis
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Bronchiectasis
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What are the key features of Bronchiectasis?
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Copious purulent sputum, hemoptysis
Result of chronic infections |
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What is most often caused by COPD?
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Secondary pulmonary hypertension
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What type of hypersensitivity is attributed to Extrinsic Asthma?
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Type 1 Hypersensitivity reaction of the airways.
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Chronic reactive airway disorder that causes episodic airway obstruction, which results from bronchospasms, increased mucus secretion, and mucosal edema.
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Asthma
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What is the prevalence by age of asthma?
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Can occur at any age
50% occur in children under 10 2x as many boys as girls |
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What are the two types of asthma?
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Extrinsic (Immune)
Intrinsic (Nonimmune) |
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Mediated by type 1 hypersensitivity response involving IgE bound to mast cells. begins in childhood, usually in patients with a family history of allergy.
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Extrinsic (immune) asthma
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Includes asthma associated with varients such as exercise, cold air, tobacco smoke, respiratory infections, ect. It usually begins in adult life and is not associated with a history of allergy.
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Intrinsic (nonimmune) asthma
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What symptoms are associated with Asthma?
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Episodic dyspnea and wheezing expiration caused by narrowing airways.
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A very common, debilitating respiratory disease, characterized by increased production of mucous by the glands of the trachea and bronchi.
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Chronic bronchitis
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Enlargement of the right ventricle of the heart
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Cor Pulmonale
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What are the common results of chronic bronchitis?
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Cor Pulmonale
Airway narrowing, and obstruction Squamous metaplasia of bronchial tree |
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What are the characteristic pathologic change in chronic bronchiti?
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Hyperplasia of bronchial submucosal glands and bronchial smooth muscle hypertrophy
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What can patients with chronic bronchitis be predisposed to?
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Lung Cancer (bronchogenic carcinoma)
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What does left sided congestive heart failure result in?
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Pulmonary Edema
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The accumulation of fluid in the extravascular spaces of the lungs. Caused by left sided heart failure and results in increased pressure in the _____ _____.
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Pulmonary edema
Pulmonary veins |
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What occurs in pulmonary edema?
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- Failing heart transmits increased pressure to lung veins
- Pressure in lung veins rise and fluid is pushed into alveolar spaces - Fluid is barrier to O2 exchange causing shortness of breath |
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What is Pulmonary edema caused by physiologically?
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- Increased Hydrostatic pressure
- Increased Alveolar capillary permeability |
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What is increased hydrostatic pressure caused by in regards to pulmonary edema?
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Lt. ventricular failure or mitral stenosis
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What is increased alveolar capillary permeability caused by in regards to pulmonary edema?
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Inflammatory alveolar reactions from:
- Inhalation of irritant gases - Pneumonia - Shock - Sepsis - Pancreatitis - Uremia - Drug Overdose |
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What are the early symptoms of pulmonary edema?
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Dyspnea, oropnea, coughing
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What are the clinical features of pulmonary edema?
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tachycardia, tachypnea, dependent cackles, neck vein distension
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What is the designed treatment of pulmonary edema?
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Designed to reduce extravascular fluid, improving gas exchange (oxygen, diuretics, vasopressorsect.)
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An irreversible, abnormal dilation of the bronchi or bronchioles caused by destruction of their supporting structures by chronic necrotizing infection.
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Bronchiectasis
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Who is Bronchiectasis most common in?
What is the most common symptom? |
Children with cystic fibrosis
Chronic, productive cough with a foul-smelling, purulent sputum. |
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What can recurrent pulmonary infection lead to?
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Lung abscess
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What does bronchiectasis most often involve?
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The lower lobes of the lungs
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A shrunken and airless state of the lung, or portion of it. This is due to failure of expansion or resorption of air from the alveoli.
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Atelectasis
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What is atelectasis also known as?
In whom is it most common? |
Atelectasis neonatorum
Common in premature infants due to lack of surfactant |
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Malabsorption of fat soluble vitamins is likely in most patients with what?
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Cystic Fibrosis
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Generalized dysfunction of the exocrine glands that affects multiple organ systems. Inherited disease affecting sodium channels in the body and causes respiratory and digestive problems
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Cystic Fibrosis
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Cystic Fibrosis is the most common fatal genetic disease in whom?
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White children
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Cystic fibrosis affects the _____ and _____ glands of the body and is caused by a defective _____.
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Mucus
Sweat Gene |
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What kind of mucus is formed in cystic fibrosis?
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Thick mucus in the lungs predisposing the patient to lung disease
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Cystic Fibrosis affects whom, and what is its life expectancy?
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Males and females
28 years |
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What are the complications of Cystic fibrosis?
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Chronic pulmonary disease
Pancreatic insufficiency Meconium ileus (intestinal obstruction in newborns) |
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What gene causes cystic fibrosis?
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Cystic Fibrosis transmembrane conductance regular gene (CFTR) on the long arm of chromosome 7.
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What does the CFTR gene code for?
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membrane proteins that facilitate movement of chloride and other ions across membranes.
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An important diagnostic test in which secretion by sweat glands of chloride and sodium is normal, but their reabsorption by sweat ducts is impaired.
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Sweat Test
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Characterized by hemangiomas of the retina and cerebellum. Also associated with cysts of the liver, kidney, adrenal glands, and pancreas.
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Von hippel-Lindau disease
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An uncommon hereditay connective tissue disorder that results in abnormalities of the eyes, bones, heart, and blood vessels. Patients are tall and thin with abnormally long legs and arms and spiderlike fingers.
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Marfan syndrome
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A genetic defect characterized by anomalies of receptors for low density lipoproteins (LDL receptors), and can result in atherosclerosis and its complications.
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Familial Hypercholesterolemia
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What is caused by the inhalation of carbon dust?
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Anthracosis
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Environmental diseases caused by prolonged inhalation of inorganic dust particles, which lead to fibrosis of the lungs.
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Pneumoconiosis
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What are the main symptoms of pneumoconiosis?
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Chronic dry cough and shortness of breath
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What are the specific types of pneumoconiosis?
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Anthracosis
Coal workers' pneumoconiosis Silicosis Asbestosis Beryliosis |
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Caused by the inhalation of carbon dust, and characterized by carbon carrying macrophages which result in black patches visible on gross inspection.
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Anthracosis
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Caused by the inhalation of coal dust, which contains both carbon and silica and exist in two forms:
Simple Progressive massive fibrosis |
Coal miners' pneumoconiosis
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Marked by coal macules around the bronchioles. In most cases, it produces no disability.
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Simple coal miners' pneumoconiosis
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Marked by fibrotic nodules filled with necrotic black fluid and can result in bronchiectasis, pulmonary hypertension or death from respiratory failure or right-sided heart failure.
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Progressive massive fibrosis
(Coal miners/ pneumoconiosis) |
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Causes by inhalation of free silica dust and is characterized by siliotic nodules that enlarge and eventually obstruct the airways and blood vessels.
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Silicosis
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What is the most common and most serious pneumoconiosis and is associated with increased susceptibility to TB
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Silicosis
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Caused by the inhalation of _____ _____. Leads to diffuse interstitial fibrosis, mainly in the lower lobes. Characterized by ferruginous bodies.
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Asbestosis
Asbestos fibers |
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What does asbestosis lead to a predisposition of?
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Bronchogenic carcinoma and malignant mesothelioma of the pleura or peritoneum
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A yellow-brown, rod-sahped bodies that stain with Prussian blue
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Ferringious bodies
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Caused by an inhalation of berylium particles. It is a systemic granulometous disorder characterized by non-caseating granulomas and primary pulmonary involvement and mimics sarcoidosis
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Beryliosis
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An inflammatory process of infectious origin affecting the pulmonary parenchyma, and can be characterized by chills and fever, productive cough, blood-tinged or rusty sputum, hypoxia with shortness of breath, and sometimes cyanosis.
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Pneumonia
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What are the three types of pneumonia?
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Lobar pneumonia
Bronchopneumonia Interstitial pneumonia |
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Most often caused by streptococcus pneumoniae. Characterized by a predominately intra-alveolar exudate, with inflammation and consolidation of a lobe or entire lung. Affects middle aged persons.
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Lobar pneumonia
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Caused by a wide variety of organisms and characterized by a patchy distribution involving one or more lobes, with an intiinflammatory infiltrate extending from the bronchioles into adjacent alveoli. It affects mainly the elderly and infants.
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Bronchopneumonia
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Characterized by diffuse, patchy inflammation localized to interstitial areas of alveolar walls, and affects young children.
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Mycoplasma pnuemniae or virus
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What type of pneumonias tend to be the most serious?
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Bacterial especially S. pnumoniae
most common fatal infection acquired in the hospital. |
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What is the virulence of the the pnomococcus associated with?
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its capsular polysaccharide
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What are the most common causes of pneumonia in young children, peaking between the ages of 2 and 3?
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Respiratory viruses (influenza virus, adenovirus, rhinovirus, RSV)
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What are the clinical findings in pneumonia?
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Cackles on auscultation, hypoxia and infiltrate on chest x-ray
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What bacteria is most responsible for lung abscesses?
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Staphylococcus
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Localized area of liquifactive necrosis that is characterized by destruction of lung tissue forming a cavity. Cavity is filled with pus or pus and gas, and is extremely foul smelling.
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Lung Abscesses
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_____ of cases of lung abscesses are associated with anaerobic organisms found mainly in the oral cavity.
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60%
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What are some mechanisms for the development of lung abscesses?
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Aspiration of infective material
Bronchial obstruction Bronchiectasis Complication of bacterial pneumonia |
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What is the single most common condition predisposing to lung abscesses?
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Alcoholism
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What people are at risk for lung abscesses?
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Drug overdosage
Epileptics Patients w/ neuro-logic dysfunction impairing the gag reflex |
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What do almost all patients with a lung abscess present with?
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Cough and fever
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What is the most characteristic clinical manifestation of lung abscesses?
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Production of large amounts of foul smelling, purulent sputum.
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Along with Staphylcocci what bacteria can cause Lung abscesses?
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Pseudomonas
Klebsiella Proteus Combined with anaerobic organisms |
