Nbde Microbiology/pathology Lng Disord

Front 1

What type of emphysema is associated with aging and alpha1-antitrypsin deficiency?

Back 1

Panacinar (Panlobular)

Front 2

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

Back 2

Emphysema

Front 3

What are the two basic problems for people with emphysema?

Back 3

1. Lungs are fixed in inspiration
2. Respiratory lung surfaces have deteriorated so that they can no longer do gas exchange.

Front 4

Obstruction of the lungs is a result of what?

Back 4

Tissue changes rather than mucus production

Front 5

What diseases of the lungs causes mucous production?

Back 5

Asthma
Chronic bronchitis

Front 6

The volume change per unit of pressure change across an elastic structure.

Back 6

Compliance

Front 7

What is the distinguishing characteristics of emphysema?

Back 7

Limited air flow due to limited elastic recoil in the lungs
Also causes an increase in compliance

Front 8

What are the three types of emphysema?

Back 8

Panacinar (panlobular)
Paraseptal (distal acinar)
Centriacinar (centrilobular)

Front 9

Emphysema that destroys alveoli and alveolar ducts; lower lobes of lungs mostly affected; associated with aging and alpha1-antitrypsin deficiency

Back 9

Panacinar (panlobular)

Front 10

Emphysema that commonly causes spontaneous pneumothorax in young adults

Back 10

Paraseptal (distal acinar)

Front 11

Emphysema that is associated with chronic bronchitis and smoking; destroys respiratory bronchioles; upper lobes of the lungs mostly are affected.

Back 11

Centriacinar (centrilobular)

Front 12

What is the most common cause of emphysema?

Back 12

Smoking

Front 13

What is a naturally occurring substance in the lungs which may prevent emphysema?

Back 13

Alpha1-antitrypsin

Front 14

Emphysema and chronic bronchitis frequently co-exist together to comprise what?

Back 14

Chronic obstructive pulmonary disease (COPD)

Front 15

Hyperplasia of bronchial submucosal glands is the characteristic pathologic change in what?

Back 15

Chronic Bronchitis

Front 16

A disease state characterized by the presence of airflow obstruction due to chronic bronchitis or emphysema, in most cases these occur together.

Back 16

COPD

Front 17

Disease defined clinically as the presence of a chronic productive cough for _____ months during each of _____ consecutive years.

Back 17

Chronic bronchitis
3
2

Front 18

What diseases does COPD often overlap with?

Back 18

Asthma
Bronchiectasis

Front 19

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

Back 19

Bronchial Asthma

Front 20

What are the key features of Bronchial asthma?

Back 20

Expiratory wheezing
Extrinsic (triggered by allergen)
Intrinsic (triggered by cold, exercise)

Front 21

Hyperplasia of bronchial submucosal glands, leading to increased Reid index

Back 21

Chronic Bronchitis

Front 22

What is the Reid index

Back 22

The ratio of the thickness of the gland layer to that of the bronchial wall

Front 23

What are the key features of chronic bronchitis?

Back 23

Blue bloaters
Chronic Irritation

Front 24

What is an abnormal dilation of air spaces with destruction of alveolar walls, reduced lung elasticity.

Back 24

Emphysema

Front 25

What are the key features of emphysema?

Back 25

Pink puffers
Barrel chest

Front 26

Abnormally dilated bronchi filled with mucus and neutrophils; inflammation and necrosis of bronchial walls and alveolar fibrosis

Back 26

Bronchiectasis

Front 27

What are the key features of Bronchiectasis?

Back 27

Copious purulent sputum, hemoptysis
Result of chronic infections

Front 28

What is most often caused by COPD?

Back 28

Secondary pulmonary hypertension

Front 29

What type of hypersensitivity is attributed to Extrinsic Asthma?

Back 29

Type 1 Hypersensitivity reaction of the airways.

Front 30

Chronic reactive airway disorder that causes episodic airway obstruction, which results from bronchospasms, increased mucus secretion, and mucosal edema.

Back 30

Asthma

Front 31

What is the prevalence by age of asthma?

Back 31

Can occur at any age
50% occur in children under 10
2x as many boys as girls

Front 32

What are the two types of asthma?

Back 32

Extrinsic (Immune)
Intrinsic (Nonimmune)

Front 33

Mediated by type 1 hypersensitivity response involving IgE bound to mast cells. begins in childhood, usually in patients with a family history of allergy.

Back 33

Extrinsic (immune) asthma

Front 34

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.

Back 34

Intrinsic (nonimmune) asthma

Front 35

What symptoms are associated with Asthma?

Back 35

Episodic dyspnea and wheezing expiration caused by narrowing airways.

Front 36

A very common, debilitating respiratory disease, characterized by increased production of mucous by the glands of the trachea and bronchi.

Back 36

Chronic bronchitis

Front 37

Enlargement of the right ventricle of the heart

Back 37

Cor Pulmonale

Front 38

What are the common results of chronic bronchitis?

Back 38

Cor Pulmonale
Airway narrowing, and obstruction
Squamous metaplasia of bronchial tree

Front 39

What are the characteristic pathologic change in chronic bronchiti?

Back 39

Hyperplasia of bronchial submucosal glands and bronchial smooth muscle hypertrophy

Front 40

What can patients with chronic bronchitis be predisposed to?

Back 40

Lung Cancer (bronchogenic carcinoma)

Front 41

What does left sided congestive heart failure result in?

Back 41

Pulmonary Edema

Front 42

The accumulation of fluid in the extravascular spaces of the lungs. Caused by left sided heart failure and results in increased pressure in the _____ _____.

Back 42

Pulmonary edema
Pulmonary veins

Front 43

What occurs in pulmonary edema?

Back 43

- 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

Front 44

What is Pulmonary edema caused by physiologically?

Back 44

- Increased Hydrostatic pressure
- Increased Alveolar capillary permeability

Front 45

What is increased hydrostatic pressure caused by in regards to pulmonary edema?

Back 45

Lt. ventricular failure or mitral stenosis

Front 46

What is increased alveolar capillary permeability caused by in regards to pulmonary edema?

Back 46

Inflammatory alveolar reactions from:
- Inhalation of irritant gases
- Pneumonia
- Shock
- Sepsis
- Pancreatitis
- Uremia
- Drug Overdose

Front 47

What are the early symptoms of pulmonary edema?

Back 47

Dyspnea, oropnea, coughing

Front 48

What are the clinical features of pulmonary edema?

Back 48

tachycardia, tachypnea, dependent cackles, neck vein distension

Front 49

What is the designed treatment of pulmonary edema?

Back 49

Designed to reduce extravascular fluid, improving gas exchange (oxygen, diuretics, vasopressorsect.)

Front 50

An irreversible, abnormal dilation of the bronchi or bronchioles caused by destruction of their supporting structures by chronic necrotizing infection.

Back 50

Bronchiectasis

Front 51

Who is Bronchiectasis most common in?
What is the most common symptom?

Back 51

Children with cystic fibrosis
Chronic, productive cough with a foul-smelling, purulent sputum.

Front 52

What can recurrent pulmonary infection lead to?

Back 52

Lung abscess

Front 53

What does bronchiectasis most often involve?

Back 53

The lower lobes of the lungs

Front 54

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.

Back 54

Atelectasis

Front 55

What is atelectasis also known as?
In whom is it most common?

Back 55

Atelectasis neonatorum
Common in premature infants due to lack of surfactant

Front 56

Malabsorption of fat soluble vitamins is likely in most patients with what?

Back 56

Cystic Fibrosis

Front 57

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

Back 57

Cystic Fibrosis

Front 58

Cystic Fibrosis is the most common fatal genetic disease in whom?

Back 58

White children

Front 59

Cystic fibrosis affects the _____ and _____ glands of the body and is caused by a defective _____.

Back 59

Mucus
Sweat
Gene

Front 60

What kind of mucus is formed in cystic fibrosis?

Back 60

Thick mucus in the lungs predisposing the patient to lung disease

Front 61

Cystic Fibrosis affects whom, and what is its life expectancy?

Back 61

Males and females
28 years

Front 62

What are the complications of Cystic fibrosis?

Back 62

Chronic pulmonary disease
Pancreatic insufficiency
Meconium ileus (intestinal obstruction in newborns)

Front 63

What gene causes cystic fibrosis?

Back 63

Cystic Fibrosis transmembrane conductance regular gene (CFTR) on the long arm of chromosome 7.

Front 64

What does the CFTR gene code for?

Back 64

membrane proteins that facilitate movement of chloride and other ions across membranes.

Front 65

An important diagnostic test in which secretion by sweat glands of chloride and sodium is normal, but their reabsorption by sweat ducts is impaired.

Back 65

Sweat Test

Front 66

Characterized by hemangiomas of the retina and cerebellum. Also associated with cysts of the liver, kidney, adrenal glands, and pancreas.

Back 66

Von hippel-Lindau disease

Front 67

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.

Back 67

Marfan syndrome

Front 68

A genetic defect characterized by anomalies of receptors for low density lipoproteins (LDL receptors), and can result in atherosclerosis and its complications.

Back 68

Familial Hypercholesterolemia

Front 69

What is caused by the inhalation of carbon dust?

Back 69

Anthracosis

Front 70

Environmental diseases caused by prolonged inhalation of inorganic dust particles, which lead to fibrosis of the lungs.

Back 70

Pneumoconiosis

Front 71

What are the main symptoms of pneumoconiosis?

Back 71

Chronic dry cough and shortness of breath

Front 72

What are the specific types of pneumoconiosis?

Back 72

Anthracosis
Coal workers' pneumoconiosis
Silicosis
Asbestosis
Beryliosis

Front 73

Caused by the inhalation of carbon dust, and characterized by carbon carrying macrophages which result in black patches visible on gross inspection.

Back 73

Anthracosis

Front 74

Caused by the inhalation of coal dust, which contains both carbon and silica and exist in two forms:
Simple
Progressive massive fibrosis

Back 74

Coal miners' pneumoconiosis

Front 75

Marked by coal macules around the bronchioles. In most cases, it produces no disability.

Back 75

Simple coal miners' pneumoconiosis

Front 76

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.

Back 76

Progressive massive fibrosis
(Coal miners/ pneumoconiosis)

Front 77

Causes by inhalation of free silica dust and is characterized by siliotic nodules that enlarge and eventually obstruct the airways and blood vessels.

Back 77

Silicosis

Front 78

What is the most common and most serious pneumoconiosis and is associated with increased susceptibility to TB

Back 78

Silicosis

Front 79

Caused by the inhalation of _____ _____. Leads to diffuse interstitial fibrosis, mainly in the lower lobes. Characterized by ferruginous bodies.

Back 79

Asbestosis
Asbestos fibers

Front 80

What does asbestosis lead to a predisposition of?

Back 80

Bronchogenic carcinoma and malignant mesothelioma of the pleura or peritoneum

Front 81

A yellow-brown, rod-sahped bodies that stain with Prussian blue

Back 81

Ferringious bodies

Front 82

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

Back 82

Beryliosis

Front 83

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.

Back 83

Pneumonia

Front 84

What are the three types of pneumonia?

Back 84

Lobar pneumonia
Bronchopneumonia
Interstitial pneumonia

Front 85

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.

Back 85

Lobar pneumonia

Front 86

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.

Back 86

Bronchopneumonia

Front 87

Characterized by diffuse, patchy inflammation localized to interstitial areas of alveolar walls, and affects young children.

Back 87

Mycoplasma pnuemniae or virus

Front 88

What type of pneumonias tend to be the most serious?

Back 88

Bacterial especially S. pnumoniae
most common fatal infection acquired in the hospital.

Front 89

What is the virulence of the the pnomococcus associated with?

Back 89

its capsular polysaccharide

Front 90

What are the most common causes of pneumonia in young children, peaking between the ages of 2 and 3?

Back 90

Respiratory viruses (influenza virus, adenovirus, rhinovirus, RSV)

Front 91

What are the clinical findings in pneumonia?

Back 91

Cackles on auscultation, hypoxia and infiltrate on chest x-ray

Front 92

What bacteria is most responsible for lung abscesses?

Back 92

Staphylococcus

Front 93

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.

Back 93

Lung Abscesses

Front 94

_____ of cases of lung abscesses are associated with anaerobic organisms found mainly in the oral cavity.

Back 94

60%

Front 95

What are some mechanisms for the development of lung abscesses?

Back 95

Aspiration of infective material
Bronchial obstruction
Bronchiectasis
Complication of bacterial pneumonia

Front 96

What is the single most common condition predisposing to lung abscesses?

Back 96

Alcoholism

Front 97

What people are at risk for lung abscesses?

Back 97

Drug overdosage
Epileptics
Patients w/ neuro-logic dysfunction impairing the gag reflex

Front 98

What do almost all patients with a lung abscess present with?

Back 98

Cough and fever

Front 99

What is the most characteristic clinical manifestation of lung abscesses?

Back 99

Production of large amounts of foul smelling, purulent sputum.

Front 100

Along with Staphylcocci what bacteria can cause Lung abscesses?

Back 100

Pseudomonas
Klebsiella
Proteus
Combined with anaerobic organisms