Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
43 Cards in this Set
- Front
- Back
What will aspiration of a foreign body result in the lung?
|
Obstruction atelectasis
|
|
Presence of fluid, air or tumor in the pleural space results in what type of atelectasis?
|
Compression atelectasis
|
|
Contraction atelectasis is due to what cause?
|
Fibrosis of the lung
|
|
Causes of patchy atelectasis
|
Lack of surfactant (hyaline membrane disease of newborn or ARDS)
|
|
Clinical features of typical pneumonia
|
Sudden onset, high fever, productive cough, tachypnea, pleuritic chest pain, consolidation on x-ray
|
|
Clinical features of atypical pneumonia
|
Insidious onset, low fever, no cough, no consolidation
|
|
Differential diagnosis of rusty sputum
|
Strep pneumonia, CHF, mitral stenosis, Goodpasture syndrome
|
|
Features of sarcoidosis
|
"GRAIN": gammaglubilinemia, rheumathoid arthritis, ACE increase, interstitial fibrosis, non-casseating granuloma, bilateral lymphadenopathy
|
|
Causes of restrictive pulmonary disease
|
Kyphoscoliosis, obesity, pneumoconiosis, ARDS, pulmonary fibrosis, sarcoidosis
|
|
Causes of obstructive pulmonary disease
|
Asthma, emphysema, chronic brnchitis, bronchiectasis
|
|
Lung volumes in obstructive pattern
|
Increased TLC, FRC and RV. Decreased FEV1, FVC, FEV1/FVC
|
|
Lung volumes in restrictive pattern
|
Decreased, TLC, FEV1, FVC, FRC, RV. Increased or normal FEV1/FVC
|
|
Diagnosis criteria for chronic bronchitis
|
Persistent cough and copius sputum production for at least 3 months in 2 consecutive years
|
|
Clinical features of chronic bronchitis
|
Cough, sputum production, dyspnea, infections, hypoxia, cyanosis, weight gain. "Blue bloater"
|
|
Microscopic findings in chronic bronchitis
|
Hypertrophy of bronchial mucous glands, globlet cell hyperplasia, mucus hypersecretion, bronchial metaplasia
|
|
Complications of chronic bronchitis
|
Recurrent infections, cor pulmonale, lung cancer
|
|
Definition of emphysema
|
destruction of alveolar septa resulting in enlarged air spaces and loss of elastic recoil
|
|
Etiology of emphysema
|
Protease/antiprotease imbalance. Proteases are made by macrophages and neutrophils. Antiproteases are alpha-1-antitrypsin, alpha-1-macroglubulin and secretory leukoprotease inhibitor
|
|
Features of centriacinar emphysema
|
Proximal brnchioles involved, distal brnchioles spared, most common (95%), associated with smoking, worst in apical segments of upper lobes
|
|
Features of panacinar emphysema
|
Entire acinus invololved, alpha-1-antitrypsin deficincy, worse in bases of lower lobes
|
|
Clinical features of emphysema
|
Progressive dyspnea, pursing of lips and accesory muscles, barrel chest, weight loss, "Pink puffer"'
|
|
Clinical features of asthma
|
Wheezing, severe dyspnea, coughing
|
|
Microscopic features of asthma
|
Charcot-leyden crystals, mucous plugs, goblet cell hyperplasia and hypertrophy, eosinophils, edema, hypertrophy of smooth muscle, thick basement membranes
|
|
Clinical features of bronchiectasis
|
cough, fever, malodorous purulent sputum, dyspnea, dilated bronchi extending out to pleura on x-ray
|
|
Etiology of bronchiectasis
|
Bronchial obstruction, necrotizing pneumonia, cystic fibrosis, Kartagener syndrome
|
|
Definition of acute respiratory distress syndrome
|
damage of alveolar epithelium and capillaries resulting in respiratory failure that is unresponsive to O2 treatment
|
|
Causes of ARDS
|
shock, sepsis, trauma, gastric aspiration, radiation, O2 toxicity, drugs, infections
|
|
Clinical features of ARDS
|
dyspnea, tachypnea, hypoxemia, cyanosis, use of accesory respiratory muscles. Bilateral lung opacity on x-ray
|
|
Microscopic features of ARDS
|
interstitial and alveolar edema, interstitial inflamation, loss of type I pneumocytes, hyaline membrane formation
|
|
RDS of newborn
|
Deficiency of surfactant in prematures (<28 weeks) and sons of diabetic mothers. Dyspnea, tachypnea, nasal flaring and cyanosis. Lecithin:sphyngomyelin < 2. Rx.: surfactant and dexamethasone
|
|
Causes of pulmonary edema
|
left heart failure, mitral stenosis, fluid overload, nephrotic syndrome, liver disease
|
|
Microscopic features of pulmonary edema
|
Intra-alveolar fluid, engorged capillaries, hemosiderin-ladden macrophages
|
|
Risk factors and genetics of bronchogenic CA
|
Cigarette smoking, pneumoconiosis, pollution. Oncogenes: L-myc (SCC), K-ras (adeno). Suppressor genes: p53 and Rb
|
|
Clinical features of bronchogenic CA
|
Cough, sputum production, weight loss, anorexia, fatigue, dyspnea, hemoptysis, chest pain. Obstruction may produce emphysema, atelectasis, bronchiectasis or pneumonia
|
|
Lung adenocarcinoma
|
Most common - 35%. More common in women. Peripheral gray mass, scarring and mucin-producing glands
|
|
Squamous cell carconima
|
2nd most common - 30%. More common in males, related to smoking. Centrally located. Invasive squamous cells with desmosomes and keratin production, PTH production
|
|
Small cell carcinoma
|
20%. More common in males, associated to smoking. Central location. Basophilic neurosecretory granules and paraneoplastic syndromes (ACTH, ADH)
|
|
Pancoast tumor
|
Apical tumor causing Horner syndrome (ptosis, miosis, anhidrosis, enopthalmos)
|
|
Superior vena cava syndrome
|
Obstruction, distended head and neck veins, plethora, facial edema
|
|
Effects of lung masses within the thorax structures
|
Pancoast tumor, superior vena cava syndrome, esopahgeal obstruction, recurrent laryngeal nerve hoarseness, Eaton-Lambert syndrome
|
|
Sites of metastasis of lung cancer
|
Adrenals (>50%), liver, brain, bone
|
|
Eaton-lambert syndrome
|
auto-antibodies against presynaptic Ca channels in neuromuscular junction
|
|
Metastasis to the lung
|
Breast (most common)
|