Systems Path Lungs

collapsed lung

atelectasis

lung collapse due to airway obstruction and resorption of air in alveoli

resorption atelectasis

Features of resorption atelectasis

dyspnea and cyanosis

risks associated with resorption atelectasis

CF, chronic bronchitis, tumor, foreign body

form of lung collapse where pleural space fills with fluid/air and compresses lungs causing collapse

compression (passive) atelectasis

features of compression atelectasis

dyspnea and cyanosis

risks for developing compression atelectasis?

heart failure and trauma

form of lung collapse due to decreased lung expansion; chronic inflammation leads to fibrosis

contraction atelectasis

risk associated with developing contraction atelectasis

history of pulmonary fibrosis

features of contraction atelectasis

dyspnea and cyanosis ; poor prognosis

severe lung injury that leads to alveolar damage and massive inflammation characterized by severe dyspnea, cyanosis, and hyaline membranes

acute respiratory distress syndrome (ARDS)

why may someone develop ARDS?

history of pneumonia or trauma

signs/symptoms of ARDS

diffuse alveolar damage, bilateral pulmonary infiltrates, acute dyspnea, hypoxemia, organ failure

acute/subacute respiratory illness defined by e-cig / vaping use, pulmonary infiltrates, or absence of other lung disease

vaping associated lung injury (VALI)

viral causes of common cold

rhinovirus, coronavirus, RSV, influenza

bacterial causes of common cold

group A b-hemolytic strep or H. influenzae

locations of acute respiratory infections

nasal cavity, pharynx, larynx, epiglottis

widespread viral infection called the "kissing disease" characterized by pharyngitis, lymphadenopathy, exudative pharyngitis, and splenomegaly

EBV (mono)

Cause of acute laryngitis

inhalation of irritating agent

acute laryngitis symptoms

pharyngitis, hoarseness, cough, dysphagia

alternative forms of laryngitis

tuberculosis, diphtheritic

hallmark of diphtheria

"dirty gray" pseudomembranes

Diphtheria causative agent

Corynebacterium diphtheriae

self-limited viral URTI caused by parainfluenza (MC) or RSV

laryngotracheobronchitis (Croup)

hallmarks of croup

prominent stridor, "seal-like" bark

croup increases risk for

secondary bacterial infection (staph MC, strep, H. influenzae)

small, round nodules on vocal cords

vocal cord polyp

raspberry-like growth on vocal cords

laryngeal papilloma

who are carcinomas of larynx MC in?

>40 years, males

what are carcinomas of larynx caused by?

smoking, alcohol, irradiation, asbestos

malignancy of larynx, early sign = hoarseness

laryngeal carcinoma

MC laryngeal carcinoma (60-70% of cases)

glottic

20-40% of laryngeal cancers

supraglottic

very rare laryngeal carcinoma

subglottic

what is the most common site of metastasis?

lungs

MC lung tumor which is benign and characterized by a single solitary pulmonary nodule called a "coin lesion"

hamartoma

lung tumor which arises from bronchial epithelia

bronchogenic carcinoma

malignancy of bronchial glandular cells which is usually found in non-smokers

adenocarcinoma

who is an adenocarcinoma MC in?

ages 50-70

malignancy of bronchial epithelial cells common in smokers

squamous cell carcinoma

malignant of bronchial epithelial cells which is the worst prognosis of all lung cancers due to increased odds of metastasis at time of diagnosis

small-cell carcinoma

who is small cell carcinomas common in?

smokers age 50-70

malignancy of bronchial epithelial cells common in smokers and non-smokers

large cell carcinoma

what causes 90% of lung cancers?

smoking

sites of mets from lung cancer?

brain, liver, bones, adrenals

most aggressive lung cancer

small cell carcinoma

MC non-small cell lung cancer located in pulmonary apex which leads to damage and symptoms with vertebrae, upper ribs, brachial plexus and sympathetics

pancoast tumor

who is pancoast tumors common in?

smokers age 50-70

signs and symptoms of pancoast tumor

pancoast syndrome and Horner syndrome

shoulder pain/C8-T2 radicular pain

pancoast syndrome

ptosis, miosis, anhindrosis

Horner syndrome

fluid in pleural cavity

pleural effusion

protein poor pleural effusion caused by heart failure

transudate (hydrothorax)

MC cause of pleural effusion

heart failure

protein rich pulmonary effusion caused by inflammatory conditions

exudate (pleuritis)

pus in pleural space

empyema

causes of pleural exudate

bacterial/viral infections, tumors, pulmary infarction

air within pleural cavity

pneumothorax

a type of pneumothorax in which air that enters the chest cavity is prevented from escaping and shifts mediastinum

tension pneumothorax

blood in pleural cavity

hemothorax

lymphatic fluid in pleural cavity

chylothorax

malignancy of mesothelium (pleura) associated almost exclusively with asbestos exposure

mesothelioma

How does mesothelioma develop?

chronic inflammation and failed phagocytosis due to asbestos

alveolar inflammation from infection causing fever and lung consolidation

pneumonia

what type of acute bacterial pneumonia affects multiple lobes?

bronchopneumonia

90% of lobar pneumonia is from what?

strep. pneumoniae

what type of pneumonia affects a single lobe, has homogenous consolidation and an abrupt line of radiopacity?

lobar pneumonia

acute lung infection from strep pneumonia, commonly follows a viral URTI, causing productive cough, fever and dyspnea

community-acquired acute pneumonia (able to be seen on X-ray)

how does community-acquired acute pneumonia develop?

local inflammation -> consolidation

risks factors associated with developing community-acquired acute pneumonia

diabetes, CHF, COPD, immunosuppression, reduced splenic function

a lobar pneumonia caused by the bacterium Legionella pneumophila which causes dyspnea, fever and aches

legionnaire disease

pathology caused by legionella pneumophila causing a mild URTI

pontiac fever

"self limited" acute lung infection from common cold virus/mycoplasma pneumonia ; causes non-productive cough and mild dyspnea

community-acquired atypical pneumonia

how does community-acquired atypical pneumonia develop?

local inflammation of alveolar septa ( no consolidation on X-ray)

what is different about community-acquired atypical pneumonia?

edema is confined to alveolar septa

community-acquired atypical pneumonia causative agent

mycoplasma pneumoniae

what type of pneumonia is caused by staph aureus (MC) or E.coli and acquired after being in a hospital setting for 48+ hours?

hospital-acquired (nosocomial)

Symptoms of hospital acquired pneumonia

productive cough, dyspnea, fever

how does hospital acquired pneumonia develop?

local inflammation = consolidation (able to be seen on xray)

pneumonia caused by inhalation of foreign material such as gastric contents

aspiration pneumonia

aspiration pneumonie causative agents

strep pneumoniae, staph aureus, H. influenze

areas of suppurative necrosis due to bacterial infection causing foul/purulent septum, cavitation (right-side), fever, cough, etc.

lung abscess

causes of a lung abscess

aspiration, bronchial obstruction, hematogenous spread

chronic infection of mycobacterium tuberculosis which is the MC cause of infectious disease worldwide

tuberculosis

What type of tuberculosis simply means infected, not symptomatic or contagious?

primary

what type of tuberculosis is symptomatic with hemoptysis, productive cough, fever and malaise and the infection is no longer dormant

secondary

what is TB diagnosed by?

tuberculin test

how does primary TB develop?

sensitization and walling off in granulomas

how does secondary TB develop?

re-emergence of T-cell hypersensitivity resulting in destructive cavitations

How is TB transmitted?

respiratory droplets

who is most likely to get TB?

80% in endemic areas of Africa and Asia

subpleural caseous granulomas

ghon focus

sub pleural and lymph node regions have granulomas (tuberculoma)

ghon complex

calcification and fibrosis of hisar nodes

ranke complex

systemic tuberculosis infection caused by pulmonary lymphatic and hematogenous spread

military tuberculosis

who can develop military TB?

anyone with secondary TB

MC form of extrapulmonary TB

lymphadenitis

TB in the spine

Pott's disease

what poses as a risk for developing pneumonia?

immunosuppression (AIDS, transplant recipients, elderly, radiation)

opportunistic viral pathogen causing fever and respiratory infection

cytomegalovirus (HHV-5)