Word association

respiratory

"pursed lips"?

pink puffer emphysema.

"red face"?

blue bloater chronic bronchitis.

HLA-DRB1 1501/2?

Goodpasture.

Dyspnea with bone fracture?

Fat/marrow embolism.

lines of Zahn?

Embolism in flowing blood.

Saddle?

Large embolus.

R2L shunt?

AVM. (right = deoxygenated (aterial), left = oxygenated (venous), AV in AVM, backwards in lungs)

Idiopathic + kids?

Hemosiderosis.

Idiopathic + kids and women 40-60?

Hypertension.

Atherosclerosis-like lesions?

Hypertension.

Cavitations?

Goodpasture. (Grandpa got CANCA for polyangiitis / wegener)

Exudative, Proliferative, Fibrosis?

ALI

Abrupt onset, in absence of heart failure?

ALI

necrosis, hyaline, fibrosis?

ALI

heavy, firm, red and boggy lungs?

ALI

Bilateral ground glass opacities?

DAD

microthrombi (PE), DAD, superinfections, fibrosis?

COVID

neutrophil trap?

COVID

interferon, complement, delayed adaptive?

COVID

Resistance to airflow?

Obstructive.

Reduced expansion?

Restrictive.

Normal FEV1/FVC?

restrictive.

Decreased FEV1/FVC?

obstructive.

Severe recurrent infections with dilation and scarring?

Bronchiectasis.

Scarring/obliteration of small airways?

Bronchiolitis (add obliterans if destroyed)

Alveolar wall damage?

Emphysema.

Protease-antiprotease, oxidant-antioxidant?

Emphysema. One protease is elastase, alpha-1-antitrypsin is its anti.

Subpleural blebs/bullae, floating fragment/alveolar section?

Emphysema.

Subpleural blebs 1+ cm?

Bullous emphysema. Bullae can burst = PTX.

Spiderweb-like looking lung on the outside?

Emphysema.

Decrease in positive pressure (or driving pressure), or elastic recoil?

Emphysema.

Wheezing, smooth muscle hyperplasia, mucus plugs?

Asthma.

Curschmann spirals?

Mucus plugs, mentioned in Asthma.

Charcot-Leyden crystals (dead eosinophil parts)?

Asthma.

Centriacinar, Centrilobular, C-moking, common?

Smoking with a "C", Emphysema. Centrilobular, Most common type. Can't touch distal acinus (sparing).

Upper lobes or upper portions of lower lobes?

Centrilobular emphysema.

Lower lobes/zones, margins?

Panacinar. (or anything dependent [on gravity] like PNA)

Panacinar?

AAT (alpha-1-antitrypsin).

SERPINA 1, chromosome 14, M vs S vs Z?

AAT. Codominant.

Respiratory acidosis + compensatory alkalosis?

Hyperventilation, pink puffers, emphysema.

Cachexia, clubbing?

pink puffer.

red face?

Blue bloater, polycythemia.

Small amplitude QRS, RAD, RVH?

pink puffer emphysema. Lungs hyperexpanded, squishes heart (similar to electrical alternans in pericarditis).

Tachycardia, MAT?

Classic COPD.

Less V/Q mismatches?

Pink puffers vs blue bloaters (chronic bronchitis - extensive damage/fibrosis when repairing).

Right sided HF, cor pulmonale?

Anything that impairs blood flow INTO the lung. Pulmonary HTN is related to Left heart failure because that's impairment of blood flow OUT of the lung.

Alveolar dilation after lung surgery/lobectomy?

Compensatory emphysema.

Hyperinflation of lungs without COPD?

Obstructive overinflation - tumor, foreign object.

Heavy casts, hyperemia (excess blood supply), > 1/2 Reid index (mucosa / wall thickness)?

Chronic bronchitis.

Inflammatory cells in submucosa, hyperplastic mucosa, cough 3+ mo, in last 2 years?

Chronic bronchitis.

Reversible bronchoconstriction, hyper-trophic/plastic smooth muscle + goblet cell, atopic (IgE) or non-atopic (infection, irritant, cold air, exercise)?

Asthma.

Exaggerated TH2 response?

Asthma.

Mast cells early, other leukocytes late?

Asthma.

Distal acinar dilation with fibrosis/scarring around?

Paraseptal emphysema.

Intrapulmonary causes (inflammation, fibrosis), DLco reduced, FEV1/FVC normal?

Restrictive diseases.

Honeycombing, bunch of factors, "danger signals", interstitial pneumonia?

Idiopathic fibrosis.

Blue on trichrome stain?

Fibrosis.

Weird drugs or radiation exposure?

Fibrosis.

Velcro crackles on auscultation, 55+ year old?

Idiopathic fibrosis.

60+ female, non-smoker, no honeycomb?

Nonspecific Interstitial Pneumonia (aka Fibrosis).

Plugs/balls of loose fibrous tissue, BOOP, bronchiolitis obliterans?

Cryptogenic Organizing Pneumonia.

Large particles in pneumoconiosis?

Think upper airway.

Small particles in pneumoconiosis?

Think alveoli.

Anthracosis, macules/nodules?

Coal worker's pneumoconiosis. Both are carbon-laden macrophages but nodules have fibrosis.

Exposure to coal but no significant decline in lung function?

Simple CWP.

Massive fibrosis in late-stage of diseases?

Complicated CWP.

Massive fibrosis in chronic stage, upper lobes more than lower?

Silicosis.

Black lung disease?

CWP.

Eggshell lymph nodes, increases TB?

Silicosis. Eggshell finish reminds me of sandblasted metal parts.

Acute form resembles pulmonary alveolar proteinosis?

Silicosis. Leads to secondary PAP.

Pleural plaques, mesothelioma, (adeno)carcinoma?

Asbestosis. Add smoking to get (adeno)carcinoma.

Amphiboles, chrysotiles, bystanders affected?

Asbestosis. Amphiboles more pathogenic apparently.

Asymptomatic for the first 10 years?

Asbestosis.

Black on Prussian blue ferruginous bodies?

Asbestos bodies wrapped in iron.

Noncaseating granulomas?

Hypersensitivity Pneumonitis OR Sarcoidosis. Densely packed - sarcoidosis, loosely formed - hypersensitivity. Unknown antigen - Sarcoidosis. Bizarre exposures - Hypersensitivity.

Noncaseating granulomas + multisystem?

Sarcoidosis.

HLA-A1/B8, black 40- Americans 10x, higher in non-smokers?

Sarcoidosis.

Hilar lymphadenopathy, elevated ACE?

Sarcoidosis.

Noncaseating granulomas + exposure to bizarre things?

Hypersensitivity pneumonitis. Pigeon poop, sugar cane, thermophilic bacteria, moldy hay.

Alveolar macrophages with dusty-brown pigment?

Desquamative interstitial Pneumonia due to smoking.

Cough goes away after you stop smoking?

Respiratory bronchiolitis, also pigmented macrophages.

Eosinophils in parasitic infections, asthma, hypersensitivity pneumonitis, allergies?

Secondary eosinophilia.

Night sweats, cough, dyspnea?

Idiopathic chronic eosinophilic pneumonia.

GM-CSF, macrophage dysfunction, hunks of gelatinous material?

Pulmonary alveolar proteinosis.

Surfactant disorders, can be autoimmune, secondary, and hereditary, and can last for years with fever?

Pulmonary alveolar proteinosis.

(not emphasized on slides, just a description of an electron microscope slide, should be safe to ignore) ABCA3 mutations?

pulmonary alveolar proteinosis.

What does a high schooler who likes melon flavor use more than a 35+ year old?

Vape pen.

Simulate cigarette smoke in vaping liquids by adding?

Glycol, glycerol.

Dilates/thickens vape liquid, strongly linked to EVALI?

Vitamin E acetate.

Most used nicotine related products in high schoolers?

Any tobacco product, and #2 e-cigarettes.

Smoking cessation efforts?

Not vaping, but maybe varenicline, bupropion.

recent use of vape, negative extensive testing for infection, common illness ruled out?

confirmed case.

recent use of vape, SOME negative testing for infection, common illness ruled out?

probale case.

THC from informal sources?

Outbreak in vape-related lung diseases, EVALI.

22 year old, has a 50/50 chance of ICU admission, with respiratory, GI, and constitutional symptoms?

EVALI.

20 year old stayed in the hospital 7 days, had pneumonia, antibiotics helped?

EVALI.

THC, nicotine, CBD in vapes caused disease in 6/10 males and 3/10 females?

EVALI.

Most common age of EVALI patients?

22. (18-24 year olds)

Least common age of EVALI patients?

Under 18. Second lowest 35+.

Hospitalized with tachypnea, SOB, tachycardia and ground-glass opacities between July and September?

EVALI.