Pulmonary - Pulmonary Pathology Pt. 1

what are the 3 patterns of atelectasis?

• -Resorption (obstruction)

• -Compression

• -Contraction

what is atelectasis?

collapsed lung

resorption atelectasis is caused by?

obstruction in the airway

- potentially reversible

which patterns of atelectasis are reversible?

resorption (obstruction)

compression

which pattern of atelectasis is irreversible?

contraction

compression atelectasis is due to...

fluid, blood or air accumulation in pleural cavity

- potentially reversible

contraction atelectasis is due to?

scarring causing contraction of parenchyma

what results from increased fluid in alveolar wall, usually from left ventricular failure?

pulmonary edema

what are "heart failure cells"

Macrophages within alveolar spaces that have phagocytosed hemoglobin

what causes increased work and right heart failure (cor pulmonale)?

pulmonary hypertension

between primary (idiopathic) and secondary pulmonary hypertension, which is more common?

secondary

pulmonary emboli account for how many deaths a year in the US?

100,000

T or F: death from pulmonary embolism may be virtually instantaneous

TRUE

pulmonary emboli are typically seen with...

venous stasis

T or F: pulmonary emboli has equal occurence no matter what material causes the embolism

FALSE they are rarely due to other material

what pathology presents as Granulomatosis with polyangiitis?

pulmonary vasculitis

what pathology was formerly known as Wegener granulomatosis?

pulmonary vasculitis

what is a characteristic oral manifestation of pulmonary vasculitis?

strawberry gingivitis

what pathology is associated with strawberry gingivitis?

Granulomatosis with polyangiitis

Pulmonary edema most commonly caused by...

left ventricular failure

what causes right heart failure?

pulmonary hypertension

pulmonary emboli most commonly are from...

deep leg veins

- 5% may cause sudden death, cor pulmonale or shock

4 pathologies associated with obstructive lung disease:

• Emphysema

• Bronchitis

• Asthma

• Bronchiectasis

❖Abnormal enlargement of airspaces distal to terminal bronchioles

❖ Destruction of alveolar walls

the above are characteristic of what?

emphysema

will you see scarring in emphysema?

NO

T or F: emphysema is strongly associated with cigarette smoking

TRUE

what is the most common, clinically significant type of emphysema?

centriacinar (centrilobular)

• -More common and severe in upper lobes

specifically, what type of emphysema is most commonly associated with smoking?

centriacinar (centrilobular)

is centriacinar (centrilobular) emphysema associated with alpha1-antitrypsin deficiency?

NO

which type of emphysema associated with alpha1-antitrypsin deficiency?

Panacinar (panlobular)

Panacinar (panlobular) emphysema more often affects which parts of the lungs?

lower lung zones

What is the most common pattern of emphysema?

GENERALLY

NO ASSOCIATION W/ SMOKING

irregular emphysema

the following represent the pathogenesis of what lung condition?

❖Results from insufficient wound repair

❖Exposure to toxins induces chronic inflammation

❖Imbalance between proteases and protease inhibitors

emphysema

T or F: chronic bronchitis is a clinical diagnosis

TRUE

what presents as Persistent productive cough for at least 3 consecutive months in 2 consecutive years?

chronic bronchtitis

T or F: there is no clear link between cigarette smoking and chronic bronchitis

FALSE

- it is clearly linked to cigarette smoking

- Also associated with air pollution, infection, and genetic factors

Airway obstruction due to hypersecretion of mucus describes what?

chronic bronchtitis

the following are hallmarks of what disease?

❖Intermittent and reversible airway obstruction

❖Chronic bronchial inflammation

❖Bronchial smooth muscle cell hypertrophy

❖Increased mucus secretion

❖Eosinophilic infiltrate with Charcot-Leyden crystals

asthma

what subcategory of asthma is a type I hypersensitivity response that begins in childhood, usually in families with history of allergy?

atopic asthma

Dilation of bronchi and bronchioles describes what pathology?

bronchiectasis

what is an important predisposing condition to bronchiectasis?

necrotizing pneumonia

the following describe what pathology?

❖ Forced vital capacity reduced

❖Expiratory flow rate reduced proportionately

restrictive pulmonary disease

❖ Normal FEV:FVC ratio

what are the 2 relevant categories of chronic interstitial lung disease seen in restrive pulmonary disease?

fibrosing

granulomatous

the following describes what disease?

❖Lung reaction to inhalation of organic or inorganic particles

pneumoconiosis

what is the most common mineral duct pneumoconiosis?

coal dust,silica, and asbestos

what substance worsens effects of all inhaled mineral dusts, especially asbestos?

tobacco smoking

what is the most prevalent chronic disease worldwide?

silicosis

• Caused by inhalation of silica, especially in crystalline form (e.g.,quartz)

the following are 2 complications of what disease?

❖Increases susceptibility to tuberculosis

❖ Carcinogenesis?

silicosis

what substance includes an increased cancer risk in the family of those exposed?

asbestos

what substance is linked to multiple diseases including:

❖Interstitial fibrosis

❖Lung carcinoma

❖Mesothelioma

❖Laryngeal carcinoma

asbestos

what pathology is an Idiopathic multisystem disorder associated with bilateral hilar lymphadenopathy?

sarcoidosis

• High incidence in Swedish, Danish, and African-American populations

• Predilection for adults

sarcoidosis is the result of formation of what?

noncaseating granulomas

with treatment of acute respiratory death syndrome:

• - Continuous positive airway pressure ventilation with support of cardiac, circulatory, and renal function

the mortality rate has been reduced to...

40%

• - Death usually from systemic inflammatory response syndrome with multi-organ failure