Syst. Path 1 - Exam 4 - Lungs

type I pneumocytes function

type II

pulmonary alveolar macrophages

gas exchange

surfactant

rid of debris

what is a common sign of tissue hypoxia that is observed on the hands

nail clubbing

obstructive lung diseases results from an obstruction in the airways causing airflow resistance which can produce ____ on exhalation

wheezing

describe the levels of forced expiratory rate and the FVC (total volume) for obstructive lung conditions

reduced expiratory rate

normal FVC

anatomic narrowing can lead to which obstructive lung diseases

chronic bronchitis, bronchiectasis, asthma

loss of elastic recoil can lead to which obstructive lung disease

emphysema

which obstructive lung disease results in a pink puffer appearance

emphysema

emphysema is a ___-inflammatory state of the ___ respiratory zone which leads to elevated ___ activity results in destruction of connective tissue within the respiratory area

pro, lower, protease

what part of the alveoli is destroyed in emphysema

alveolar septa

what are some major s/s of emphysema

dyspnea, wheezing, DRY cough

there are 2 types of emphysema, what is the most common type

centriacinar

what is destroyed in centriacinar emphysema? what is the major cause of this condition?

central acinus

smoking

the less common form of emphysema is called

panacinar

what is destroyed in panacinar emphysema

entire acinus

what is the leading cause of panacinar emphysema

genetic antitrypsin deficiency

which type of obstructive lung disease presents as a Blue Bloater

chronic bronchitis

what kind of cough is seen in chronic bronchitis patients

productive - mucus/sputum

what are the diagnostic criteria of chronic bronchitis

persistent productive cough for 3 or more months in 2 or more years

COPD is the result of what two conditions

emphysema + chronic bronchitis

is emphysema or chronic bronchitis seen later in life when compared to each other

emphysema

what is a shared risk factor of both chronic bronchitis and emphysema

smoking, air pollution

is COPD a reversible obstructive lung disease

no

is asthma a reversible obstructive lung disease

yes

what causes the obstruction in asthma

bronchoconstriction

what are the diagnostic factors of asthma

curschmann spirals

charcot-leyden crystals

the atopic form of asthma is caused by ____

allergies

is atopic or non-atopic asthma more common

atopic

the permanent dilation of bronchi from the destruction of connective tissue/musculature represents which obstructive lung disease

bronchiectasis

describe the cough seen in bronchiectasis

severe productive cough

hemoptysis (blood)

purulent foul-smelling sputum

Kartagener Syndrome results from defective what

cilia

Restrictive Lung diseases result from what

decreased lung expansion due to fibrosis

describe FVC and expiratory rate of Restrictive Lung diseases

reduced, normal

ground glass shadows and honeycomb lung describe the dense tissue appearance found in what lung diseases

chronic interstitial

idiopathic pulmonary fibrosis involves widespread interstitial fibrosis from faulty repair and is most common in who

males >55

what is the name of the fibrosing lung disease caused by inhaling a particulate that stimulates inflammatory lung reactions

pneumoconiosis

describe the particulates which will lead to an inflammatory response

mineral dusts between 1-5 micrometers, reactive

which two pneumoconiosis diseases have the potential to cause lung caner

silicosis, asbestosis

what is the most common worldwide pneumoconiosis

silicosis from quartz countertops

does cola/carbon cause a high inflammatory response

no

what is the term that describes the increased pigmentation of the lungs from increased carbon from coal dust

anthracosis

10% of coal worker's pneumoconiosis will reach a stage in which problems start to arise, what is the name of this stage

progressive massive fibrosis

progressive massive fibrosis results when there is significant fibrosis and respiratory distress which lead sot pulmonary ___ and ultimately pulmonary ___ and __ ___

constriction, hypertension, cor pulmonale

what part of the lobe of the lung is affected by coal worker's pneumoconiosis

upper

what part of the lobe is affected by silicosis

upper

on x-ray, silicosis will appear as __-___ calcifications in the upper lung fields

egg shell

asbestos exposure may cause

pleural effusion

what part of the lungs are affected by asbestos

lower lungs/pelura

what is the histological findings of asbestos

ferruginous bodies/asbestos bodies

sarcoidosis of which tissue is the most severe

lungs

is sarcoidosis an autoimmune disorder

yes

what often forms from sarcoidosis

noncaseating granulomas

on x-ray, sarcoidosis often appears a ___-like nodes

potato

bilateral hilar lymphadenopathy is indicative of what

sarcoidosis

who are most at risk for sarcoidosis

Af. Am. danish, swedish, 20-40 year old

non-smokers

t/f

70% of those with sarcoidosis will recover

true

what do most pulmonary embolisms originate as

DVTs

what are risks of pulmonary embolisms

immobility, dehydration, hypercoagulability, oral contraception, metastasis, CHF, trauma

what are some warning signs of a pulmonary embolism

sudden onset of acute dyspnea

cough

chest pain

one consequence of pulmonary emboli is increase pulmonary blood pressure which can lead to ___ ___ and eventually death

cor pulmonale

where do saddle emboli commonly occur

pulmonary artery bifurcation

80% of pulmonary emboli are clinically _____ and 2% are ____

silent, fatal

what is the normal mean pulmonary BP? what number indicates pulmonary hypertension?

12 mmHg

>25 mmHg

what kind of shunt does pulmonary hypertension result in

left to right

what people is primary pulmonary hypertension most common in

young adult females

diffuse alveolar hemorrhage syndromes represents a group of diseases that cause pulmonary _____

hemorrhage

what are the 3 characteristics seen in Diffuse Alveolar Hemorrhage Syndromes

hemoptysis (coughing blood)

anemia

diffuse pulmonary edems

Goodpasture syndrome is an example of diffuse alveolar hemorrhage syndrome in which antibodies act against the ___ and Type 4 kidney ____

lung, collagen

what type of hypersensitivity is Goodpasture syndrome

2

what is a key characteristic of pneumonia

lung consolidation leading to edema/exudate

what are the patterns of appearance of acute bacterial pneumonia

bronchopneumonia

lobar pneumonia

describe bronchopneumonia

patchy edema and consolidation of lungs

describe lobar pneumonia

edema and consolidation in a single lobe

90% of lobar pneumonia is from what causative agent

strep. pneumoniae

what is the causative agent of community-acquired acute pneumonia

strep. penumoniae (pneumococcal pneumonia)

describe the cough of community-acquired acute pneumonia

productive cough with yellow-green sputum

what increases the risk of community-acquired acute pneumonia

long periods of lying on back

what makes community-acquired atypical pneumonia atypical?

no physical findings to support lung consolidation

minimal pulmonary infiltrates

where is edema confined in community-acquired atypical pneumonia

alveolar septa

what microbes cause community-acquired atypical pneumonia

common cold

bacteria: mycoplasma pneumoniae

viral: rhinovirus, coronavirus

where is community-acquired atypical pneumonia commonly spread

schools, military, camps, prisons

describe the cough in community-acquired atypical pneumonia

non-productive

symptoms of hospital-acquired pneumonia occur after how many hours of being at the facility

48

what is the most common bacteria to cause hospital-acquired pneumonia

staph aureus (MRSA)

inhalation of a gastric contents/foreign material leads to ___ pneumonia

aspiration

what kind of people are more at risk of aspiration pneumonia

debilitated

in which lung are lung abscesses more common

right side

what is the causative agent of tuberculosis

mycobacterium tuberculosis

what is the most common cause of infectious death

TB

where is TB most common

SE Asia and Southern Africa regions

describe primary TB

infected but not symptomatic or contagious

describe secondary TB

symptomatic, destructive lung lesions, caseous granulomas

how is TB diagnosed

tuberculin test

how is TB transmitted

respiratory droplets

progressive destruction of the lungs from TB results in coughing up of blood called _____

hemoptysis

what is the severe form of TB that is systemic called

miliary

how does miliary TB spread

pulmonary lymphatics and blood

evidence of TB seen as caseous granulomas in the subpleural area is called

Ghon Focus

what is Ghon Complex

subpleural and lymph node regions have granulomas

calcification and fibrosis of hilar nodes is evidence of a TB infection called

Ranke Complex

TB in the spine is known as

Pott's Disease