Respiratory - Pathology Flashcards Preview

A patient presents with sudden-onset dyspnea one hour after suffering a femur fracture. He is found to have a ventilation/perfusion mismatch. What is your diagnosis?

Amniotic fluid emboli can lead to what dangerous hematologic condition in postpartum women?

A patient presents with sudden chest pain, tachypnea, and dyspnea. What is the most likely diagnosis?

Name the six most common causes of emboli to the lungs.

What is the origin of the majority of emboli that become lodged in the lungs?

Which three factors that promote blood coagulation are known as Virchow’s triad?

Describe Homan’s sign.

What medication is used to prevent deep venous thrombosis?

What is the hallmark pulmonary function test finding in patients with obstructive lung disease?

List four types of obstructive lung disease.

In obstructive lung disease, there is a(n) _____ (decrease/increase) in residual volume and a(n) ____ (decrease/increase) in functional vital capacity.

What criteria must a patient meet to be considered to have chronic bronchitis?

What histologic changes would be seen on lung biopsy in a patient with chronic bronchitis?

The mucus gland hypertrophy seen in chronic bronchitis can be quantified using the _____ _____, which tends to be greater than what value in symptomatic patients?

How is the Reid index calculated?

What clinical findings are auscultated in the lungs of patients with chronic bronchitis?

What visible skin finding may be noted in patients with chronic bronchitis?

What pathologic changes are seen in the lungs of a patient with emphysema?

Smoking is associated with _____ (centriacinar/panacinar) -type emphysema, whereas α₁-antitrypsin deficiency is associated with _____ (centriacinar/panacinar) -type emphysema.

In addition to panacinar emphysema, α₁-antitrypsin deficiency also causes what condition?

A deficiency of α₁-antitrypsin results in the increased activity of what enzyme?

What exam finding is often auscultated in the lungs of patients with emphysema?

In emphysemic lungs, there is a(n) (decrease/increase) _____ in recoil and, subsequently, a(n) _____ (decrease/increase) in compliance.

In emphysema, the decrease in lung recoil is a result of destruction of alveolar walls by increased activity of which enzyme?

Paraseptal emphysema is associated with bullae that can rupture and lead to _____ _____ in otherwise young healthy males.

Individuals with emphysema tend to exhale through pursed lips to increase _____ _____ and prevent _____ _____ during expiration.

The definitive feature of the bronchoconstriction of asthma is that it is fully _____.

In patients with asthma, there is hyperresponsiveness of what lung segment?

While chronic bronchitis is a disease of the _____ (bronchi/bronchioles), asthma is a disease of _____ (bronchi/bronchioles).

Kartagener’s syndrome is associated with what types of lung disease?

Cough and wheezing are noted in patients with what two types of obstructive lung disease?

Tachypnea and pulsus paradoxus are noted in patients with what type of obstructive lung disease?

A child presents with cough, wheezing, dyspnea, tachypnea, hypoxemia, and mucus plugging. On exam, the patient also has a pulsus paradoxus. From what disease is this patient likely suffering?

What finding is commonly noted on pulmonary function testing of patients with asthma as well as those with emphysema?

What blood pressure/pulse finding is often observed in patients with asthma?

What are Curschmann’s spirals?

What two pathologic findings are associated with asthma?

_____ is a chronic necrotizing infection of bronchi.

In bronchiectasis, chronic necrotizing infection of the bronchi leads to what?

Patients with bronchiectasis often have a cough productive of what?

Which two genetic diseases are associated with bronchiectasis?

Individuals with bronchiectasis are prone to develop which fungal pulmonary infection?

What are three common triggers of asthma attacks?

Compare the onset of dyspnea and hypoxia in emphysema vs chronic bronchitis.

What causes late-onset hypoxemia in emphysema?

What causes early-onset hypoxemia in chronic bronchitis?

What two lung volumes are typically decreased in patients with restrictive lung disease?

Patients with restrictive lung disease typically have a forced expiratory volume₁/forced vital capacity ratio within what range?

What are the two general types of restrictive lung disease?

Extrapulmonary causes of restrictive lung disease are generally the result of what?

Pulmonary causes of restrictive lung disease are generally the result of what category of diseases?

What infectious disease can cause poor muscular effort and thereby lead to extrapulmonary restrictive lung disease?

What disease of the neuromuscular junction can cause poor muscular effort and thereby lead to extrapulmonary restrictive lung disease?

What is the mechanism of extrapulmonary restrictive lung disease in scoliosis?

Other than scoliosis and muscle diseases, what condition can lead to extrapulmonary restrictive lung disease?

What category of interstitial lung diseases has a clear association with an environmental exposure?

What disease is associated with repeated cycles of lung injury and wound healing with increased collagen deposition?

Name three pneumoconioses that can cause restrictive lung disease.

What nongranulomatous disease that commonly affects the renal and pulmonary systems can cause interstitial lung disease?

What disease can cause restrictive lung disease due to eosinophilic granulomas in the lungs?

Name three drugs that can cause interstitial lung disease.

What processes cause restrictive lung disease due to poor muscular effort?

What processes cause restrictive lung disease due to poor structural breathing mechanics?

What processes cause restrictive lung disease due to interstitial lung pathology?

Which lobe of the lung is most affected in coal miner’s disease?

Coal miner’s disease can be associated with what two additional pathologic conditions?

Patients with silicosis likely worked in what three fields?

What cell type is responsible for the fibrosis induced by silica inhalation?

Silicosis increases the risk of what infectious disease?

What lobe of the lung is most affected by silicosis?

The finding of eggshell calcification on chest x-ray would increase suspicion of what disease?

What substance, used for such things as shipbuilding and insulation, can result in a diffuse pulmonary interstitial fibrosis?

Patients with asbestosis are at increased risk of what two cancers?

What gross pathologic finding can be found on the pleura of patients who have been exposed to asbestos?

Asbestosis is most commonly seen in practitioners of what professions?

Asbestosis mainly affects the ____ (lower/upper) lung lobes, while coal worker’s lung affects the _____ (lower/upper) lobes.

What are asbestos bodies and where are they located?

In neonatal respiratory distress syndrome, there is a deficiency of what chemical?

How does the lack of surfactant in neonatal respiratory distress syndrome impair gas exchange in the lungs?

What cells make surfactant?

Surfactant is made most abundantly during which period of neonatal gestation?

What ratio is used as a measure of lung maturity in neonates? How is it tested?

In neonatal respiratory distress syndrome, the lecithin-to-sphingomyelin ratio is usually within what range?

Medical treatment for neonatal respiratory distress syndrome includes what treatment for the mother before birth?

What vascular pathology is associated with persistently low oxygen tension due to neonatal respiratory distress syndrome?

What are three risk factors for neonatal respiratory distress syndrome?

How can neonates be treated for respiratory distress syndrome after birth?

Use of supplemental oxygen in neonates can lead to what ocular pathology?

In acute respiratory distress syndrome, acute alveolar damage leads to a(n) _____ (decrease/increase) in alveolar capillary permeability.

Despite many etiologies, what pathophysiology is seen in all cases of acute respiratory distress syndrome?

Name seven conditions known to cause acute respiratory distress syndrome.

What obstetric complication can result in adult respiratory distress syndrome?

A chronic alcoholic suffering from acute pancreatitis is experiencing difficulty breathing and oxygen desaturation. From what pulmonary complication of acute pancreatitis may she be suffering?

Name three molecular mechanisms that contribute to the initial damage to the alveoli in acute respiratory distress syndrome.

The forced expiratory volume₁:forced vital capacity is what percent in normal lungs; in obstructive lung disease; in and restrictive lung disease?

Forced expiratory volume₁ and forced vital capacity are reduced in both obstructive and restrictive pulmonary diseases; however, forced expiratory volume₁ is more dramatically reduced in ____ (obstructive/restrictive) pulmonary disease.

In ____ (obstructive/restrictive) pulmonary disease, forced expiratory volume₁/forced vital capacity <80% and lung volumes are increased.

In _____ (obstructive/restrictive) pulmonary disease, forced expiratory volume₁/forced vital capacity >80% and lung volumes are decreased.

How do total lung volumes in obstructive lung disease compare with normal lung volumes?

Is residual volume decreased, increased, or normal in obstructive lung disease?

How do total lung volumes in restrictive lung disease compare with normal lung volumes?

In which type of lung disease, obstructive or restrictive, is the forced expiratory volume₁/forced vital capacity ratio more dramatically reduced?

Define sleep apnea.

Define central sleep apnea.

Define obstructive sleep apnea.

An obese man complains of chronic fatigue. His wife says he is an especially loud snorer. What condition may be contributing to this patient’s fatigue?

Name three treatments of sleep apnea.

Name five conditions potentially associated with sleep apnea.

In the case of bronchial obstruction, what happens to the breath sounds over the affected area?

What are the physical exam findings in a patient with bronchial obstruction?

What are the physical exam findings in a patient with pleural effusion?

What are the physical exam findings in a patient with lobar pneumonia?

What are the physical exam findings in a patient with pneumothorax?

Pleural effusions cause a(n) _____ (decrease/increase) in fremitus, whereas pneumonia causes a(n) _____ (decrease/increase) in fremitus.

Bronchial obstructions may cause tracheal deviation _____ (away from/toward) the lesion, whereas pneumothoraces result in deviation _____ (away from/toward) the lesion.

In what area of the lungs does squamous cell carcinomas typically arise?

In what area of the lungs does small cell carcinoma typically arise?

In what area of the lungs does adenocarcinoma typically arise?

In what area of the lungs does large cell carcinoma typically arise?

List the two lung cancers that have a link to smoking.

Squamous cell carcinoma of the lungs is known for the ectopic production of what substance?

List three forms of bronchogenic carcinoma that tend to arise peripherally in the lungs.

What is the most common type of lung cancer in non-smokers?

What peripherally arising form of bronchogenic carcinoma is most anaplastic or undifferentiated?

What are the classic symptoms of carcinoid syndrome and what is the cause?

Are metastases from primary lung cancers very rare, rare, common, or very common and to what three sites do they occur?

In association with a primary lung cancer, what finding suggests brain metastases?

In association with a primary lung cancer, what finding suggests bone metastases?

In association with a primary lung cancer, what two findings suggest liver metastases?

What type of cancer is the leading cause of cancer death?

Lung cancer can present with what incidental radiologic finding?

How can the voice of a patient with lung cancer change?

Which potential spaces can develop effusions as a result of lung cancer?

How does the mnemonic SPHERE help one to remember common complications associated with lung cancer?

A cavitary hilar mass arising from the bronchus of a long-time smoker may suggest which disease process?

Histologically, which lung carcinoma forms keratin pearls and intercellular bridges?

Which lung carcinoma may develop in sites of prior pulmonary inflammation or injury and is the most common lung cancer in nonsmokers and females?

Which of the following is more common on x-ray of the chest in lung adenocarcinoma, a single lesion or multiple densities?

Clara cells differentiate into type II pneumocytes in which type of lung cancer?

Which cells are the precursors to small-cell lung cancer?

Name three possible paraneoplastic syndromes associated with small cell carcinoma of the lung.

What is Lambert-Eaton syndrome?

What is the usual approach to the treatment of large cell carcinoma of the lung?

Histologically, which lung cancer is associated with pleomorphic giant cells with leukocyte fragments in the cytoplasm?

What is the approach to treatment of small-cell lung cancer?

Patients with metastases to the lung present with symptoms of _____ (cough/dyspnea) and patients with primary lung cancer present with symptoms of _____ (cough/dyspnea).

Bronchioloalveolar adenocarcinoma can present similarly to which other non-cancer pathological lung disease?

A long-time shipbuilder presents with difficulty breathing. X-ray demonstrates an effusion. On tap, the fluid is bloody. A biopsy shows psammoma bodies. What is the disease process?

Small-cell carcinoma is associated with the production of what two hormones?

In what region of the lung does Pancoast’s tumor occur?

Because of its location, Pancoast’s tumor may affect what neurologic structure?

When Pancoast’s tumor disrupts the cervical sympathetic plexus, it can result in what condition?

Horner’s syndrome includes what three findings?

Lobar pneumonia is most frequently the result of infection with what organism?

Which type of pneumonia is most often caused by viruses?

List two viruses that commonly cause interstitial pneumonia.

In which type of pneumonia does an intra-alveolar exudate lead to consolidation?

Which type of pneumonia characteristically shows diffuse, patchy inflammation?

Interstitial pneumonia characteristically shows diffuse, patchy inflammation that is localized to what areas of the lung?

The distribution of interstitial pneumonia characteristically involves how many lobes?

Which type of category of pneumonia typically has a less acute presentation?

List four bacterial etiologies of bronchopneumonia.

List three bacterial causes of interstitial pneumonia.

What is a lung abscess?

What two conditions can predispose a patient to lung abscesses?

What type of individuals are predisposed to developing lung abscesses, even in the absence of preexisting pulmonary disease?

Name two organisms (or classes of organisms) most commonly implicated in the development of lung abscesses.

In terms of pleural effusions, transudates have _____ (less/more) protein than exudates.

In terms of pleural effusions, exudates have _____ (less/more) protein than transudates.

What are three common causes of transudative pulmonary effusions?

Name four causes of exudative pulmonary effusions.

What makes an exudate cloudy?

Name the three types of pleural effusions.

Are pleural effusions that are secondary to trauma usually transudates or exudates?

Which type of pleural effusion consists of high levels of triglycerides and has a milky appearance grossly?

For what reason does an exudative pleural effusion require drainage?