Term
| Repeated rhinitis, cystic fibrosis, & aspirin-intolerant asthma can lead to... |
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Definition
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Term
| Triad of aspirin-intolerant asthma |
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Definition
| asthma, aspirin-induced bronchospasm, nasal polyps |
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Term
| benign mass in nasal mucosa of fibrous tissue & blood vessels in an adolescent male that presents as profound epistaxis |
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Definition
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Term
| Rapidly enlarging cervical lymph nodes of an african/chinese male. Nasopharyngeal mass biopsy reveals poorly differentiated, keratin-positive epithelium in background of lymphocytes |
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Definition
| Nasopharyngeal carcinoma (EBV) |
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Term
| barking cough & inspiratory stridor |
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Definition
| laryngotracheobronchitis, i.e. croup (parainfluenza virus, a paramyxovirus) |
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Term
| where are singers nodules? |
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Definition
bilateral on the true vocal chords. Composed of degenerative (myxoid) connective tissue
these will go away w/ resting of voice |
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Term
| cause of laryngeal papilloma? Benign or malignant? |
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Definition
benign tumor of vocal chords caused by HPV 6 & 11.
These can RARELY transform to laryngeal carcinomas, which are classically due to alcohol/tobacco |
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Term
| red current jelly sputum. lobar consolidation. abscess. alcoholic/elderly person |
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Definition
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Term
| 4 stages of lobar pneumonia |
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Definition
Congestion
Red hepatization: RBCs are intact
Gray hepatization: RBCs are fragmented
Resolution: T2pneumocytes responsible |
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Term
Name pathogen for each case of bronchopneumonia:
1) most common cause of bacterial superinfection pneumonia post influenza; abscess/empyema common
2) secondary pneumonia & pneumo superimposed on COPD. G- coccobacilli. fastidious growth (V & X)
3) Cystic fibrosis
4) Community acquired & superimposed on COPD. G-, oxidase+ coccobacilli (not to be confused w/ Neisseria)
5) Community acquired, COPD, or immunosuppressed. very high fever. Water-based coolers. Intracellular, visualized w/ silver stain |
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Definition
1) S.aureus
2) H.flu
3) P.aeruginosa
4) M.catarrhalis (also causes sinusitis & otitis; but S.pneumo is most common cause of these)
5) L.pneumonia |
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Term
| where is the inflammation in atypical pneumonia |
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Definition
in the interstitium, between the alveoli. The alveoli aren't filled w/ pus. This type of pneumonia is also called "interstitial pneumonia".
The "atypical" refers to no sputum & low fever. The chest X-ray classically shows increased interstitial markings |
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Term
Give bacteria for each cause of atypical (interstitial) pneumonia:
1) most common cause of atypical after infancy. usually occurs in close quarters (dorms, military, etc). Cold-AB hemolytic anemia (IgM) & erythema multiforme assoicate. Not visible on gram stain.
2) 2nd most common cause in adults. intracellular in macros (visualize w/ giemsa). possible atherosclerosis link.
3) Most common cause in infants. Bronchilitis. Ribavirin Tx
4) Elderly, immunocompromised, preexisting lung disease. possible S.aureus/H.flu superinfection. Orthomyxovirus
5) post-transplant. Tx w/ gancyclovir or foscarnet
6) High (Q) fever. farmers, vets (on cattle & cattle placenta). rickettsial organism, but is not transmitted by arthropod (spores are stable & inhaled) |
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Definition
1) Mycoplasma pneumonia
2) C.pneumonia
3) RSV
4) Influenza virus
5) CMV
6) Coxiella burnetii |
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Term
| Bacteroides, Fusobacterium, Peptococcus pneumonia |
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Definition
aspirational pneumonia
These are anaerobic G(-) bacteria --> treat w/ clindamycin |
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Term
| location (in brain) of TB meningitis? |
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Definition
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Term
| Reid index criteria for chronic bronchitis? |
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Definition
>50% of the wall length must be composed of mucinous glands (normal is <40%)
This thickness does NOT include the cartilage |
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Term
| why do you get cyanotic w/ bronchitis? |
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Definition
| b.c. mucus plugs trap CO2 |
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Term
Smoking or A1AT def:
- Centriacinar
- Panacinar |
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Definition
- Centriacinar emphysema w/ smoking (& preferentially @ lung apices)
- Panacinar emphysema w/ A1AT def (& preferentially @ lung bases) |
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Term
| 2 things associated w/ A1AT deficiency? |
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Definition
Liver cirrhosis (3% will get HCC)
Panacinar emphysema |
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Term
| 3 IL's that Th2 cells secrete & the action of each |
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Definition
IL4: IgE class switch
IL5: Eosinophil recruitment (& stimulus for production in marrow)
IL10: inhibit Th1; Also depress inflammatory response along with TGF-beta
Th2 cells are the cells responsible for the asthmatic response |
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Term
| Describe the basic pathogenesis of asthma (after IgE has already been made) |
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Definition
*Early phase*
Allergen --> crosslink IgE --> Mast cells degranulate --> vasodilation & increased vascular permeability (histamine); AA metabolites (esp LTC4,D4,E4) --> bronchospasm & further edema
*Late phase*
Eosinophils are recruited & release major basic protein --> damages cells & causes further bronchoconstriction |
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Term
| Asthma attack refractory to pharmacotherapy? |
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Definition
status asthmaticus.
May be fatal |
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Term
| Liver biopsy in someone w/ A1AT def? |
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Definition
PAS-positive intracellular granules.
A1AT accumulates in the ENDOPLASMIC RETICULUM (it is a problem of transporting it to the golgi) |
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Term
foul smelling sputum. Necrotizing inflammation of airway wall.
may lead to cor pulmonale or AA amyloidosis |
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Definition
Bronchiectasis. Causes include:
1) Cystic fibrosis
2) Kartagner syndrome
3) Tumor or foreign body
4) Necrotizing infection
5) Allergic bronchopulmonary aspirgillosis (usually seen in asthmatics or CF pts) |
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Term
| in idiopathic pulmonary fibrosis. what factor (secreted from the T2-pneumocytes) induces fibrosis? |
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Definition
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Term
| 2 drugs that can cause pulmonary fibrosis? |
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Definition
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Term
| only pneumoconioses that has increased risk of TB infection? |
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Definition
silicosis
silica impairs phagolysosome formation by macrophages |
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Term
| Pneumoconiosis that looks like sarcoid (noncaseating granulomas in lung, hilar lymph nodes, & systemic organs) |
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Definition
Berylliosis
occupational exposure is a big hint here: beryllium miners, aerospace industry workers |
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Term
| Pneumoconiosis w/ fibrosis & cancer of lung and pleura |
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Definition
asbestosis
remember that lung cancer>mesothelioma |
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Term
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Definition
| coal workers pneumoconiosis/silicosis/asbestosis + rheumatoid lung nodules |
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Term
| Dry mouth, dry eyes w/ non-caseating granulomas. Restrictive lung disease. uveitis. Hypercalcemia |
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Definition
Sarcoidosis (noncaseating granulomas most commonly in lung & hilar nodes)
Treat w/ corticosteroids |
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Term
| Granulomatous reaction to inhaled organic antigen. Presents w/ fever, cough, & dyspnea even after removal of substance. May progress to interstitial fibrosis if there is repeated exposure. |
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Definition
Hypersensitivity pneumonitis
Remember granulomas & interstitial fibrosis.
Pidgeon breeders lung, silo filler's disease, farmers lung, etc etc etc |
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Term
| definition of pulmonary HTN |
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Definition
mean arterial pressure >25
remember MAP = (1/3)*systolic + (2/3)*diastolic |
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Term
| Familial pulmonary hypertension gene |
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Definition
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Term
Etiologies of secondary pulmonary HTN:
1) Lung disease
2) Heart disease
3) Blood disease |
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Definition
1) something causing diffuse hypoxia leading to reactive vasoconstriction: COPD, interstitial fibrosis
2) Congenital heart disease causing eisenmenger's syndrome
3) recurrent pulmonary embolism |
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Term
| Why does maternal diabetes increase risk for neonatal RDS? |
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Definition
| Insulin decreases production of surfactant |
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Term
| 3 causes of coin lesions on chest Xray |
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Definition
1) cancer
2) granuloma (TB, fungus esp Histo)
3) Hamartoma (tissue that should be there, but is just disorganized & often calcified) |
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Term
2 major categories of lung cancer?
Major subtypes of more common type? |
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Definition
1) Small cell (15%), not amenable to surgery
2) Non-small cell (85%)
- Adeno(40%): Glands & mucin, nonsmokers & female smokers; in periphery --> can affect pleura
- Squamous(30%): Keratin, smokers, central, PTHrP
- Large cell(10%): No glands/keratin; smokers; poor prognosis
- Carcinoid(5%): well differentiated neuroendocrine (chromogranin+); polyp-like growth in periphery
- Bronchoalveolar: columnar clara cells grow along bronchioles; no smoking relation; good prognosis |
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Term
Lung cancer that likes to affect the pleura?
Where do lung cancers like to met? |
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Definition
adeno (it grows in the periphery)
Adrenal glands |
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Term
| Which lung cancer can present w/ pneumonia-like symptoms? |
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Definition
| Bronchoalveolar carcinoma (secretes ton's of mucus in the respiratory unit, thus it's name) |
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