Term
|
Definition
atelactasis = collapse of the lung
-no air exchange
-it becomes a "culture plate" for bugs
-most common cause of fever post op |
|
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Term
| physical exam findings of atelectasis/solid lung |
|
Definition
in a solid lung:
^conduction of vibration and sound
^tactile fremitus
^whisper pectoriloquy
^egophany E-->A |
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Term
| bugs that cause rusty colored sputum |
|
Definition
strep pneumo
klebsiella (bloody and mucoid), alcoholics
staph - abscess that gets bloody |
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Term
| final location of aspiration contents based on body position |
|
Definition
standing/sitting: RLL posterior basal segment
laying on back: RLL superior segment
laying on R side: RML, RUL
laying on L side: lingula |
|
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Term
| major causes of atypical pneumonia |
|
Definition
atypical pneumo = interstitial pneumonitis w/o consolidation, "walking pneumonia"
1. mycoplasma-->cold agglutinins! (IgM)
2. chlamydia pneumo
3. any virus (esp RSV in kids, CMV in immcomp) |
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Term
| ddx of lung granuloma --> how to test |
|
Definition
TB --> acid fast stain
fungus --> silver stain
foreign body --> polarized light
Wegners --> C-ANCA
Sarcoid <-- a dx of exclusion one all of the above ruled out |
|
|
Term
dissemination of TB
-miliary spread (tropism) |
|
Definition
KIDNEYS are most common site outside of the lung
cervical LN (scrofula), larynx (most contagious), liver/spleen, adrenals (Addisions), terminal ileum, lumbar vertebrae (Psoas signs), bone marrow, fallopian tubes, epididymis |
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Term
| some common features of sarcoidosis |
|
Definition
non-caseating granulomas in ANY organ
-hilar and mediastinal adenopathy
red skin bumps = erythema nodosum (strong association with granulomatous disease)
elevated ACE and calcium (the granuloma activates Vit D)
bx: schaumann bodies (calcification), stellate bodies |
|
|
Term
| etiology of the "blue bloater" |
|
Definition
refers to a COPD patient with chronic bronchitis (most common COPD cause)
BLUE: mucus (hyperplasia of goblet cells) plugs up everything so the terminal bronchioles can't engage in air exchange...cyanosis
BLOATER: 2ndary pulm htn leads to R heart failure (cor pumonale)...edema |
|
|
Term
| etiology of the "pink puffer" |
|
Definition
refers to a COPD patient with emphysema
better O2 exchange than chronic bronchitis pts, so not cyanotic = PINK
breath through pursed lips (make their own PEEP) and increased use of accessory muscles of respiration = PUFFER |
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Term
|
Definition
destruction of alveolar septa resulting in enlarged air spaces and loss of elastic recoil
imbalance of proteases (ELASTIN) and antiprotease (alpha-1-antitrypsin)
elastase is produced my NF and macrophages in response to irritation/stimulation from smoke and pollution |
|
|
Term
| centriacinar/centrilobular COPD |
|
Definition
most common type
associated with smoking, air pollution
worst in apical segments of UL (smoke rises) |
|
|
Term
| panacinar/panlobular COPD |
|
Definition
usually from alpha-1-antitrypsin deficeient
everything gets broken down because there is no protection
entire lung involvement, worse in the bases of LL bc tere is more injury there due to more blood flow |
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|
Term
|
Definition
Curschmann spirals - twisted mucous plugs
eosinophils
Charcot-Leyden crystals |
|
|
Term
|
Definition
an abnormal permanent airway dilation due to chronic necrotizing inflammation
cough, fever, malodorous purulent sputum, dyspnea
#1 cause = CF |
|
|
Term
| triad of Kartagener syndrome |
|
Definition
1. bronchiectasis/pneumonias/lung infections
2. chronic sinusitis
3. situs inversus (infertility from immobile sperm, on CXR look for stomach bubble to be on opposite side)
WHY? AR condition of immotile cilia bc of DYEIN arm defect |
|
|
Term
| the role of pneumocytes in ARDS |
|
Definition
diffuse alveolar damage from shock, *SEPSIS*, trauma, GI aspiration, radiation, drugs, infection, etc kills the thinner and weaker type 1 pneumocytes
hyaline membrane formation composed of cellular debris of dead pneumocytes
type 2 pneumocytes important in repairing lung injury - hyplerplasia, reline alveoli, flatten out to a type 1 |
|
|
Term
pneumoconiosis
-def
-presentation
-CXR findings |
|
Definition
fibrosing pulmonary diseases caused by inhalation of an aerosol
all present with dyspnea on exertion and dry cough
CXR showing thickening of septa (fibrosis) and restrictive pulmonary function tests |
|
|
Term
| pneumoconiosis of coal worker |
|
Definition
from ANTHRACOSIS, a carbon pigment in coal that accumulates on the macrophages along the pleural lymphatics and interstitium
-simple:black lung disease. black lungs and sputum
-complicated:progressive massive fibrosis that can lead to secondary pulm htn and cor pulmonale |
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Term
|
Definition
| pneumoconiosis accompanied by rheumatoid arthritis |
|
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Term
|
Definition
pneumoconiosis with a variety of environmental/occupational exposures:
shipyard worker, insulation, construction, brake-lining, flame retardants
diffuse interstitial fibrosis most severe in LL
ferruginous bodies - needle shaped with iron coating |
|
|
Term
| asbestosis cancer correlations |
|
Definition
bronchocarinoma - most common
synergistic effect with smoking
malignant mesothelioma - rare, but strong association
recurrent pleural effusions, tumor grossly encases and compresses the lung |
|
|
Term
|
Definition
pneumoconiosis from silicon dioxide (silica exposure)
-sandblasters, metal grinders, ceramics)
"sinister silicosis" - this is the worst one, most toxic
dense nodular fibrosis of the UL |
|
|
Term
|
Definition
-leading cause of cancer death in men and women
-primary lung cancer
-SMOKING
-hemoptysis
ADENOCARCINOMA, BRONCHIOLALVEOLAR CARCINOMA, SQUAMOUS CELL CARCINOMA, SMALL CELL CARCINOMA, LARGE CELL CARCINOMA |
|
|
Term
| genetics of bronchiogenic carcinoma |
|
Definition
mutation of L-myc oncogene (small cell - Little Lung ca)
mutation of K-ras oncogene (adenocarcinoma)
tumor suppressor gene mutations: p53, RB |
|
|
Term
|
Definition
#1 type of lung cancer, both smokers and non-smokers
less smoking associations than other lung cancers
F>M
peripheral gray-white mass with pleural puckering
-->bronchioloalverolar carcinoma is a subset of this that arises from terminal brochioles or alveolar walls |
|
|
Term
|
Definition
strongly associated with smoking, M>F
bronchial epithelium: metaplasia-->dysplasia-->carcinoma insitu-->invasive carcinoma
centrally located grey-white bronchial mass, invasive nests of squamous cells with keratin pearls
(swashbuckling squamous cells of the carribean, pink pearl) |
|
|
Term
| features of INVASIVE cancers |
|
Definition
to be invasive, a cancer must make collagenase 4
why?
bc all basement membranes contain type four collagen and thus need that metalloprotease to invade and spread |
|
|
Term
| small cell (oat cell) carcinoma |
|
Definition
STRONGEST association with smoking, M>F
very aggressive, rapid growth and early dissemination
a neuroendocrine tumor, associated with many paraneoplastic syndromes
central, grey-white masses; small round/polygonal cells in clusters |
|
|
Term
|
Definition
very rare and aggressive
large anaplastic cells w/o evidence of differentiation
makes a lot of beta-hcg, can get gynecomastia |
|
|
Term
|
Definition
intrathoracis spread of lung cancer causing obstruction of the SVC
distended head and neck veins, plethora (red and swollen from the nipples up), facial and upper arm edema
usually from small cell or squamous cell |
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