lung pathology

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Acute pancreatitis: this is what our US attorney general had. : pathophysiology mechanism?: activation and thus autodigestion by pancreatic enzymes
Acute pancreatitis: this is what our US attorney general had. : Causes? (good mnemonic): Get Smashed (EtOH will can lead to AP) = 1) Gallstones 2) EtOH 3) Trauma 4) Steroids 5) Mumps 6) autoimmune disease 7) scorpion sting of all things! 8) hyperlipidemia 9) drugs
Acute pancreatitis: this is what our US attorney general had. : clinically presents with?: intense epigastric pain radiating to back
Acute pancreatitis: this is what our US attorney general had. : labs(name 2): which of the two has a higher specificity?: â†‘ amylase + â†‘lipase (higher specificity) "li is hi"
Acute pancreatitis: this is what our US attorney general had. : Name 5 nasty complications that can result from AP?: 1) DIC 2) ARDS 3) diffuse fat necrosis 4) hypocalcemia 5) pseudocyst formation
Acute pancreatitis: this is what our US attorney general had. : if you have CHRONIC pancreatitis: what do we think of your life habits?: Chronic Pancr. Is strongly associated w/ alcoholism
Acute pancreatitis: this is what our US attorney general had. : 0: 0
Acute pancreatitis: this is what our US attorney general had. : Pancreatic cancer: p.250
what is a common and fatal pancreatic cancer?: pancreatic adenocarcinoma
pancreatic adenocarcinoma : what is the prognosis?: 6 months: very aggressive: usually has mets when pt. presents
pancreatic adenocarcinoma: where are tumors most commonly located? And what does this lead to?: pancreatic head â†’ obstructive jaundice.
COPD = also known as OLD: obstructive lung disease: why is it called obstructive?: obstruction of AIR FLOW â†’ air trapping in lungs
COPD = also known as OLD: obstructive lung disease: what is the major PFT finding?: FEV1 / FVC ration is â†“ (hallmark finding)
COPD = also known as OLD: obstructive lung disease: name the 4 types of COPD: 1) Chronic Bronchitis (Blue Bloater) 2) emphysema (pink puffer) 3) asthma 4) bronchietasis
COPD = also known as OLD: obstructive lung disease: what is the definition of Chronic Bronchitis: productive cough for >3 consecutive months in two or more years.
COPD = also known as OLD: obstructive lung disease: what do you expect on lung histology?: hypertrophy of mucus-secreting glands in the bronchioles (Reid index of >50%)
COPD = also known as OLD: obstructive lung disease: leading cause is smoking: what are the physical findings for Chronic Bronchitis? (name 3): 1)cyanosis 2) wheezing 3) crackles
what is the pathophysiological mechanism of EMPHYSEMA?: destruction of fibrous septa/alveolar walls â†’ enlargement of air space and â†“ total surface area for gas exchange
if the cause is smoking, what kind of emphysema would you see on histo slide?: centri-acinar emphysema
what else can cause emphysema: (also may work synergistically with smoking): What kind of findings do you see in lung histo and name another organ affected?: alpha 1-antitrypsin deficiency â†’ panacinar emphysema + liver cirrhosis
what causes the emphysema in this disorder?: â†‘ elastase activity to damage lung tissue.
name 4 findings of emphysema (in general): 1) dyspnea; 2) â†“ breath sounds 3) tachycardia 4) â†“ I/E ratio
What is mechanism of asthma: BRONCHIAL hypersensitivity/hyperresponsiveness â†’ REVERSIBLE bronchoconstriction
name 3 common asthma triggers: 1) viral URI 2) allergens 3) stress!!
name 7 asthma findings: 1) cough 2) wheezing 3) dyspnea 4) hypoxemia 5)â†“ I/E ratio 6) tachypnea 7) pulsus paradoxus
BRONCHIECTASIS: what is its mechanism??: chronic necrotizing infection of BRONCHI â†’ dilated airways, purulent sputum, recurrent infections, hemoptysis (see Robbins for a good discussion of this)
what disorders is bronchietasis commonly associated with?: 1) bronchial obstruction 2) cystic fibrosis 3) poor ciliary motility
What are classic PFT findings for RLD?: â†“ VC â†“TLC ; FEV1/FVC ration > 80%
Name the two MAJOR types of RLD: 1) poor breathing mechanics (EXTRA-pulmonary) 2) Interstitial lung diseases
Name 3 lung volumes that are increased in COPD: â†‘TLC, â†‘FRC, â†‘RV
What 2 values are BOTH reduced in COPD and RLD?: 1) FEV1 and 2) FVC (think FEV1/FVC ratio) NOTE! in COPD, FEV1 is more dramatically reduced and thus the FEV1/FVC ratio is â†“
what is the main pathology resulting from asbestosis?: DIFFUSE, interstitial fibrosis caused by inhaled asbestos Fibers.
What cancers are increased in pts with asbestosis?: 1) pleural mesothelioma 2) bronchogenic carcinoma (BC)
Major finding in lung w/ asbestosis?: Ferruginous bodies: asbestos fibers coated with hemosiderin also 2) ivory white pleural plaques
Neonatal respiratory distress syndrome: What is the main cause: surfactant deficiency --> to increased surface tension --> alveolar collapse
Neonatal respiratory distress syndrome: surfactant is made by which cells? After when?: type 2 pneumocytes after 35th gestational week
Neonatal respiratory distress syndrome: what do you measure? Where do you get this fluid?: lecithin-to-sphingomyelin ratio in the amniotic fluid = measure of lung maturation <1.5 in neonatal distress syndrome
Neonatal respiratory distress syndrome: what is surfactant made of (chemical name): dipalmitoyl phosph-tidyl-choline (DP-PTC)
Neonatal respiratory distress syndrome: treatment for poor maturation of lungs: 1) before birth = maternal steroids 2) after= artificial surfactant
Karta-gener's syndrome: what is this?: immotile cilia due to dynein arm defect
Karta-gener's syndrome: results in what in female and male? (4 things): 1) sterility (in male sperm also immotile) 2)bronchietasis 3)recurrent sinusitis (bacteria & particles not pushed out) 4) associated with situs inversus (e.g. dextro-cardia)
name the 3 main classes of cancers that affect parts of the lung: 1) bronchogenic carcinoma (with different subtypes) 2) carcinoid tumor 3) metastasis
list the 5 types of major bronchogenic carcinomas: CENTRAL 1) squamous cell ca 2)small cell ca; PERIPHERAL 3) adenocarcinoma 4) bronchoalveolar ca 5) large cell ca
mnemonic: what is meant by SPHERE of symptoms?: S= superior vena cava syndrome; P= pancoast tumor; H= Horner's syndrome; E= Endocrine (paraneoplastic); Recurrent laryngeal / hoarseness; E = Effusions (pleural OR pericardial)
What can a CARCINOID tumor cause?: Carcinoid Syndrome = flushing, diarrhea, wheezing, and salivation
Metastases to lung is very common, LUNG cancer also prone to metastasize to what other parts?: 1) brain (epilepsy) 2) bone (fracture) 3)liver (jaundice + hepatomegaly)
What is Pancoast's tumor?: it's a carcinoma of the apex of lung
what may Pancoast's tumor affect?: may affect CSP= cervical sympathetic plexus causing Horner's syndrome
what is Horner's syndrome?: P.A.M. is Horny = Ptosis, Anhydrosis, Miosis
1st AID breaks it down into TYPE/ ORGANISM/ CHARACTERISTICS = cover parts of this table and fill in the blanks: 0

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