USMLE 1 Path Resp
Terms
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- what causes acute epiglottitis, which may be life-threatening in young children?
- H. influenzae
- MC nasal and laryngeal tumor
- Squamous cell CA
-
Dx:
Decreased FEV1/FVC ratio - COPD
-
Dx:
Charcot-Leyden crystals, Curschmann spirals, bronchial smooth muscle hypertrophy - Asthma
-
Definition:
Productive cough occurring at least 3 consecutive months over at least 2 years
what change occurs w/ cells? -
Chronic Bronchitis
(Inc mucous due to hyperplasia of mucous-secreting glands) -
Definition:
Dilation of air spaces w/ destruction of alveolar walls and lack of elastic recoil - Emphysema
- Type of emphysema dealing with smoking
- Centriacinar
-
Type of emphysema dealing with A-1-A deficiency
what gene is difficient in most severe? -
Panacinar
(piZZ - homozygous) - Type of emphysema dealing with blebbing or subpleural bullae
- Paraseptal
-
Definition:
perminant abnormal bronchial dilation caused by chronic infection w/ inflammation and necrosis of the bronchial wall - Bronchiestasis
-
Dx:
dilated airways, copious purulent sputum, hemoptysis and recurrent pulmonary infections leading to lung abscess (obstruction) - Bronchiectasis
-
Definition:
Diffuse alveolar damage w/ resultant increase in alveolar permeability, causing a leak of protein-rich fluid from the alveoli and formation of intra-alveolar hyaline membrane - Adult Respiratory Distress Syndrome (ARDS)
-
Definition:
Group of environmental diseases caused by inhalation of inorganic dust particles - Pneumoconioses
-
Dx:
inhalation of carbon dust, marked by carbon-carrying macrophages - Anthracosis
-
Dx:
progressive massive fibrosis w/ necrotic black fluid and dark macules around bronchioles - Coal Miners Pneumoconiosis
-
Dx:
diffuse interstitial fibrosis mainly in the lower lobes w/ ferruginous bodies and dense fibrocalcific plaques of parietal pleura
what can it lead to? -
Asbestosis
leads to: Mesothelioma -
Dx:
bilateral hilar lymphadenopathy, hypercalcemia, noncaseating granulomas - Sarcoidosis
-
Dx:
localized proliferation of histiocytes that have characteristic inclusions resembling tennis rackets (birbeck granules) - Eosinophilic granulomas
-
Definition:
Immune complex Dz w/ progressive fibrosis of the alveolar wall - Idiopathic Pulmonary fibrosis
- MCC of Pulmonary HTN
- COPD
-
MCC of interstitial pneumonia
(2) -
Mycoplama Pneumoniae;
Viruses - What virus produces a Giant cell pneumonia?
- Measles
- What pneumonia is seen in people working with cattle or sheep?
-
Rickettsial pneumonia
(Q-fever) -
Dx:
Gohn complex - Primary TB
-
Pulmonary infection:
Abscess and sinus tract formation w/ exudate containing sulfur granules - Actinomycosis
- Tx of Neonatal Respiratory Distress syndrome
-
Give mother steroids before birth
(or artificial surfactant for infant) - MCC of Lobar pneumonia
- Pneumococcus
-
Definition:
Carcinoma in the apex of the lung that may affect cervical sympathetic plexus - Pancoast tumor
-
what are the (2) lung cancers that are central?
what do they have a causitive link to? -
Squamous cell
Small cell (Oat cell)
both: Smoking! -
Dx:
cough, hemoptysis, bronchial wheezing, pneumonic "coin" lesion on x-ray - Lung Cancer
- Describe the (3) peripheral Lung Cancers
-
Adenocarcinoma:
MC non-smoking; K-RAS oncogene
Bronchoalveolar:
Tall columnar cells w/ along alveoli
Large cell:
Undifferentiated -
Dx:
lung tumor of major bronchi that may also cause flushing, diarrhea, wheezing and salivation - Carcinoid tumor
- (5)* complications of Lung tumors
-
SPHERE:
Superior vena cava syndrome
Pancoast tumor
Horner's syndrome
Endocrine (paraneoplastic)
Recurrent Laryngeal Sx (hoarsemess)
Effusions (pleural or pericardial) -
Causes of Respiratory sounds:
Stridor -
Inspiratory sound from narrowing extrathoracic area
(above glottis) -
Causes of Respiratory sounds:
Wheezing - Narrowing of the intrathoracic airway during expiration
-
Causes of Respiratory sounds:
Crackles -
Alveoli popping open
due to:
fluid (pneumonia, HF, ARDS)
or fibrosis -
Causes of Respiratory sounds:
Dullness to Percussion - fluid, pus, tumor or blood absorbing the sound b/t alveoli and chest wall
-
Causes of Respiratory sounds:
Hyperresonance -
Air under the chest wall
(Pneumothorax) -
Causes of Respiratory sounds:
Fremitus / Egophany -
Consolidation
(Pneumonia) -
Dx:
Increased Cold Agglutinin - Mycoplasma pneumonia
-
Dx:
laryngeal edema, steeple sign, unusual cough -
Parainfluenza
(Croup) -
Dx:
inhaling quartz or talc - Silicosis
- what is the second MCC of lung CA?
- Radon gas
-
Dx:
Tracheal deviation towards side of lesion
(one main one possible) -
Atelectasis
(Bronchial obstruction) -
Dx:
Tracheal deviation away from the side of lesion
(one main one possible) -
Pneumothorax
(Pleural Effusion) -
Dx:
bronchiectasis, recurrent sinusitis, infertility, situs inversus
defect? -
Kartagener's syndrome
(Dynein arm defect)