First Aid: Respiratory Pathology 2

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created 7 years ago by jgaversa5
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1

what is the leading cause of cancer death

lung cancer

2

what is the presentation of lung cancer

cough
hemoptysis
bronchial obstruction
wheezing
pneumonic coin lesion on x ray film or noncalcified nodule on CT

3

what is the most commmon metastasis

lung

4

where are mets from lung from

breast
colon
protate
bladder

5

where are the sites of mets from the lung

adrenals
brain (epilepsy)
bone (pathologic fracture)
liver (jaundice, hepatomeg)

6

what are the complications of lung cancer

"SPHERE"
SVC syndrome
pancoast tumor
horner's syndrome
endorcrine (Paraneoplastic)
recurrent laryngeal symptoms
effusions (pericardial or pleural)

7

what are the types of lung cancer

small cell carcinoma (oat cell)
adenocarcinmoa (bronchial or bronchioloalveolar)
SCC
large cell carcinoma
carcinoid tumor
mesothelioma

8

where are small cell carcinomas located

centrally

9

where are bronchial adenocarcinomas located

periphearlly

10

where are bronchioavleolar adenocarcinomas located

peripherally

11

where are SCCs located

centrally

12

where are large cell carcinomas located

peripherally

13

where are mesotheliomas located

pleural spaces

14

what are some characteristics of small cell carcinomas

undifferentiated and very agggresseive and ofetn associated with ectopic production of ACTH or ADH

15

what can small cell carcinoam of the lung lead to

Lambert-Eaton syndrome (autoantibodies against calcium channels)

16

is small cell carcinoma responsive to chemotherapy

yes

17

is small cell carcinoma operable

no

18

what are small cell carcinomas a neoplasm of

neuroendocrine Kulchitsky cells: small dark blue cells

19

where do bronchial adenocarcinomas develop

site of prior inflammatory inflammation or injury

20

what is the most common lung cancer in nonsmokers and females

bronchial adenocarcinoma

21

what is the original cell of adenocarcinoma

clara cells or type II pneumocytes

22

what will adenocarcinomas show on X ray

multiple densities

23

is bronchioalveolar adenocarcinoma linked to smoking

no

24

what will bronchioalveolar adenocarcinoma present like

pneumonia

25

what can bronhioalveolar adenocarcinoma result in

hypertrophic osteoarthropathy

26

what is SCC like

hilar mass arising from bronchus

27

what will SCC look like

cavitation

28

is SCC linked to smoking

yes

29

what type of activity will SCC show

parathyroid like activity (PTHrP)

30

what will SCCs show histologically

keratin pearls and intracellular bridges

31

what will large cell carcinoma characteristics show

highly anaplastic undifferentiated tumor; poor prognosis and less responsive to chemotherapy

32

how is large cell carcinoma treated

usually surgery because not responsive to chemo

33

what do large cell carcinomas look like

pleomorphic giant cells with leukocyte fragments in cytoplasm

34

waht does carcinoid tumor secrete

serotonin

35

what can carcinoid tumors cause

carcinoid syndrome: flushing, diarrhea, wheezing, salivation

36

what can carcinoid do to right heart valves

fibrous deposits leading to TCR, pulmonic stenosis, RHF

37

what is mesothelioma assd with

asbestos

38

what can mesothelioma rsult in

hemorrhagic pleural effusions and pleural thickening

39

what is of note in mesotheliomas

psammoma bodies

40

what is a pancoast tumor

carcinoma that occurs in apex of lung and may affect cervical sympathetic plexus, causing horner's syndrome

41

what is invovled in horner's syndrome

ptosis
miosis
anhidrosis

42

what is SVC syndrome

an obstruction of the SVC that impairs blood drainage from the head (facial plethora), neck (jugular venous distention), and upper extremities (edema)

43

what is SVC syndrome most cmommonly caused by

neoplasms and thromboses

44

what can SVC syndrome do to intracranial pressure

raises it if obstruction is severe

45

how does increased intracranial pressure present

headaches and dizziness, can increase risk of aneurysm/rupture of cranial arteries

46

what are the most common organisms causing lobar pneumonia

pneumococcus then klebsiella

47

what will a lobar pneunoia look like

intra-alveolar exudate that consolidates

48

can a lobar pneumonia involve the entire lung

yes

49

what causes bronchopneumonia

s. aureus
h. flu
klebsiella
s. pyogenes

50

what is a bronchopneumonia like

acute inflammatory infiltrates from bronchioles into adjacent alveoli in a patchy distribution involving more than one labe

51

what causes interstitial (atypical) pneumonias

viruses (RSV, adenovirus)
mycoplasma
legionella
chlamydia

52

what is an interstitial pneumonia like

diffuse patchy inflammation localized to interstitial areas at alveolar walls, distribution involving more than one lobe

53

does interstitial or bronchopneumonia follow a more indolent course

interstitial pneumonia

54

what is a lung abscess

localized collection of pus within parenchyma

55

what can cause a lung abscess

bronchial obstruction, aspiration of oropharyngeal contents

56

what can often be seen on CXR in terms of lung abscess

air-fluid levels

57

what is lung abscess due to usually

s. aureus or anaerobes (bacteroides, fusobacterium, peptostreptococcus)

58

what is a hypersensitivity pneumonitis

mixed type III/IV hypersensitivity reaction to environmental antigen

59

what do hypersensitivity pneumonitises lead to

dyspnea, cough, chest tightness, headache

60

who is HS pneumonitis seen in often

farmers and those exposed to birds

61

what causes transudative pleural effusions

CHF, nephrotic syndrome, or hepatic cirrhosis

62

what causes exudative pleural effusions

malignancy, pneumonia, collagen vascular diseases, trauma (increased vascular permeability)

63

what will be elevated in an exudative pleural effusion

protein content

64

what will be elevated in a lymphatic pleural effusion

triglycerides

65

what does pneumothorax present with

unilateral chest pain and dyspnea

66

how will pneumothorax come up in physical exam

unilateral chest expansion, decreased tactile fremitus, hyperresonance, diminished breath sounds

67

what is a spontaneous pneumothorax

accumulation of air in the pleural space

68

what types of people does a spontaneous pneumo happen most in

tall thin young males

69

where do blebs usually rupture in tall thin males

apically

70

where does the trachea deviate in a spontaneous pneumo

toward affected lung

71

what situation brings about a tension pneumo

trauma or lung infection

72

what is the situation of tension pneumo in a nutshell

air can enter pleural space but cannot exit

73

where does the trachea deviate in a tension pneumo

away from affected lung