Phys 3-4,5

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Phys 3-4,5
2010-06-10 05:46:13
Pathology lungs

Lung tumors, bacterial pneumonia and abscess, TB, COPD
Show Answers:

  1. Most common risk factors for lung cancer?
    Tobacco Smoke

    occupational exposure; nickel chromates, arsenic, beryllium, asbestos

    radiation: atomic bombs, uranium miners, radon

    Fibrosis/ Scarring lungs
  2. Central keratinization or intercellular bridging. May grow to large size and cavitate, can be associated with hypercalcemia and there is a strong association with smoking.
    squamous cell carcinoma

    development pmeumonia, cough, eroded epi can cause cough with secretion including blood
  3. Commonly in women and non-smokers. In the periphery of lung and defined with glandular differentiation or mucin production and sometimes associated with fibrous scar.
    Adenocarcinoma, difficult to differentiate from metastatic carcinoma.

    subtype: Bronchioloalveolar carcinoma
  4. Tumor along pre-exsisting alveolar septa as solitary mass, multiple nodules or diffuse process. Well differentiated and diffuse. May have abundant mucus production.
    Bronchiolalveolar carcinoma

    subtype of adenocarcinoma, non smokers and women most common
  5. Centrally located "oat cell" that has a strong association with cigarette smoking. High incidence of extra pulmonary spread at diagnosis, commonly associated with ectopic hormone production, and most malignant end of neuroendocrine lung tumors
    Small cell carcinoma
  6. Central or peripheral non-cell carcinoma. Does not display obvious squamous or glandular differentiation.
    Large cell carcinoma
  7. A cancer that presents with signs of hormones, may be Cushing's like (ATCH), or ADH, gonadotropins, PTH
    ectopic hormone production

    small cell carcinoma, can also happen in squamous cell carcinoma
  8. to cough up blood
  9. Clinical manifestations of intrapulmonary growth
    • -cough and or cough with blood because of bronchial irritation and mucosal erosion
    • -Post-obstructive pneumonia, abscess formation, atelectasis or air trapping due to obstruction of the bronchus
    • -tumor may be silent and only detected incidentally on chest xray- peripheral (subpleural)
  10. atelectasis
    collapse of all or part of the lung
  11. Manifestations of extrapulmonary growth
    Centrally located tumors may invade the mediastinum, superior vena cava syndrome, invasion of recurrent laryngeal nerve causing hoarseness,

    peripheral tumors may cause pain by invading the pleura

    Apically located tumor invasion too
  12. Dusky cyanosis with distention of veins of head, neck, upper extremities, veins don't collapse when patient lifts their arm
    Superior vena cava syndrome compress or invade vena cava because of centrally located tumor.
  13. Pancoasts or Superior Sulcus Tumor
    Apically located tumor, extra pulmonary manifestation includes invasion of:

    • brachial plexus - arm pain
    • cervical sympathetic plexus- horners syndrome
  14. ipsilateral enophthalmos (recession of eyeball within orbit), ptosis (eyelid droops), meiosis (pupil constriction), and anhidrosis ( loss of sweating)
    Horners syndrome due to apically located tumor
  15. Describe metastatic growth
    May be Regional: bronchopulmonary adn mediastinal lymph nodes

    May be distant metastasis: to extrathorac lymph nodes, liver, bone, brain, adrenal glands, these may be the first manifestations that lead to diagnosis of a lung carcinoma
  16. Paraneoplastic syndromes
    tumors associated with syndromes that are not attributable to growth pattern

    lambert eaton syndrome, hypertrophic pulmonary osterarthropathy, myopathy
  17. symptoms resembling myathenia gravis
    lambert eaton syndrome

    neuromuscular disorder of voluntary muscles
  18. periostitis, clubbing of digits, arthritis
    hypertrophic pulmonary osterarthropathy
  19. Lungs cancers that are associated with secretion of hormones.
    ectopic hormone secretion: most commonly small cell carcinomas

    hypercelcemia- PTH- squamous cell carcinoma
  20. Understanding carconigenesis in lung
    usually mutational changes to oncogenes or activation

    or loss of tumor suppressor genes

  21. Prognosis lung carcinomas
    Poor because usually not determined until stage 3.

    small cell carcinoma prog is worst because of freq metastatic spread

    squamous cell carcinomas grow slow

    poorly differentiated tumors behave more aggressively
  22. patient under 40, male:female ratio the same, neuroendocrine tumor of lung, no risk factor or smoking relationship; central or peripheral
    carcinoid tumor
  23. polypoid mass projecting into bronchus lumen infiltrating peribronchial tissue, usually do not metastasize and are low grade malignant, very vascular
    Carcinoid tumors
  24. most frequent carcinoma of the lung as multiple nodules(most common growth patten, solitary nodules, or rarely lymphangitic spread ( diffusely infiltrate pulmonary lymphatics with or without a nodular pattern)

    resembles primary tumor, high incidence pulmonary metastasis from soft tissue and bone sarcomes
    metastatic tumors of the lung
  25. rare benign tumor that a mix of mature cartilage, fibrous tissue, and fat. Solitary nodule on chest x-ray
    hamaroma; benign neoplasm

    usually solitary nodule, excision is curative
  26. an inflammatory disease of the lungs characterized by vascular response and exudate

    caused by bacteria, viruses, fungi, and parasites
  27. 4 routes of pneumonia infection
    aspiration, inhalation, bacteremia, direct extension(acute inflammatory process from adj organ or structure)

    aspiration is most common
  28. 4 defense mechanisms of pneumonia
    reflex closure of vocal cords, cough reflex, mucociliary clearance and macrophage activity and immune competence
  29. 6 clinical situations that can impair defense mechanisms
    will increase rick of bacterial infection:

    • loss of consciousness
    • immunodeficiency state
    • pulmonary edema
    • neutropenia
    • chronic airway obstruction
    • viral infection
  30. What components make up bacterial infection exudate
    edema fluid, RBCs, leukocytes, fibrin