respiratory

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rere_girl4ever
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298607
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respiratory
Updated:
2015-03-17 18:36:19
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respiratory
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respiratory
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respiratory
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  1. Where is surfactant stored?
    Lamellar bodies
  2. How is surfactant released?
    By exocytosis into the alvelolar spaces by calcium dependent fusion of lamellar body membranes with the type II pneumocyte membrane.
  3. What is the risk factor associated with Mesothelioma?
    • Asbestosis 
    • roofing material 
    • insulation for pipes in ships and homes
    • old cars with brake liners
  4. What increases the synthesis of surfactant?
    Cortisol and Thyroxine
  5. What decreases the synthesis of surfactant?
    Insulin 
  6. When does surfactant synthesis begin?
    28th week of gestation
  7. Describe the presentation and microscopic findings of mesothelioma.
    • Presents as unilateral pleural thickening or mass along with a large (hemorragic) pleural effusion
    • Psammoma bodies 
  8. What is the pathology seen below?
    • Mesothelioma - arises from the mesothelium linning the pleural cavity. 
    • Associated with asbestosis
  9. This lung disease is associated with asbestosis.
    Bronchiogenic carcinoma Mesothelioma
  10. What part of the lungs does foreign material aspirate in the standing or sitting position?
    • Posterobasal segment of right lower lobe
    • Baslilar segment of right lower lobe
    • Lower potion of right inferior lobe
  11. What part of the lungs does foreign material aspirate in a semi-recumbent position?
    • Posterobasal segment of right lower lobe
    • Baslilar segment of right lower lobe
    • Lower potion of right inferior lobe
  12. What part of the lungs does foreign material aspirate if supine?
    • Superior segment of the right lower lobe
    • Posterior segment of right upper lobe
  13. Why is the right main bronchus more prone to aspiration than the left main bronchus?
    Because it has a larger diameter, it is shorter and more vertically oriented than the left main bronchus.
  14. What are the risk factors associated with Silicosis?
    • Foundries (casting metal)
    • Sandblasting
    • Working in mines
  15. What is Foundries and which lung disease is it associated with?
    • A workshop or factory for casting metal
    • Silicosis ⇨ Bronchiogenic carcinoma
  16. What component of silica is highly implicated in Silicosis?
    Quartz  - crystalline silicone dioxide
  17. Sandblasting is associated with the development of which lung disease?
    Silicosis ⇨ Bronchiogenic carcinoma
  18. Describe the pathogenesis of Silicosis.
    Macrophages respond to silica (quartz) Release fibrogenic factors ⇨ FIBROSIS
  19. Describe the findings of silicosis.
    • NODULAR densities/ opaciates
    • "Egg-shell" calcification in HILAR nodes/ rim of dystrophic caclification 
  20. Egg-shell calcification in hiliar nodes are characteristic of?
    Silicosis
  21. Patients with silicosis are at increased risk of developing?
    Tuberculosis and Bronchiogenic carcinoma
  22. Describe the pathology seen below.
    • Ferruginous bodies - golden-brown beaded/ fusiform rods with a translucent center coated with an iron-containing material
    • Prussian blue
  23. What are ferruginous bodies?
    • Asbestosis
    • Ferruginous bodies - golden-brown beaded/ fusiform rods with a translucent center coated with an iron-containing material
    • Resembles dumbbells
    • Prussian blue
  24. What risk factor is associated with Asbestosis?
    • Shipbuilding 
    • Roofing
    • Plumbing
  25. Describe the findings of asbestosis.
    Pleural thickening and  CALCIFIED pleural plaques
  26. Fusiform or beaded rods with a translucent center are characteristic of?
    • Asbestosis
    • Ferruginous bodies - golden-brown beaded/ fusiform rods with a translucent center coated with an iron-containing material
    • Resembles dumbbells
    • Prussian blue
  27. Calcified pleural plaques and pleural effusions are pathognomonic of?
    Asbestosis
  28. What is the pathology seen below?
    • Asbestosis
    • Calcified supradiaphragmatic and pleural plaques
  29. What is the pathology seen below?
    • Asbestosis
    • Calcified supradiaphragmatic and pleural plaques
  30. Where do nosebleeds most commonly occur?
    • In the anterior segment of the nostril (Kisselback plexus)
  31. Where do life threatening nose bleeds occur?
    • In the posterior segment of the nostril (Sphenopalantine artery, a branch of maxillary artery)
  32. What risk factor is associated with Berylliosis?
    Exposure in the nuclear and aerospace industry
  33. Working in the aerospace industry is associated with the development of which lung disease?
    Berylliosis
  34. Describe the findings of Berylliosis.
    Resembles Sarcoidosis- nodular infiltrates, enlarged lymph noses, non-caseating granulomas
  35. In this lung disease, there is increased risk of developing tuberculosis.
    Silicosis
  36. What are some geometric forms of asbestosis?
    • Serpentine
    • Amphibole
  37. How do the lungs clear particles 10-15m in size?
    Trapped in the upper respiratory tract
  38. How do the lungs clear particles 2.5-10m?
    Are cleared by mucocilliary transport
  39. How do the lungs clear particles less than 2m in size?
    Phagocytosis by macrophages
  40. Describe the pathogenesis of Coal worker's pheumoconiosis.
    • Prolonged coal dustexposure ⇨
    • macrophages laden with carbon⇨ inflammation and fibrosis
  41. What is anthracotic pigment?
    • Coal dust
    • Coal workers' pneumoconiosis/ Black lung disease
  42. What are the sources of coal dust (anthracotic pigment)?
    • Coal mines
    • Large urban areas
    • Tobacco smoke
  43. Alveolar macrophages with anthracotic pigment are characteristic of?
    Coal workers' pneumoconiosis/ Black lung disease
  44. ↑risk of cor pulmonale is associated with which types of pneumoconiosis?
    • Enlargement and failure of the right ventricle of the heart as a response to pulmonary hypertension
    • Coal workers
    • Silicosis
    • Asbestosis
  45. What is Caplan syndrome?
    Rheumatoid nodules in the lungs + Pneumoconiosis
  46. What is the pathology seen below?
    • Silicosis
    • egg-shell calcifications in hiliar lymph node
  47. Label the diagram below.
  48. What is the image shown below?
    Lamellar bodies of Type II pneyumocytes
  49. What is the major component of surfactant?
    Phosphatidylcholine (lecithin)
  50. What are the causes of neonatal respiratory distress syndrome?
    • 1. Prematurity - MCC
    • 2. Maternal diabetes (fetal hyperglycemia increases insulin release → ⇩ surfactant production)
    • 3. Cesarean section- Lack of stress induced increase in cortisol from a vaginal delivery
  51. What is intrapulmonary shunting? What disease is it seen with?
    • A physiological condition which results when the alveoli of the lungs are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.
    • In other words, the ventilation/perfusion ratio is 0.
    • Seen in Atelectasis/ Neonatal respiratory distress syndrome
  52. What are the pathophysiological effects of Neonatal respiratory distress syndrome?
    • Ventilation defect: Lungs are perfused but not ventilated. V/Q=0
    • This produces INTRAPULMONARY SHUNTING
  53. Describe the histological features of atelectasis.
    Collapsed alveoli are lined by hyaline membranes which are derived from proteins leaking from damaged pulmonary vessels.
  54. Chest x-ray of newborn shows "ground glass" appearance of lung fields. What is the pathology?
    Neonatal respiratory distress syndrome
  55. What are some of the complications that can arise from oxygen therapy in neonatal respiratory distress syndrome?
    • Retinopathy (blindness)
    • Bronchopulmonary displasia (damage to small airways)
    • Intraventricular hemorrage
  56. What are some of the complications of neonatal respiratory distress syndrome?
    • Metabolic acidosis- poor tissue perfusion 
    • PDA- due to low O2 tension (hypoxemia)
    • Necrotizing enterocolitis- intestinal ischemia allows entry of gut bacteria
  57. How do we treat neonatal respiratory distress syndrome?
    • 1. Maternal steroids (cortisol) before birth
    • 2. Artificial surfactant for infant.
  58. What is bronchiectasis?
    Permanent dilation of the bronchi/ bronchioles due to destruction of cartilage and elastic tissue by chronic necrotizing infections.
  59. Permanent dilation of the bronchi/ bronchioles is characteristic of?
    Bronchiectasis
  60. What are some of the causes of Bronchiectasis?
    • Poor ciliary motility e.g. smoking, Kartagener
    • Cystic fibrosis
    • Allergic bronchopulmonary aspergilliosis
  61. What is the pathology seen below?
    Bronchiectasis- permanently dilated airways
  62. What is the pathology seen below?
    Bronchiectasis- permanently dilated airways
  63. Describe the symptoms of bronchiectasis.
    • Productive cough (often cupfuls)
    • Hemoptysis that is sometimes massive
    • Digital clubbing
    • Cor pulmonale
  64. Cystic fibrosis is associated with the development of which lung disease?
    • Bronchiectasis
    • Permanent dilation of the bronchi/ bronchioles due to destruction of cartilage and elastic tissue by chronic necrotizing infections.
  65. Allergic bronchopulmonary aspergilliosis is associated with the development of which lung disease?
    • Bronchiectasis
    • Permanent dilation of the bronchi/ bronchioles due to destruction of cartilage and elastic tissue by chronic necrotizing infections.
  66. Kartagener syndrome is associated with the development of which lung disease?
    • Bronchiectasis
    • Permanent dilation of the bronchi/ bronchioles due to destruction of cartilage and elastic tissue by chronic necrotizing infections.

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