Term
|
Definition
Greater than 0.5
Normal is 0.4 |
|
|
Term
| Blue bloaters describe what disease ? |
|
Definition
Chronic bronchitis
Are cyanotic, respiratory acidosis, right-sided heart failure |
|
|
Term
| Diagnosis of chronic bronchitis ? |
|
Definition
| Productive cough for 3 months in at least 2 consecutive years |
|
|
Term
| Pink puffers are persons with ? |
|
Definition
Emphysema
Barrel chest
Complication is Cor Pulmonale
Early PCO2 normal, late PCO2 high
Do not give O2 as therapy |
|
|
Term
| Characteristics of Panlobular Emphysema ? |
|
Definition
Present as younger age, around 40
Hereditary deficiency of alpha-1 antitrypsin
Abnormal allele is PIZZ homozygous
Alveolar septal rupture and loss of capillaries
Affects lower lobes
Associated with liver cirrhosis |
|
|
Term
| Most accurate way to diagnose bronchioectasis ? |
|
Definition
|
|
Term
| Etiological factors of bronchiectasis ? |
|
Definition
Cystic fibrosis is most common cause
Kartagener's Syndrome
TB
Hypogammaglobulinemia
Recurrent pneumonia
Measles
Asthma
Centrally located tumors |
|
|
Term
| Characteristics of bronchiectasis ? |
|
Definition
On sputum culture, will see mixed flora
Foul smelilng sputum
On histology, peribronchial fibrosis and desquamation |
|
|
Term
| Two unique inclusions see in sputum of asthma patients ? |
|
Definition
Curshmann spirals (shed epithelium from mucus plugs)
Charcot-Leyden crystals (fragments of eosinophilic membranes) |
|
|
Term
|
Definition
Bronchial hyper-responsiveness causes "Reversible" bronchoconstriction
Most imp mediator is **leukotrienes**
Hyperplasia of bronchial goblet cells causes mucus plugs to form
Hyperventilate so see resp. alkalosis
Symapthetics are good for trt b/c cause bronchodilation
Symptoms are cough, wheezing, dyspnea, decreased I/E ratio, pulsus pardoxus, mucus plugging
Extrinsic type and Intrinsic type
Status Asthmaticus |
|
|
Term
| 2 examples of intrinsic asthma ? |
|
Definition
Non-reaginic asthma
Pharmacologic asthma - due to aspirin (inhibits only cycloxygenase pathway)
Triad asthma (take aspirin, develop asthma, nasal polyps) |
|
|
Term
| Spirometry for asthma would be ? |
|
Definition
Same as for emphysema
Decreased FEV1/FVC ratio
Increased TLC
Increased RV |
|
|
Term
|
Definition
Squamous Cell Carcinoma of Lung
Both are centrally located tumors |
|
|
Term
| Characteristics of bronchogenic carcinoma ? |
|
Definition
Endogenous lipid pneumonia
Foamy macrophages
Complications:
Phrenic nerve paralysis
bronchiectasis
Lymphadenopathy
Other problems due to obstruction in center of chest |
|
|
Term
| Characteristics of Squamous Cell Carcinoma ? |
|
Definition
Two main causes of squamous cell cancer:
Cigarette smoking (most common)
Radon exposure
Also p16 and p53 mutations
Morphology:
Keratin pearls
Intracytoplasmic bridges
Paraneoplastic Syndrome:
Associated with PTH-like peptide leading to hypercalcemia |
|
|
Term
| Symptoms of Pancoast tumor (tumor of the pulmonary apex) is related what 2 syndromes ? |
|
Definition
1) Horner's Syndrome (due to compression of superior cervical ganglion)
ipsilateral miosis, anhidrosis, ptosis
Weakness of arm in ulnar distribution
Hoarse voice and bovine cough
2) Superior Vena Cava Syndrome
Facial and arm swelling, cyanosis, dilatation of veins of head and arms |
|
|
Term
| Characteristics of Small (Oat) Cell Carcinoma ? |
|
Definition
Central tumor
High nuclear : cytoplasm ratio, small hyperchromatic nuclei, diffuse sheets of cells
Cell of origin is Kulchitsky cell (neuroendocrine cell)
Strong corr to smoking
Very aggressive - need chemotherapy soon
Paraneoplastic Syndromes - mainly neurological, production of hormones (ADH, ACTH, rarely serotonin, Lambert Eaton Syndrom, Myasthenic Syndrome) |
|
|
Term
| Facts about Carcinoid tumor of lung ? |
|
Definition
Slow growing neuroendocrine tumor
Not linked to smoking or other factors
90% benign
Cell of origin prob Kulchitsky cell
Carcinoid Syndrome rare so rarely secrete ACTH or serotonin
Findings of intraluminal growth (cought, hemoptysis, recurrent infections) or asymptomatic |
|
|
Term
| Adenocarcinoma of Lung facts ? |
|
Definition
Peripheral lung cancer
KRAS and EGFR genetic mutations
PAS and cytokeratin positive
Three Types:
1. AAH (Atypical Adenomatous Hyperplasi
2. Bronchial/Frank Invasive Adenocarcinoma
Has hematological / thormobosis paraneoplastic syndromes
3.Bronchioalveolar Carcinoma (BAC)
Not linked to smoking
Lepidic growth pattern
Spread via pores of Kohn
Multiple densities on x-ray |
|
|
Term
| Most common lung cancer in females and non-smokers ? |
|
Definition
| Bronchial / Frank Invasive Adenocarcinoma |
|
|
Term
| Most common cause of death from adenocarcinoma of lung ? |
|
Definition
|
|
Term
| Metastiatic lung lesions show up as what on x-ray ? |
|
Definition
|
|
Term
Most common site for metastiatic lesions of the lung ?
Common metastiatic sites of primary lung cancers ? |
|
Definition
Breast
(HALBB)
Hilar lymph nodes
Adrenals
Liver
Brain
Bone |
|
|
Term
| M0st common cause of solitary (coin) lung lesions ? |
|
Definition
| Granulomatous disease (TB, Wegener's, Histoplasmosis) |
|
|
Term
| Clubbing is not associated with what subtype of lung disease ? |
|
Definition
| COPD (Emphysema or Bronchitis) |
|
|
Term
| Cytokine responsible for pathogenesis of IPF (Idiopathic/Interstitial Pulmonary Fibrosis) ? |
|
Definition
|
|
Term
| How to treat pt. with solitary (coin) lung lesion ? |
|
Definition
Just reassure pt. it is probably benign
Do not do biopsy b/c can cause pneumothorax |
|
|
Term
| Clubbing present in what diseases ? |
|
Definition
H O G L
Heart disease
Other - hyperthyroidism, axillary artery aneurysm
Gastrointestinal and Hepatobiliary
Lung Disease
***But not COPD (emphysema or bronchitis)*** |
|
|
Term
|
Definition
| Variation in size of RBCs |
|
|
Term
| Normal Myeloid : Erythroid (M:E ratio) is ? |
|
Definition
|
|
Term
| Characteristics of bone marrow biopsy ? |
|
Definition
Used to study architecture
Can see intact tissue with trabeculae
Results in a week |
|
|
Term
| Characteristics of bone marrow biopsy ? |
|
Definition
Used to study architecture
Can see intact tissue with trabeculae
Results in a week |
|
|
Term
| Characteristics of extravascular hemolyssi ? |
|
Definition
Occurs within mononuclear-phagocyte system secondary to RBC defect , see Heinz bodies
No hemoglobinuria, hemosiderinuria, or methemoglobinuria
Decreased plasma haptoglobin
Anemia and Jaundice
Splenomegaly |
|
|
Term
| Hereditary Spherocytosis caused by ? |
|
Definition
Intrinsic defect in the cell membrane
Increased MCHC
Decreased MCV
Ankyrin most common protein affected
Pigment gall stones
Splenomegaly
Howell Jolly bodies
Osmotic Fragility Test as definitive investigation
Trt is splenectomy (eliminates anemia but not spherocytes) |
|
|
Term
| Splenomegaly and gall stones are rare in ? |
|
Definition
G6PD Deficiency
b/c hemolysis is episodic
Has mostly extravascular hemolysis and some intravascular hemolysis |
|
|
Term
| Bite cells and Heinz bodies seen in ? |
|
Definition
|
|
Term
| What GPI proteins are deficient in PNH ? |
|
Definition
C8 binding protein
CD 55
CD 59 |
|
|
Term
| Ham's test is used to diagnose what disease ? |
|
Definition
|
|
Term
| Two types of Immune Hemolytic Anemia ? |
|
Definition
Warm antibody type (favors IgG) and Cold antibody type (favors IgM)
Both are Coombs test positive |
|
|
Term
| Microangiopathic Hemolytic Anemia ? |
|
Definition
Due to mechanical hemolysis of RBCs
Seen with prosthetic heart valves, severe calcific aortic stenosis, SLE, obstruction of bvs
See schistocytes / helmet cells in peripheral blood |
|
|
Term
| A test that reduces oxygen tension, and is used to detect HBS in Sickle Cell Anemia ? |
|
Definition
| Sodium Metabisulphate test |
|
|
Term
| Crew cut appearance of skull and frontal bossing seen in what two disease states ? |
|
Definition
| Chronic hemolytic anemia (sickle cell) and Beta Thalassemia Major |
|
|
Term
| Trs for Sickle Cell Anemia ? |
|
Definition
Bone Marrow Tx
Hydroxyurea to increase HbF
O2 for hypoxia
Water for dehyration |
|
|
Term
| Most accurate invetigative test for sickle cell, Beta Thallassaemia Major, and Beta Thallassaemia Minor ? |
|
Definition
|
|
Term
| Most commmon cause of death in Beta Thall. Major ? |
|
Definition
| Heart failure from secondary hemochromatosis |
|
|
Term
| Most definitive diagnosis for Iron Deficiency Anemia ? |
|
Definition
| Bone Marrow biopsy with Prussian blue |
|
|
Term
| What things increased in iron studies of iron deficiency anemia ? |
|
Definition
These are increased:
RDW
Platelets
TIBC
Soluble transferrin receptors
FEP and Zn protophyrin levels |
|
|
Term
| Do not give excess iron to ? |
|
Definition
| Beta Thallassemia Minor pts |
|
|
Term
| What iron studies are increased in Anemia of Chronic Disease ? |
|
Definition
Serum ferritin
Bone marrow iron
Hepcidin also increased from liver |
|
|
Term
| Hypersegmented neutrophils seen in what disorder ? |
|
Definition
|
|
