PATHOLOGY

Respiratory

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Matching: Types of obstructive lung disease (COPD):

-?-emphysema enlargement of air spaces & ↓ recoil resulting from destruction of alveolar walls; caused by smoking & α1-antitrypsin deficiency → ↓ elastic activity; findings: dyspnea, ↓ breath sounds, tachycardia, ↓ I/E ratio; "pink puffer"
-?-asthma bronchial hyperresponsiveness causes reversible bronchoconstsriction; can be triggered by viral URIs, allergens, stress; findings: cough, wheezing, dyspnea, tachypnea, hypoxemia, ↓ I/E ratio, pulsus paradoxus
-?-chronic bronchitis productive cough for > 3 consecutive months in 2 or more yrs; hypertrophy of mucus-secreting glands in the bronchioles (Reid index > 50%); leading cause is smoking; findings: wheezing, crackles, cyanosis
-?-bronchiectasis chronic necrotizing infection of bronchi → dilated airways, purulent sputum, recurrent infections, hemoptysis; associated with bronchial obstruction, cystic fibrosis, poor ciliary motility
chronic bronchitis emphysema asthma bronchiectasis

Restrictive lung disease

Type Feature Diseases
I. Poor breathing mechanics (extrapulmonary) a) poor muscular effort two diseases?
  1. -?-polio
  2. -?-myasthenia gravis
b) poor apparatus one disease?
  1. -?-scoliosis
II. Interstitial lung diseases Polypeptide eight diseases?
  1. -?-adult resp distress syndrome (ARDS)
  2. -?-neonatal respiratory distress syndrome (hyaline membrane disease)
  3. -?-pneumoconiosis (anthracosis, silicosis, asbestosis)
  4. -?-sarcoidosis
  5. -?-idiopathic pulmonary fibrosis
  6. -?-Goodpasture's syndrome
  7. -?-Wegener's granulomatosis
  8. -?-eosinophilic granuloma

Lung - physical findings

Abnormality Breath Sounds Resonace Fremitus Tracheal Deviation
Bronchial obstsruction Absent over area -?- Toward side of lesion
Pleural effusion ↓ over effusion -?-Dulless --
Pneumonia (lobar) -?-May have bronchial breath sounds over lesion Dullness --
Pneumothorax Hyperresonant Absent -?-Away from side of lesion

Lung cancer/bronchogenic carcinoma

Tumors that arise centrally:
-?-squamous cell carcinoma clear link to smoking; ectopic PTH-related peptide production
-?-small cell carcinoma clear link to smoking; associated with ectopic hormone production (ADH, ACTH); may lead to Lambert-Eaton syndrome

Tumors that arise peripherally:
-?-adenocarcinoma most common
-?-bronchioalveolar carcinoma thought not to be related to smoking
-?-large cell carcinoma undifferentiated

Lung cancer:

Features of carcinoid tumor: -?-can cause carcinoid syndrome (flushing, diarrhea, wheezing, salivation)

Features of metastases: -?-very common; brain (epilepsy), bone (pathologic fracture), and liver (jaundice, hepatomegaly)

Pneumonia

Type Organism(s) Characteristics
Lobar Most frequently? -?-pneumococcus Intra-alveolar exudates → consolidation; may involve -?-entire lung
Bronchopneumonia S. pyogenes and the other three?
-?-S. aureus
-?-H. Flu
-?-Klebsiella
Acute inflammatory infiltrates from brochioles into adjacent alveoli; -?-patchy distribution involving ≥ 1 lobes
Interstitial (atypical) pneumonia Two viruses?
-?-RSV
-?-adenoviruses
Also mycoplasma, legionella and -?-chlamydia
Diffuse patchy inflammation localized to interstitial areas at -?-alveolar walls; distribution involving ≥ 1 lobes
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