Step Up: Pulmonary Diseases

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increased Reid Index excess mucus productive cough for three consecutive months to 2 yrs seen in smokers possible cor pumonale: Chronic Bronchitis
COPD
increased sensitivity of bronchioles Charcot-Leyden crystals or Curschmans spirals wheezing treat with B-agonist and steroids: Asthma
COPD
Decreased elastic recoil, dilated and damaged alveoli may be assoc. with hereditary a1 antitrypsin deficiency dyspnea, barrel shaped chest, expiration thru pursed lips: Emphysema
COPD
caused by bronchial obstruction or infection dilated airways in lower lobes cough w/ purulent sputum; hemopytosis; cyanosis seen in CF patients or those with Kartageners syn: Bronchiectasis
COPD
intra-alveolar exudate leading to consolidation CXR shows radio-opaque lobe involvement fever, dyspnea, productive cough: Lobar Pnuemonia
Pneumococcus (S.pnuemoniae)
multilobar involvement; neutrophil exudate extends from bronchii CXR shows patchy opacities Fever, dyspnea, and productive cough: Bronchopneumonia
Staph. aureus, H. influenza, S. pyogenes
multilobar involvement; neutrophil exudate extends from bronchii CXR shows patchy opacities Fever, dyspnea, and productive cough seen in patients with alcoholism: Bronchopneumonia
Klebsiella
diffuse infiltrate in alveolar wall, patchy; no consolidation abrupt onset of fever, gradual paroxysmal cough w/ Rales at PE positive cold agglutinin test usually affects young adults: Mycoplasma pneumoniae
pulmonary hemorrahge, anemia, glomerulonephritis anti basement membrane antibodies affects middle aged males P/W hemoptysis; hematuria CXR bilateral fluffy infiltrates: Goodpastures Syndrome
ILD
*Chronic Inflammation of the alveolar wall Fibrosis; csytic spaces usually occurs in the sixth genration of life *Honeycomb lung fatal within years: Idiopathic Pulmonary Fibrosis
ILD
Interstitial fibrosis, uveitis, polyarthritis *Dx based on biopsy showing non- caseating granulomatous lesions *MC affects Young black females may p/w dyspnea on exertion, dry cough, fever, fatigue and bilateral hilar lym: Sarcoidosis
ILD
prolonged exposure to organic antigens in atopic individuals interstitial inflammation alveolar damage leads to chronic, fibrotic lung affects those with occupational history of farming or bird keeping p/w dry: Hypersensitivity Pneumonitis
ILD
presence of Langerhans like cells and Birbeck granules; subset of histiocytosis X former smokers are at risk shows lesions in lung or ribs; pnuemothorax: Eosinophilic granuloma
ILD
Carbon dust ingested by alveolar macrophages *visible black deposits usually asymptomatic seen in smokers and urban dwellers: Anthracosis
fibroblast proliferation and interstitial fibrosis of the lower lobes disease specific bodies and ferruginous bodies pleural plaques and effusions increased risk of bronchiogenic carcinoma and malignant mesothelioma: Asbestosis
Carbon dust ingested by alveolar macrophages forms bronchiolar macules may progress to fibrosis plaques are asymptomatic, often benign but may progress to fibrosis may be fatal due to pulmonary hypertension and *cor pumon: Coal Workers Pneumoconiosis
silica dust is ingested by alveolar macrophages causing release of harmful enzymes silicotic nodules that may obstruct air or blood flow concurrent TB is common seen in miners, stone cutters, and glass production: Silicosis
induction of cell mediated immunity leads to non-caseating granulomas several organ systems are affected; histologically identical to sarcoidosis increases lung cancer: Berylliosis
most common oppurtunistic infection in AIDS patients diffuse atypical pneumonia extesnive pink alveolar exudate but minimal inflammation GMS stain demonstrates organism: P. carinii
hyaline membranes: ARDS
NRDS

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