Pulmology Patho Exam Questions with Correct Answers

Pulmology Patho Exam Questions with Correct Answers Define pleural effusion and describe the two different forms of it - Answer-definition = fluid accumulation within the pleural space 1. transudative (hydrothorax) = intact capillaries, low protein, due to condition that DO NOT directly affect pleural tissue and result in fluid diffuses out of capillaries due to high hydrostatic pressure (HF) and low plasma proteins (cirrhosis, nephrotic syndrome) 2. exudative = leaky capillaries, high protein, due to condition that DIRECTLY affect the pleural tissue, fluid diffuses out due to increased vascular permeability (TB, PNA) Define chylothorax, hemothorax, and empyema - Answer-chylothorax = lymph & dat, due to impaired lymphatic drainage hemothorax = blood, trauma, surgery, cancer empyema = pus, abscess, bacterial pneumonia Define and describe the four different types of pneumothorax - Answer-definition = accumulation of air or gas in pleural space causing separation of the 2 layers, increased Pip and lung collapse 1. spontaneous = rupture of air sacs leads to air in the pleural space, primary = unknown cause (tall, thin, males) or secondary = underlying lung disease (COPD) 2. traumatic = chest trauma, iatrogenic, mechanical ventilation 3. open = the air can go in and out during inspiration/exhalation, Pip = barometric pressure 4. tension = one-way entry of air into the pleural cavity, deviated trachea on the contralateral side, Pip > barometric pressure Define pulmonary hypertension and the 5 groups of it - Answer-definition = increase in mean pulmonary arterial pressure to >25 mmHg (nml is around 14), can be acute or chronic group 1 = idiopathic group 2 = left-sided heart failure group 3 = chronic lung disease group 4 = chronic thromboembolic PH group 5 = miscellaneous all groups but group 2 can lead to cor pulmonale Describe the pathophysiology of idiopathic PAH - Answer-enhanced Ca2+ signaling and reduced cyclic nucleotide signaling leads to imbalance favoring contraction and proliferation, eventually leading to pulmonary vessel remodeling Define, list common causes, and describe patho of cor pulmonale - Answer-definition = altered structure & function of RV caused by a primary respiratory problem common acute cause = PE common chronic cause = COPD patho = pulmonary artery remodeling leads to increased to right ventricle afterload, so the RV remodels and leads to RHF Define, list most common cause, and describe patho of PE - Answer-definition = occlusion of the main pulmonary artery or its branches by something most common cause = from DVT that broke off patho = the thrombi will occlude pulmonary circulation leading to hypoxic VC, V/Q mismatch (because less perfusion), inflammation, pulmonary edema, and fibrosis What is a saddle embolus - Answer-sudden massive PE that blocks the main pulm artery leading to a fatal decrease in cardiac output, resulting in death if not treated Define, list etiology, patho, and effects of pulmonary edema - Answer-definition = fluid accumulation in interstitium & alveoli etiology and patho = 1. cardiogenic = increased pulmonary capillary hydrostatic pressure 2/2 LHF 2. non-cardiogenic = increased capillary permeability 2/2 ARDS (or other stuff that affects lungs), decreased oncotic pressure (liver failure, renal failure), block lymph drainage (tumors)