UTMB Advanced Pathophysiology 5355 Module 6.2 Pulmonary Exam practice questions with 100% correct solutions

Paroxsymal nocturnal dyspnea - redistribution of fluids from dependent areas of the body that occurs in the recumbent or supine positions, increases intravascular fluids and places more fluid in the heart. may take a few hours resulting in the patients wake up from SOB. usually relieved by upright position which redistributes the fluids back to dependent areas of the body such as the legs. Abd. pressure plays a greater role in orthopnea, but there is overlap between the two terms. Since the heart is not an effective pump in heart failure the fluids back up into the lungs creating - pulmonary edema (fluid in the lungs) Predominantly heart Failure and lung disorders are often associated with - PND How does smoking cause emphysema? - The process begins with epithelial inflammation triggering cytokines to increase protease activity (breakdown of protein in the lung tissue) and inhibition of the normal endogenous antiproteases in the lung. Smoking leads to reduced endogenous antiproteases AND Smoking causes an imbalance between excessive protease activity and deficient endogenous anti-proteases. Emphysema - Emphysema is an enlargement of alveolar air spaces associated with destruction of alveolar septa. The interstitial connective tissue proteins provide the major structural framework of the lung parenchyma, pathogenesis of emphysema have emphasized factors which affect the integrity of this matrix, particularly elastin and collagen fibers. The current most widely held explanation for the development of emphysema is the protease pathogenesis hypothesis. The concept holds that progressive destruction of the interstitium is due to an excess of proteolytic enzymes (particularly elastase) in relationship to the availability of proteolytic inhibitors. A potentially important mechanism causing a relative elastase excess in the lungs of smokers is by oxidative inactivation of α1-antiprotease which is the major antiprotease in the normal human lower respiratory tract. Consolidation - When the lungs and small airways fill with dense material (fluid) or products of inflammation (pus), the lung is said to be consolidated. Tuberculosis Pathophysiology - Causative agent: mycobacterium tuberculosis, an acid-fast bacillus that invades the lungs and other body systems, read in your content notes, but one of the uniquefindings of Tb are the granulomatous lesions called tubercles. Once the infected cells in the tubercle die, there is caseous necrosis and a collagenous scar tissue grows around the tubercle- it is walled off and dormant at this point. pneumonia - is an acute infection of the lower respiratory tract caused by either bacteria, viruses, fungi, protozoa or parasites. Infection occurs through aspiration of oropharyngeal secretions, bacteremia, inhalation of microorganisms or through nosocomial transmission.