Term
| Obstrictive V restrictive lung disease |
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Definition
| Obstructive - increased resitance to outflow, anatomical narrowing or loss of recoil decreased FEV1/FVC. Restrictive - recuced expansion of parenchyma, decreased TLC, no obstruction to airflow increased FEV1/FVC |
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Term
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Definition
| increased airflow resistance or obstruction that is not fully reversable |
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Term
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Definition
| Thin, breathless, hyperinflated, pink (hyperemic), low PO2 and normal or low CO2 |
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Term
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Definition
| not breathless, centrally cyanosed (blue), signs of cor-pulmonale, Low PO2 and Low PCO2 |
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Term
| Pathology of Chronic bronchitits |
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Definition
| large airway - increased sub mucosal glands (reid index), increased goblet cells, increased smooth smucle, generalised dilation, sacculation between muscle bundles, inflammatory cells. Small airways - goblet cell hyperplasia, peribronchial fibrosis, macrophage accumulation, muscle hyperplasia. Morphology - macro (hyperaemia, swelling, oedema and excessive mucus) histo - chronic inlammatory cells enlargement of mucos glangs |
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Term
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Definition
| dilation of the airspaces distal to the terminal bronchiole, wall destruction. Panacinar - whole acinus, lower zones (Alph-1-antitrypsin). Centrolobular (proximal) - proximal parts of acini/resp bronchioles and airspaces. upper zone (ciggarettes). Paraceptal (distal acinar)- along interlobular septa and pleura usually upper zones. |
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Term
| Pathogenesis of emphysema |
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Definition
| smoking induces inflammation and production of production of free radical. recruited inflammatory cells release degradive proteases eg elastase. smoking also inhibits the activity of protease inhibitors as well as depleting anti oxidants. impalace between destruction and repair |
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Term
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Definition
| apical blebs and bullae secondary to scaring. Bleb collection of air within the visceral pleura risk factor for pneumothorax. Bullae large air filled spaces |
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Term
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Definition
| disease of reversable air way obstruction associated with mucosal inflammation and airway hyperresponsiveness |
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Term
| Pathological features of asthma |
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Definition
| thickening of mucous and shedding of epithelial cells (creola bodies, Charcot leyden crystals). thickening of the BM, Increase in eosinphil numbuers. increased goblet cells and mucus secretion (curshman spirals). Increased mucus glands, increased smooth muscle mass |
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Term
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Definition
| permanent dilation of bronhi/bronchioles due to destruction of muscle/elastin. Aetiology - congenital (CF, Primary ciliary dyskinesia), infectious (necrotising pneumonia). bronchial obstruction (tumour, foreighn body, mucus). other - RA, SLE, IBD |
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Term
| pathogenesis of bronchiectasis |
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Definition
| obstruction/infection major factors impairing the clearance of secreations and subsequent inflammation. leads to inflammation, necrosis, fibrosis, and dilation |
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Term
| Interstitial lung disease |
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Definition
| disease characterised by diffuse inflammation and fibrosis of the lung interstitium resulting in a restrictive pattern of disease. Clinical features - dyspnoea, tachypneoea, inspiratory crackles, cyanosis, NO wheeze. reduced diffusion capacity, lung volume and compliance. CXR - diffuse infilttraion by small nodules, irregular lines and ground glass shadows |
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Term
| Etiology of interstitial lung disease |
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Definition
| pneumoconiosis (asbestsis, silicosis), hypersensitivity pnemonitis, infection, oxygen toxicity, autoimmune (RA, Sarcoid), Drug reaction (amiodarone, gold) idiopathic |
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Term
| pathogenesis of interstitial pneumonitis |
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Definition
| lung injury leads to alveolitis and inflammation of the alveolar septum. Intertitium becomes wideded with inflammatory cells(lymphocytes, macrophages). progressive inlammation leads to damage and distortion of the lung architecture. influx of fibroblasts and progressive fibrosis of the lung tissue. |
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Term
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Definition
| end stage of chronic interstitial disease. morphology - enlarged airspaces with surrounding fibrosis and scarring, cysts several centimeters in diameter |
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Term
| Systemic diseased affectign lung |
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Definition
| collagen vascular or connective tissue disease - RA, SLE, Scleroderma. cause pleural inflammation and fibrosis and parenchymal lesions - UIP, nodules, vascular changes |
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Term
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Definition
| multisystem non-caseating granulomatous disorder or unknown aetiology. 90% involing interstitial disease of lung, also - lymph, spleen, bone marrow, skin, muscle. Clinical features - cough, restrictive respiratory pattern, CXR-bilateral hilar involvement. lymphadenopathy. Granuloma - non necrotising, asteroid inlusions, Schaumann conretions, conchoid bodied, berefingeent cyt |
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Term
| hypersensitivivy pneumonitis |
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Definition
| immunological rection to inhaled antigens (bacteria, fungi, animal) Acute - large antigen exposure, dyspnea, fever, chills, short duration. Chronic - small prolonged exposure. slow onset dyspnea, dry cough, fatigue, infitrates on CXR, and irreversable damage. |
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Term
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Definition
| Dust disease - non neosplastic reaction to inhaled mineral or organic dust. reactoin depends upon - dust propertity (fibrogenic), quantity, duration, size, individual host |
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Term
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Definition
| exposure to silica from quartz a fibrogenic dust. pathology - hyaline and collagenous nodules in lung and mediastinum 10-20 yrs exposure. Complications - conglomerate nodules, progressive massive fibrosis, TB, Caplans syndrome (RA + silicosis) |
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Term
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Definition
| interstitial fibrosis in lower lobes, pleural fibrosis and plaques. Presence of asbestos bodies and increased risk of meso and lung cancer |
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Term
| Drug induced lung disease |
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Definition
| range of aucte and chronic - bronchospasm, pulmonary oedema, DAD, interstitial alveolitis, eosinic pneumonai. Eg bleomysin/methotrexate (pneumonitis,fibrosis), amiodarone (pneumonitis, fibrosis) B-blockers, aspirin (bronchospasm) |
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Term
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Definition
| infiltrate of eosinophils. mild illness, fever, cough, may become chronic. Cause - unknown, lofflers, tropical, secondary (asthma, infection) idiopathic |
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Term
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Definition
| 1 in 6 >45. 4th cause of death, 3rd burden of disease. High health care cost |
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Term
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Definition
| Cigarette smoking (90%)-dose responce. Airway hyperresponsiveness. Respiratory infectons (flareups), occupational exposure (dust), Air pollutions, second hand smoke, Alpha one antitripsin defeciency (severe -2%) |
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Term
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Definition
| Airflow obstruction - reduced elastic recoil and airway obstruction cause dynamic air way compression. Hyperinflation - early airway closure (increased RV)and increased inspiration. limits airflow limitation by increase elastic recoild and relieves obstruction in quietbreathing but reduced inspiratory reserve. impaired gas exchange - V/Q mismatching and impaired diffusion |
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Term
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Definition
| large airway - mucus gland hypertrophy, goblet cell hyperplasia, squamous metablasia,loss of ciliary muscle, smooth muscle hypertrophy, neutraphil influx. Small airway - reduced airway diameter (mucus, oedema, infiltrate), goblet cell hyperplasia, smooth muscle hypertrophy, . Lung parenchyma - destruction of airspace (respiratory bronchioles, alveolar ducts, alveoli) enlarged airspaces, macrophage/lymphocyte accumulation |
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Term
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Definition
| gradual onset of cough, dyspnea, sputum production. often present as acute exacerbation. |
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Term
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Definition
| cigarette smoking, dyspnea, barrel chested, pursed lips, accessory muscle use, wasting. decreased expansion, percussion (hyperesonant,diplaced diaphragm, liver ptosis), auscultation (decreased breath sound,prolonged expiratory phase, inspiratory crackles, wheeze). Cor-pulmonale - loud P2, RV heave, raised JVP, ascities, oedema, hepatosplenomegaly |
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Term
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Definition
| spirometry (dec FEV1,FVC,inc RV, diffusion capacity). ABG (typeI or II). CXR-radiolucency, displacement of diaphragm(6th ant, 10post), narrow mediastinum, bullae. 6 minute walk |
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Term
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Definition
| COPDX- confirm diagnosis, optimise function, prevent deteriation, develop networks, manage exacerbations. |
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Term
| Acute exacerbation of COPD |
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Definition
| increased dyspnea, cough, sputum production +/- (fever,sorethroat, myalgia) causes - bacterial, viral, un identified. inv - spirometry, sputum culture, CXR, ABG. Tx - oxygen, bronchodilators, antibiotic, steroids, |
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Term
| occupational lung disease |
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Definition
| history - sequention occupations, titles, duties, duration, known exposures |
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Term
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Definition
| simple- depostion of coal dust producing fine shadowing. Progressive massive fibrosis - fibrotic masses with necrotic centers leading to lung disruption and emphysema. mixed obstructive and restrictive lung pattern dyspnea, cough, black sputum |
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Term
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Definition
| asbestos body(fiber coated with protein and iron engulfed by macrophage) pleural plaques (thickening of pleura with lumps and bumps) diffuse pleural thickening. Asbestosis - progressive fibrosis or parenchyma and pleura. (progressive dyspneoa, clubbing, inspiratory crackels |
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Term
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Definition
| malignancy of lung pleura caused by asbestos exposure. symptoms - pleural effusion, chest pain, dyspnea. 50% mortality in 12 months |
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Term
| epidemiology of lung cancer |
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Definition
| most common world wide, 17% of cancer deaths, majority due to tobacco, 3rd cause of death in australia, poor prognosis. 99% carcinomas - SCC (44%m,25%F) Adeno (28%m,42%F). small cell 20%, large cell undiff 9% |
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Term
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Definition
| smoking (dose, duration, age at begining, type, depth of inhalation), Occupational (passive, asrenic, asbestos, radiation) |
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Term
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Definition
| exposures lead to mutations that accumulate to form neoplastic phenotype. Oncognes - CMYC, KRAS, EGRF. TSG- RB, P53. Famililial clusters , variability amoung smokers |
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Term
| Presentation of lung cancer |
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Definition
| Symptom - cough, weight loss, chest pain, haemoptsis. Systemic effect - compression(pancoast), obstruction(SVC), atelectasis, bronchiectasis, Abscess. metastasis, paraneolastic, |
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Term
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Definition
| sputum cytology, bronchoscopy (washings, brushing, biopsy) cytology of pleura, FNA (CT guidance), biopsy of noeds |
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Term
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Definition
| Local-parenchyma, peribronchila, mediastinal, pleura, chest wall. Lymphatic-peribronchila, hilar, mediastinal. Hematogenous - liver, adrendal , brain, bone. Transcoelic - pleura. Major metastasis - Liver, adrenal, brain, bone |
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Term
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Definition
| Small cell - limited v extensive. non-small cell - TNM system |
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Term
| treatment decisions for lung cancerq |
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Definition
| Type, Stage, lung function, co-morbidities, performance status, age, patient preferance |
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Term
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Definition
| M>F, Cental>peripheral, local agressive, rare metastais, >90% smokers. Macro-necrosis and cavitation. Micro - keratin pearls, intracellular corss bridges, high mitotic activity, poorly differentiated. |
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Term
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Definition
| F>M most common type for non-smokers,increasing incidence, Peripheral > central. Histology - acinar, papillary , bronchioalveolar, solid with mucin (grows in airspaces, does not invade stroma, peripheral, single or multiple nodules |
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Term
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Definition
| neuroendocrine, highly malignant, Central > peripheral, V.strong smoking association. metastasise early, common hormone production. Histo - small cell, non prominent nucleolus, lots of mitosis and necrosis, small cytospasm, spindle shaped |
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Term
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Definition
| central or peripheral, poor prog, some neuroendocrine, Histo - no features of small cell,squamous, glandular. large nuclei, prominent nucleolus, mod cytoplasm |
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Term
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Definition
| neuroendocrine, M=F, young patients, slow growing, lots non smkders, central or peripheral, rarely metastasise. Histological - typical v atypical, nested organoid patter, dense granual filled with hormones |
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Term
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Definition
| most common site. blood or lymphatic spread. Breast, colon, stomach, pancreas, kidney,. Morphology - discrete nodules (cannon ball), peripheral > central |
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Term
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Definition
| caused by ectopic hormone production (1-10%)- ADH (hyponatreaemia), ACTH (cushings), parathyroid related peptide (hypercalcaemia), gonadatrophins (gynaecomastica), serotonin (carcinoid) |
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