how do you use FEV1/FVC?
- decreased in obstructive disease (airflow problem)
- increased in restrictive disease (lung size limitation)
what's the Reid index?
mucus gland depth/total thickness of bronchial wall; >50% in COPD d/t mucus hypertrophy
centriacinar emphysema caused by?
panacinar emphysema caused by?
alpha1 antitrypsin deficiency
asthma, shed epithelium from mucous plugs
histological finding in asthma?
smooth muscle hypertrophy and Curschmann's spirals
how to test for asthma?
methacholine challenge (musc agonist that should constrict airway)
- primary ciliary dyskinesia, defect in cilia of resp and reproductive tracts d/t dynein mutation, AR
- combo of situs inversus, chronic sinusitis, bronchiectasis
drug causes of restrictive lung disease?
bleomycin, busulfan, amiodarone
coal miner's disease?
pneumoconiosis from coal mine exposure, affects upper lobes
RA + pneumoconiosis
pneumoconiosis from foundries, mines, affects upper lobes; macrophages respond to silica -> fibrosis; increased risk of TB
what pneumoconiosis increases TB risk?
eggshell calcification of hilar LN?
xray finding with silicosis?
eggshell calcification of hilar LN
ivory white calcified pleural plaques?
golden-brown dumbbells in macrophages?
lung finding: tracheal deviation toward side of lesion?
lung finding: tracheal deviation away from side of lesion?
coin lesion on xray?
most common cause of lung cancer?
mets from breast, colon, prostate, bladder
central lung cancers?
peripheral lung cancers?
adeno, large cell
keratin pearls and intercellular bridges?
squamous cell cancer
cancer with parathyroid-like activity (Ca2+)?
squamous cell cancer
most common lung cancer in nonsmokers?
can result in hypertrophic osteoarthropathy?
cancer at site of prior pulm inflammation or injury?
cancer associated with ectopic ACTH or ADH productio?
cancer that may lead to Lambert Eaton?
small cell (autoAb against Ca channels)
prognosis of small cell?
very aggressive, inoperable, responds to chemo (whereas large cell is aggressive and doesn't respond to chemo as well)
neoplasm of neuroendocrine Kulchitsky cells (small, dark, blue)?
pleomorphic giant cells with leukocyte fragments in cytoplasm?
produce ectopic serotonin, ACTH, calitonin, bradykinin?
carcinoid tumor can do what to heart?
fibrous deposits in R heart valve -> tricuspid insuff, pulm stenosis, R heart failure
which lung cancer has psammoma bodies?
cancer in apex of lung?
Pancoast location and impact?
apex of lung, can affect cervical sympathetic plexus -> Horners (ptosis, miosis, anhidrosis)