Pulmonary Diseases Quiz

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Questions and Answers

The primary lesion of pulmonary tuberculosis in childhood is known as a gumla focus.

False (B)

In emphysema, the destruction of alveolar walls leads to increased air space size distal to the terminal bronchiole.

True (A)

Proteases and antiproteases contribute to the pathogenesis of emphysema by producing protease.

False (B)

Asthma is characterized by paroxysmal constriction of the bronchial airways and occlusion by thin mucous plugs.

<p>False (B)</p> Signup and view all the answers

Chronic bronchitis involves persistent cough with sputum production.

<p>True (A)</p> Signup and view all the answers

Non-small cell carcinoma accounts for 70-80% of epithelial lung tumours.

<p>True (A)</p> Signup and view all the answers

Squamous cell carcinoma of the lung primarily arises in the peripheral bronchi.

<p>False (B)</p> Signup and view all the answers

Cigarette smoking is a recognized cause of primary bronchial carcinoma.

<p>True (A)</p> Signup and view all the answers

Small cell carcinoma accounts for 10-15% of malignant lung tumours.

<p>False (B)</p> Signup and view all the answers

Histamine release in allergic asthma results from the activation of mast cells and basophils.

<p>True (A)</p> Signup and view all the answers

Peripheral tumours of the lung are typically adenocarcinomas.

<p>True (A)</p> Signup and view all the answers

Finger clubbing is a common metastatic effect of bronchial carcinoma.

<p>False (B)</p> Signup and view all the answers

Secondary lung tumours usually manifest as a solitary mass within the lung.

<p>False (B)</p> Signup and view all the answers

A benign tumor cannot metastasize but can still be lethal, such as in the central nervous system.

<p>True (A)</p> Signup and view all the answers

Malignant tumors are incapable of invading and spreading from their original site.

<p>False (B)</p> Signup and view all the answers

Carcinomas primarily spread through blood.

<p>False (B)</p> Signup and view all the answers

Differentiation refers to how closely cancer resembles its original site of origin.

<p>True (A)</p> Signup and view all the answers

Epithelium refers to tissues that line external or internal surfaces of the body.

<p>True (A)</p> Signup and view all the answers

Anaplasia describes cells with a uniform appearance.

<p>False (B)</p> Signup and view all the answers

Oncogenes suppress tumor growth and prevent cancer formation.

<p>False (B)</p> Signup and view all the answers

Germ cell tumors may affect reproductive systems such as testes and ovaries.

<p>True (A)</p> Signup and view all the answers

The primary cause of infections in the upper respiratory tract is typically bacterial.

<p>False (B)</p> Signup and view all the answers

The lower respiratory tract can be affected by secondary bacterial infections following a viral infection.

<p>True (A)</p> Signup and view all the answers

Acute laryngitis can be caused by Streptococcus Pyogenes.

<p>True (A)</p> Signup and view all the answers

Pneumonia is a result of infection in the bronchial tree rather than in the alveolar spaces.

<p>False (B)</p> Signup and view all the answers

Lobar pneumonia inflammation starts in the bronchus and spreads to adjacent alveolar spaces.

<p>False (B)</p> Signup and view all the answers

The defence mechanisms of the respiratory organs include nasal hairs and the cough reflex.

<p>True (A)</p> Signup and view all the answers

Viral sore throat can be caused by the Adenovirus.

<p>True (A)</p> Signup and view all the answers

Bronchopneumonia is characterized by interstitial pneumonia with initial atypical inflammation.

<p>False (B)</p> Signup and view all the answers

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Which of the following is a common causative agent of community-acquired pneumonia?

<p>Streptococcus pneumoniae (A)</p> Signup and view all the answers

Nosocomial pneumonia is defined as pneumonia acquired outside of a hospital setting.

<p>False (B)</p> Signup and view all the answers

Name two gram-negative rod bacteria that are commonly associated with nosocomial pneumonia.

<p>Klebsiella, E.coli, Pseudomonas</p> Signup and view all the answers

Pneumococcal pneumonia often presents with an abrupt onset including symptoms like high fever, chills, and ______ chest pain.

<p>pleuritic</p> Signup and view all the answers

Match the type of pneumonia with its associated characteristics or causative agents:

<p>Community-acquired pneumonia = Often follows a viral infection; common causative agent is Streptococcus pneumoniae Nosocomial pneumonia = Acquired in a hospital; commonly caused by gram-negative rods like Klebsiella and E. coli Pneumonia in immunocompromised host = Associated with opportunistic infections like CMV, Pneumocystis carinii, and Aspergillosis</p> Signup and view all the answers

Which of the following is typically associated with upper respiratory tract infections?

<p>Mild and transient diseases (C)</p> Signup and view all the answers

The lower respiratory tract includes the nose, larynx, and trachea.

<p>False (B)</p> Signup and view all the answers

Name two defense mechanisms of the respiratory tract that can be impaired leading to pneumonia.

<p>cough reflex, ciliary apparatus</p> Signup and view all the answers

Common cold is most frequently caused by different serotypes of _________.

<p>rhinovirus</p> Signup and view all the answers

Match the type of pneumonia with its description:

<p>Bronchopneumonia = Inflammation starts in bronchi and spreads to adjacent alveoli, often patchy and bilateral Lobar pneumonia = Inflammation starts in alveoli, spreads throughout an entire lobe, often with consolidation</p> Signup and view all the answers

Which of these is NOT a typical cause of lower respiratory tract sepsis?

<p>Trauma (B)</p> Signup and view all the answers

Secondary bacterial infections can occur following a viral infection in the respiratory tract.

<p>True (A)</p> Signup and view all the answers

What is the primary host reaction in pneumonia, leading to consolidation?

<p>alveolar exudates</p> Signup and view all the answers

Acute laryngitis or epiglottitis can be caused by _ _ _ _ _ _ _ _ _ _ _ _ _ _ influenza type B or _ _ _ _ _ _ _ _ _ _ _ _ _ pyogenes.

<p>Haemophilus, Streptococcus</p> Signup and view all the answers

Which defense mechanism is impaired by cigarette smoke, hot gases, corrosives, and viruses?

<p>Ciliary apparatus (B)</p> Signup and view all the answers

Lobar pneumonia typically heals with fibrosis.

<p>False (B)</p> Signup and view all the answers

Name one bacterial genus commonly associated with bronchopneumonia.

<p>Streptococcus</p> Signup and view all the answers

Influenza mainly involves the _________ respiratory tract and is accompanied by fever, lassitude, and depression.

<p>upper</p> Signup and view all the answers

What is a crucial step in managing pneumonia according to the text?

<p>Identifying the organism through culture and sensitivity (C)</p> Signup and view all the answers

Upper respiratory tract bacterial infections are common in healthy individuals in developed countries.

<p>False (B)</p> Signup and view all the answers

Which type of hypersensitivity reaction is classically associated with atopic asthma?

<p>Type I IgE hypersensitivity (C)</p> Signup and view all the answers

Squamous cell carcinoma of the lung typically originates in peripheral lung tissue.

<p>False (B)</p> Signup and view all the answers

Name two environmental antigens that can trigger atopic asthma.

<p>dusts, pollen, foods, house dust mite</p> Signup and view all the answers

Bronchial carcinoma is strongly associated with smoking, particularly the use of ______.

<p>cigarettes</p> Signup and view all the answers

Match the following lung cancer types with their characteristics:

<p>Squamous cell carcinoma = Arises in a main bronchus and may cause bronchial stenosis. Adenocarcinoma = Typically presents as peripheral tumours. Small cell carcinoma = May produce hormones leading to paraneoplastic syndromes. Large cell carcinoma = A subtype of non-small cell carcinoma, accounting for 10-15% of cases.</p> Signup and view all the answers

What is the most common type of primary malignant lung tumour?

<p>Epithelial (D)</p> Signup and view all the answers

The incidence of bronchial carcinoma is currently higher in females than in males in the US.

<p>False (B)</p> Signup and view all the answers

List two common sites of blood metastasis for bronchial carcinoma.

<p>liver, adrenal glands, brain, bone</p> Signup and view all the answers

Neuroendocrine carcinomas of the lung can produce hormones such as ACTH, ADH, and ______.

<p>PTH</p> Signup and view all the answers

Which of the following is NOT considered a non-metastatic systemic effect of bronchial carcinoma?

<p>Liver metastasis (B)</p> Signup and view all the answers

Which conditions are encompassed by the clinical term Chronic Obstructive Pulmonary Disease (COPD)?

<p>Emphysema and Chronic Bronchitis (D)</p> Signup and view all the answers

Chronic bronchitis is defined by a persistent cough with sputum production for at least six months in one year.

<p>False (B)</p> Signup and view all the answers

What is the primary characteristic of emphysema related to the lung's air spaces?

<p>abnormal permanent enlargement</p> Signup and view all the answers

In emphysema, the destruction of alveolar walls is primarily due to an imbalance between increased ______ and decreased antiproteases.

<p>proteases</p> Signup and view all the answers

Match the type of asthma with its precipitating mechanism:

<p>Allergic (Atopic) Asthma = Specific allergens; Type I (IgE) immune reaction Occupational Asthma = Chemicals; Type I and Cell Mediated immune reaction Nonatopic Asthma = Respiratory tract infection; Unknown; Hyper-reactive airways</p> Signup and view all the answers

Which of the following is a typical symptom of asthma?

<p>Paroxysmal constriction of bronchial airways (C)</p> Signup and view all the answers

Emphysema is more commonly observed in women between 50-80 years old.

<p>False (B)</p> Signup and view all the answers

Name one factor that predisposes individuals to chronic bronchitis by interfering with ciliary action.

<p>smoke</p> Signup and view all the answers

Status asthmaticus, an unremitting attack of asthma, can be potentially ______.

<p>fatal</p> Signup and view all the answers

In the pathogenesis of emphysema, what is the role of neutrophils and macrophages in smokers?

<p>They produce elastase, leading to lung damage. (A)</p> Signup and view all the answers

Flashcards

Upper Respiratory Tract Infection

Infection that affects the nose, sinuses, larynx, trachea, and main bronchi. Usually caused by a virus.

Lower Respiratory Tract Infection

Infection that affects the bronchi, lungs, and terminal bronchi. Often more serious, caused by bacteria, viruses, irritants, fungi, or atypical pathogens.

Bronchopneumonia

An inflammation of the bronchus that spreads to the surrounding alveoli, characterized by white-yellowish foci of condensation.

Lobar Pneumonia

Inflammation that starts in the alveoli and spreads to the entire lobe, characterized by stages of congestion, red hepatization, and grey hepatization.

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Common Cold

Infection that mainly affects the upper respiratory tract, often leading to congestion, watery discharge, and secondary bacterial infections.

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Viral Sore Throat

Viral infection that can cause pharyngitis, also known as a sore throat, and can lead to secondary infections with pus.

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Influenza

Viral infection that primarily affects the upper respiratory tract, characterized by inflammation and congestion.

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Pneumonia

Bacterial infection of the alveolar spaces, leading to the formation of exudates. May cause complications such as pleurisy.

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Primary Tuberculosis

A primary infection with Mycobacterium tuberculosis, often seen in childhood, resulting in a small lesion (Ghon focus) in the lung. The lesion typically heals with fibrosis and calcification, but the bacteria may survive and cause later infection.

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Secondary Tuberculosis

A condition in which new infection occurs or the previously contained bacteria in the Ghon focus reactivates. This leads to a more widespread infection, often with coughing up of caseous material (dead tissue) that can spread the infection.

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Chronic Obstructive Pulmonary Disease (COPD)

A collection of chronic lung diseases characterized by airflow obstruction, which worsens over time and is usually caused by smoking. The two main types are chronic bronchitis and emphysema.

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Chronic Bronchitis

Characterized by persistent cough with sputum production, often caused by chronic inflammation of the airways.

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Emphysema

A condition where the air sacs (alveoli) in the lungs are damaged and enlarged, leading to difficulty breathing. The destruction of alveolar walls results in weak air spaces that can be easily ruptured.

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Neoplasia

New growth of cells that can be either benign or malignant.

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Tumor

Abnormal mass of tissue that can be either benign or malignant.

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Cancer

A malignant tumor that can invade and spread to other parts of the body.

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Oncology

The study of cancer.

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Pathologist

A specialist who studies diseases.

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Oncologist

A medical doctor who treats cancer patients.

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Benign Tumor

A non-cancerous tumor that cannot spread to other parts of the body but may still be dangerous.

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Malignant Tumor

A cancerous tumor that can invade and spread to other parts of the body.

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Allergic Asthma (Type 1)

A type of allergic asthma triggered by repeated exposure to certain substances, like pollen, dust mites, or animal dander.

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Bronchial Carcinoma

A cancer arising from the epithelial cells lining the bronchi, the main airways of the lungs. This is the most common type of lung cancer.

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Metastasis

The spread of cancer cells from the primary tumor to other parts of the body.

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Local Spread

The growth of a tumor in the area where it originated before spreading to other parts of the body. For bronchial carcinoma, this includes the lung tissue, hilar area (where the bronchi branch off), and major blood vessels.

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Lymphatic Spread

Tumors that spread to lymph nodes, which are small, bean-shaped organs that filter lymph fluid and help fight infection. In the case of lung cancer, the hilar lymph nodes are often affected first.

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Bloodborne Spread

Tumors that spread through the bloodstream to distant organs, such as the liver, adrenal glands, and brain.

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Paraneoplastic Syndromes

A collection of signs and symptoms caused by the tumor, rather than the direct growth of cancerous cells.

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Adenocarcinoma

A type of lung cancer that originates from glandular epithelium, often found in the peripheral areas of the lungs.

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Nosocomial Pneumonia

Infection acquired in a hospital setting, often caused by bacteria. Think of it as getting sick in the place meant to make you healthy.

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Methicillin-Resistant Staphylococcus Aureus (MRSA)

Strong and harmful bacteria that commonly resist many antibiotics, making their eradication difficult. They are often found on surfaces and can cause infections.

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Streptococcus Pneumoniae

Bacteria from the same family as strep throat but causing lung infections. Often seen after a viral illness. Think of it as the culprit after the initial "cold" takes its toll.

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Pleural Adhesions

The most common complication of pneumonia, usually due to inflammation and healing. It's a common after-effect of pneumonia and not always a major concern.

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Defenses of the Respiratory Tract

The body's natural defenses against respiratory infections, such as the cough reflex, nasal hairs, ciliary apparatus, IgA antibodies, phagocytic activity of alveolar macrophages, alveolar fluid, and cell-mediated immunity are vital for preventing pneumonia.

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Secondary Bacterial Infection

A form of secondary bacterial infection that follows a primary viral infection. Often occurs when the body's defenses are compromised.

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Identify the Organism

The process of identifying the specific organism responsible for a pneumonia infection using laboratory techniques such as culture and sensitivity testing. This step is crucial for selecting the appropriate treatment.

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Aetiology of Pneumonia

The various causes of pneumonia, including bacterial, fungal, viral, aspiration, radiation, and allergic mechanisms.

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Community-Acquired Acute Pneumonia (CA-Pneumonia)

Pneumonia acquired in the community setting, often caused by Streptococcus pneumoniae.

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Impaired Respiratory Defenses

A condition where the defenses of the respiratory tract are compromised, increasing susceptibility to pneumonia.

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Aspiration Pneumonia

A type of pneumonia that occurs as a result of inhaling foreign material, such as food, vomit, or saliva.

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Allergic Pneumonia

Pneumonia that is caused by an allergic reaction to certain substances like pollen, dust mites, or animal dander.

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Viral Pneumonia

Viral infections that can cause pneumonia, including influenza, RSV (respiratory syncytial virus), adenovirus, and parainfluenza virus.

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What is COPD?

A chronic lung disease characterized by airflow obstruction that worsens over time. It's often caused by smoking and includes conditions like emphysema and chronic bronchitis.

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What is Emphysema?

A condition where the air sacs (alveoli) in the lungs are damaged and enlarged. It makes breathing difficult and is often related to smoking.

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What is Chronic Bronchitis?

Persistent cough with sputum production for at least three months in at least two consecutive years. It is often associated with smoking or inhaled pollutants.

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What is Asthma?

A condition where the lungs are overly responsive to various stimuli, causing temporary narrowing of the airways. It often results in wheezing and shortness of breath.

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What is Status Asthmaticus?

A severe asthma attack that doesn't respond to usual treatments and can be life-threatening.

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What's the primary cause of Emphysema?

Destruction of the elastic tissue in the alveolar walls, often a result of smoking or excess protease activity.

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What is Allergic Asthma?

A type of asthma that is triggered by specific allergens, like pollen, dust mites, or animal dander. It is an allergic reaction to specific allergens.

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What are Bronchi?

The main airway in the lungs where the air enters and exits. This is where the air goes before it reaches the alveoli for gas exchange.

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What are Alveoli?

The microscopic air sacs in the lungs where gas exchange occurs. This is where oxygen is taken in and carbon dioxide is released.

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What is Cor Pulmonale?

A condition where the heart is weakened and enlarged due to lung problems. It is a secondary problem that arises from a lung issue.

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Atopic Asthma

Asthma triggered by allergens like dust mites, pollen, and foods. Often runs in families with history of allergic rhinitis, eczema, or urticaria.

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Occupational Asthma

Occupational asthma develops after repeated exposure to substances found in workplaces, like fumes, gases, dusts, or chemicals.

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Type I Hypersensitivity

A type of allergic reaction involving the release of histamine from mast cells and basophils, triggered by allergens like pollen, dust mites, and foods.

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Squamous Cell Carcinoma

A type of lung cancer arising from squamous epithelium in the main bronchus, often forming large, friable masses.

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Neuroendocrine Carcinoma

A type of lung cancer arising from endocrine cells in the main bronchus that produce various hormones, leading to associated syndromes.

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Local Spread (Lung Cancer)

The spread of cancer cells within the lung area, including the hilar region (where bronchi divide) and large blood vessels.

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Lymphatic Spread (Lung Cancer)

The spread of cancer cells through lymph nodes, often affecting the hilar nodes first.

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Bloodborne Spread (Lung Cancer)

The spread of cancer cells via the bloodstream, leading to distant organs or distant metastases.

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Study Notes

The Respiratory System

  • The upper respiratory tract (upper RT) includes the nose, sinuses, larynx, trachea, and main bronchi.
  • The lower respiratory tract (lower RT) includes the bronchi, terminal bronchi, and lung parenchyma.
  • Upper RT Symptoms (Mild/Transient): Viral infections are common, causing often trivial or mild and transient conditions.
  • Lower RT Symptoms (Serious/Mortality): Bacteria, viruses, or atypical fungi can cause more serious conditions, frequently associated with morbidity and mortality, and often secondary to irritants.
  • Lower RT Infections: Respiratory syncytial virus (RSV), influenza virus, adenovirus, SARS-CoV-2, and various bacterial species (e.g., S. pneumoniae, S. aureus, H. influenzae type b, K. pneumoniae, P. aeruginosa) are possible causes. Upper respiratory tract infections may also be viral and bacterial.

Respiratory Organs' Defense Mechanisms

  • Cough reflex (aspiration)
  • Nasal hairs
  • Ciliary apparatus
  • Secretion of IgA antibodies
  • Phagocytic activity by alveolar macrophages
  • Accumulation of secretions
  • Alveolar fluid
  • Cell-mediated immunity (chronic diseases)
  • Virulent infections
  • Primary infections (viral, bacterial, mycoplasma, fungal)
  • Secondary bacterial infections (following a viral infection)
  • Secondary to irritants

Viral Infections

  • Common Cold: Acute inflammation of eyes and throat, with watery exudate. Secondary bacterial infection is possible.
  • Viral Sore Throat: Adenovirus causes pharyngitis; secondary bacterial infection (purulent pus) is possible.
  • Influenza: Primarily affects the upper respiratory tract; accompanied by fever, fatigue, and in serious cases, progresses to pneumonia.

Bacterial Infections

  • Streptococcus Pyogenes: Can cause acute laryngitis/epiglottitis and pneumonia.
  • Haemophilus influenzae type B/Streptococcus Pyogenes: Associated with pneumonia.
  • Pneumonia: Infection of alveolar spaces causing inflammation and exudates. Complications may include pleurisy. Bacterial pneumonia often leads to more serious illness.

Bronchopneumonia

  • Inflammation in bronchi, spreading to adjacent alveolar spaces.
  • Common bacterial causes include Streptococcus pneumoniae, Staphylococcus Aureus, Haemophilus influenzae, and other bacteria.
  • Characterized by white, yellowish foci of condensation.

Lobar Pneumonia

  • Inflammation within an entire lobe.
  • Caused by Streptococcus pneumoniae (90-95% of cases).
  • Characterized by congestion, red and grey hepatization.
  • Viral pneumonia includes interstitial pneumonia, which is initially atypical. Viral causes can include Influenza A, B, Adenovirus, SARS-CoV, and other viruses; these infections are typically less severe than bacterial infections.

Pulmonary Tuberculosis

  • Primary tuberculosis in childhood may occur but is rare.
  • Caused by Mycobacterium tuberculosis. This typically spreads through airborne droplets and can be an infection in itself or a secondary infection.

The Respiratory System 2

  • Chronic Bronchitis: Persistent cough with sputum production.
  • Emphysema: Weakening of air spaces, often due to destruction of alveolar walls, contributing to COPD.
  • COPD: Chronic bronchitis and emphysema frequently overlap; they can result in widespread air obstruction.
  • The pathogenesis of emphysema involves an imbalance between proteases and antiproteases, damaging lung tissue.
  • Asthma: Bronchial airways constrict, often through allergic reactions, irritant stimuli, or other triggers; airways are often clogged with thick mucous plugs.

Classification of Malignant Lung Tumors

  • Epithelial (90-95%):
    • Non-small cell carcinoma (70-80%): Squamous cell, Adenocarcinoma, Large cell carcinoma
    • Small cell carcinoma (20-25%): Oat cell

Bronchial Carcinoma

  • Incidence is high in the 40-70-year-old demographic.
  • Cigarettes are a primary causal factor.

Prognosis of Lung Tumors

  • Surgical resection, when possible, offers a better prognosis.
  • 30-40% 5-year survival rate for patients who undergo surgical intervention.

Spread and Metastasis

  • Lung tumors can spread locally, through lymphatics (e.g., hilar, cervical), and through blood vessels (e.g., causing lesions in the liver, adrenal glands).
  • Non-metastatic systemic effects such as finger clubbing and cachexia may manifest.
  • Secondary tumors may be found at multiple sites.

Secondary Lung Tumors

  • Metastases from other primary cancers.
  • Multiple nodules spread throughout the lungs.
  • May arise from different organ systems (e.g., breast, kidney, testis).

Neoplasia

  • Neoplasia: New growth, benign or malignant.
  • Tumor: New growth (benign or malignant).
  • Cancer: Malignant new growth.
  • Oncology: Study of cancer.
  • Pathologist: Studies disease in general.
  • Oncologist: Treats cancer patients.
  • Benign tumors (suffix -oma) cannot metastasize but can still be lethal (e.g., CNS tumors).
  • Malignant tumors (e.g., -carcinoma) have the ability to invade and spread.
  • Differentiation represents the resemblance of the cancer to its original tissue type.
  • Pleomorphism: Variation in the size and shape of cancer cells.
  • Mitotically Active: Rapid cell division and proliferation.

Cell Types

  • Epithelium: Lining tissue
  • Mesenchymal: Bone, cartilage, muscle
  • Germ cell: Reproductive systems (e.g., testes, ovaries)
  • Benign: Cannot metastasize (spread) but can be lethal.
  • Malignant: Cancer spreads from original site.

Epidemiology

  • Epidemiology: Study of disease occurrence in different populations. Factors like environment, age, and occupational exposures are key influences.
  • Environmental Factors: A major factor in many diseases.
  • Ageing Population: Increase in cancer cases, including lung cancers, with age.
  • Iatrogenic Factors: Medical treatments, like chemotherapy, can provoke cancer as a side effect.

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