Honey, I shrunk the tumor
There are 3 planes in the lungs:
Upper/Lower
Anterior/Posterior
Right/Left
Where is a tumor most likely to be found?
What is the upper, anterior, right lobe?
A 65-year-old male with a 40 pack-year smoking history presents with shortness of breath and chronic productive cough. Physical exam reveals decreased breath sounds, wheezing, and prolonged expiration. Spirometry shows an FEV1/FVC ratio of 60%.
What is Chronic Obstructive Pulmonary Disease (COPD)?
This rare type of interstitial lung disease is associated with intraalveolar accumulation of macrophages, primarily affects smokers, and shows ground-glass opacities on imaging.
What is Desquamative Interstitial Pneumonia (DIP)?
This is a gram-positive, capsulated diplococcus. One of the prime causes of community-acquired pneumonia and meningitis. _______ is α-hemolytic and catalase-negative.
What is Streptococcus pneumoniae?
A group of RNA viruses of the Orthomyxoviridae family. Transmission is predominantly airborne, typically in winter. Serotypes A and B are virulent in humans.
What is Influenza virus?
A 65-year-old male with a 50 pack-year smoking history presents with a persistent cough, hemoptysis, and weight loss. Imaging shows a centrally located lung mass. Biopsy reveals keratin pearls and intercellular bridges. Hypercalcemia is noted due to paraneoplastic PTHrP secretion.
What is squamous cell carcinoma of the lung?
A 55-year-old smoker presents with a persistent cough, hemoptysis, and unexplained weight loss. A chest X-ray shows a mass in the right upper lobe, and biopsy reveals malignant cells with keratin pearls.
What is squamous cell carcinoma of the lung?
This chronic, progressive interstitial lung disease is characterized by irreversible fibrosis and a usual interstitial pneumonia (UIP) pattern, with respiratory failure typically occurring within 3–7 years.
What is Idiopathic Pulmonary Fibrosis (IPF)?
A gram-negative coccobacillus that colonizes the respiratory tract. Nontypeable strains cause mucosal infections (e.g., otitis media, sinusitis, pneumonia). The type b strain can cause more severe infections (e.g., meningitis, epiglottitis), but the incidence of these infections has decreased with routine vaccination.
What is Haemophilus influenzae?
An enveloped, negative-strand RNA virus of the Pneumoviridae family. Infection typically occurs during fall and winter. It is transmitted via respiratory droplets or through contact with contaminated surfaces. Manifestations include fever, cough, rhinorrhea, wheezing, and difficulty breathing. Commonly causes lower respiratory tract infections in young children and older adults.
What is Respiratory syncytial virus?
A 55-year-old male with a history of heavy smoking presents with cough, hemoptysis, and neurological symptoms, including weakness and ptosis. Imaging reveals a centrally located lung mass, and biopsy shows small, round, hyperchromatic cells with scant cytoplasm. He is diagnosed with a highly aggressive cancer that often presents with paraneoplastic syndromes, such as SIADH or Lambert-Eaton myasthenic syndrome.
What is small cell lung carcinoma?
A 40-year-old woman presents with acute shortness of breath and pleuritic chest pain. She has a history of recent long-haul travel. Physical exam shows tachypnea and tachycardia. D-dimer is elevated, and CT pulmonary angiography reveals a filling defect in the pulmonary artery.
What is a pulmonary embolism (PE)?
This type of inflammation is characterized by a collection of activated macrophages, often seen in chronic infections, autoimmune diseases, and foreign body reactions.
What is granulomatous inflammation?
A species of bacteria that causes atypical pneumonia and tracheobronchitis, especially in pediatric patients. Lacks a cell wall.
What is Mycoplasma pneumoniae?
A double-stranded DNA virus that is spread by secretions (saliva, urine, blood, etc.). Infection is usually asymptomatic in immunocompetent hosts (sometimes causing heterophile-negative mononucleosis) but may cause severe disease in immunocompromised patients (e.g., those with AIDS) and severe congenital malformations. Cells with a characteristic owl-eye appearance are visible on biopsy.
What is Cytomegalovirus?
A 58-year-old smoker presents with cough, weight loss, and clubbing. Imaging reveals a large peripheral lung mass. Histological examination shows poorly differentiated large cells with no evidence of glandular or squamous differentiation. The tumor lacks markers for other specific lung cancers.
What is large cell carcinoma of the lung?
A 60-year-old male with a significant smoking history presents with progressive dyspnea. He has a barrel-shaped chest, uses accessory muscles to breathe, and has decreased breath sounds bilaterally. Chest X-ray shows hyperinflation and flattened diaphragms.
What is emphysema?
This type of granuloma, typically associated with tuberculosis, exhibits central necrosis.
What is a caseating granuloma?
A gram-negative rod that grows in water and humid conditions (e.g., hot tubs, lakes, or contaminated contact lens solution). Causes nosocomial infections (e.g., urinary tract infections or pneumonia), pneumonia in adult patients with cystic fibrosis, external otitis ("swimmer's ear"), and endocarditis in intravenous drug users.
What is Pseudomonas aeruginosa?
A non-enveloped virus with a linear, double-stranded DNA structure and icosahedral nucleocapsid. Transmitted via contaminated water or via the fecal-oral route. Causes pharyngitis, conjunctivitis, pneumonia, hemorrhagic cystitis, gastroenteritis, myocarditis, and epidemic keratoconjunctivitis.
What is Adenovirus?
A 52-year-old woman, a nonsmoker, presents with progressive shortness of breath and pleuritic chest pain. Imaging shows a peripheral lung nodule, and biopsy reveals glandular formation with mucin production. She is diagnosed with the most common lung cancer in nonsmokers.
What is adenocarcinoma of the lung?
A 4-year-old child presents with a heart murmur on routine exam. The murmur is described as a systolic ejection murmur with fixed splitting of the S2. Echocardiogram reveals abnormal blood flow between the atria.
What is an atrial septal defect (ASD)?
This member of your PBL group has a twin brother.
Who is Marc Todd?
A gram-negative diplococcus that colonizes the upper respiratory tract. It commonly causes acute otitis media in children and COPD exacerbations in adults.
What is Moraxella catarrhalis?
A group of RNA viruses of the Paramyxoviridae family. Contracted via droplet and contact transmission, typically in spring and summer. Has 4 serotypes. Type 1 is the most common causative organism of laryngotracheobronchitis (croup). Type 3 causes bronchiolitis. Other serotypes cause less severe respiratory tract infections.
What is Parainfluenza virus?