Cystic fibrosis

 Presentation: lethargy, vomiting

 Mechanism: CFTR mutation, can’t reabsorb NaCl, so secrete sweat with high NaCl
(hyponatremia/chloremia),
 Treatment: salt supplementation
Collapsed lung due to bronchial obstruction
 Presentation: decreased breath sounds
 Mechanism: obstruction of mainstem bronchus, trachea deviates because loss of lung
volume
 Workup: CXR hemithorax opacification, tracheal deviation toward opacified side
Pleural effusion/Tension pneumothorax
 Tracheal deviation away from affected lung because excess air or fluid pushes against
mediastinal structures
Lobar pneumonia
 Presentation: cough, SOB, fever, lobe infiltrate on CXR
 Mechanism: community acquired pathogen (Strep pneumo)
Silicosis
 Presentation: history, hilar adenopathy, nodular densities, birefringent particles
 Mechanism: impairs macrophages
 Workup: calcifications, in the peripheral lymph nodes of the upper lobes
Sarcoidosis
 Presentation: malaise, night sweats, cough, WL, skin rash, eye prob
 Mechanism: CD4+ T cell mediated disease, noncaseating granulomas consisting of
epithelioid macrophages and multinucleated giant cells, activated macrophages express
1 alpha hydroxylase, forming 1,25 dihydroxycit D w/o PTH hormone (hypercalcemia)
 Workup: hilar adenopathy
ARDS
 Presentation: pneumonia, sepsis (low bp, high RR)
 Mechanism: injury of pulmonary epithelium, neutrophils recruited causing capillary
damage and leakage of fluid into alveoli
Granulomatosis with polyangiitis
 Presentation: cough, hemoptysis, nephritic syndrome
 Mechanism: necrotizing inflammation and pulm hemorrhage, and kidneys
Small cell lung cancer
 Presentation: weakness, cough, decreased appetite
 Mechanism: SIADH (hyponatremia), Cushing, Lambert Eaton, cerebellar ataxia, stain for
neuroendocrine markers like neural cell adhesion molecule (NCAM), enolase,
chromogranin
Squamous cell lung cancer:
 Presentation: weakness, cough, decreased appetite