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Y2 - Path - Exam 4 > 10: Pulm 3 > Flashcards

10: Pulm 3 Flashcards

1
Q

What are predisposing factors for pulmonary infection?

A

Anything that alters your normal defense mechanisms.

  • Loss of cough reflex
  • Altered physical barriers
  • Defect in mucocilliary apparatus
  • Accumulation of secretions
  • Decreased function of macrophages
  • Underlying pulmonary pathology
  • Immunodeficiency
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2
Q

What are the common characteristics of community-acquired acute pneumonias?

A
  • most are bacterial
  • usually follow a viral upper respiratory tract (URT) infection
  • abrupt onset
  • high fever, chills, pleuritic chest pain, productive cough
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3
Q

What is the most common cause of community acquired acute pneumonias?

A

Streptococcal pneumoniae –> “pneumococcal pneumonia”

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4
Q

What three groups of people are more predisposed to pneumococcocal pneumonia?

A
  • Underlying chronic diseases (COPD, CHF, diabetes)
  • Congenital or acquired immunoblobulin defects
  • Decreased/absent splenic function (spleen macrophages are the largest means to remove pneumococci from the blood)
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5
Q

What are the two types of acute bacterial pneumonia?

A
  • Bronchopneumonia
  • Lobar pneumonia
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6
Q

In which type of acute bacterial pneumonia would you expect to see patchy consolidation and suppuration, acute suppruative exudate in airspaces, and abscesses?

A

Bronchopneumonia

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7
Q

In which type of acute bacterial pneumonia would you expect to see these four stages of inflammatory response:

  • congestion
  • red hepatization
  • gray hepatization
  • resolution
A

Lobarpneumonia

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8
Q

Which image shows the pathology associated w/ lobar pneumonia?

A

A. Bronchopneumonia

B. Lobar pneumonia

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9
Q

What is the general cause of atypical pneumonia?

A

Viral infections

Atypical pneumonia: peribronchiolar and interstitial inflammation without consolidation

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10
Q

What are the pathological characteristics you would see in atypical (viral) pneumonia?

A
  • patchy or diffuse
  • interstitial edema and mononuclear infiltrate
  • alveolar damage with acute inflammation and hyaline membranes
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11
Q

What condition might atypical (viral) pneumonia lead to?

A

Adult Respiratory Distress Syndrome (ARDS)

w/ the histological correspondent: diffuse alveolar damage

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12
Q

What are the possible causes of necrotizing bronchitis/bronhiolitis?

A
  • Influenza virus
  • adenovirus
  • varicella
  • herpes simplex virus
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13
Q

What viruses cause the very distinctive viral inclusions (“viral cytopathic effects”) in viral pneumonia infections?

A
  • CMV
  • HSV
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14
Q

What is the cause of “walking pneumonia”?

A

Mycoplasma pneumonia

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15
Q

What three intracellular bacteria can cause atypical pneumonia?

A
  • Chlamydia
  • Coxiella burnetti (Q fever pneumonia)
  • Ricckettsiae (Rocky mountain spotted fever)
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16
Q

What are the most common causative agents of chronic pneumonia?

A
  • fungi
  • mycobacteria
17
Q

What four pulmonary conditions have a granulomatous component?

A
  • Chronic pneumonias
  • Fungal pneumonia
  • Sarcoiditis
  • Hypersensitivity pneumonitis
18
Q

What stain is used to visualize necrotizing granulomas in primary pulmonary tuberculosis?

A

Acid Fast stain

**remember: necrotizing granulomas are the characteristic histological component in primary pulmonary Tb

19
Q

In what pulmonary condition would you see a Ghon complex?

A

Primary pulmonary tuberculosis

Ghon complex: parenchymal subpleural lesion and caseous lymph node draining the focus

20
Q

What are the main differences between primary and secondary pulmonary Tb?

A

Primary: original infection, probably will not progress to miliary Tb

Secondary: reactivation of old infection, may progress to cavitary fibrocaseous Tb, Tb bronchopneumonia, or miliary Tb

21
Q

How is fungal pneumonia acquired?

A

By inhalation of infected spores

22
Q

What is the gold standard of fungal pneumonia?

A

Culture diagnosis

*Remember that fungal pneumonias tend to have a limited geographic distribution

23
Q

What causative agent of fungal pneumonia is a small yeast with a narrow-based bud and multiplies within macrophages?

a. histoplasma capsultum
b. coccidioides immitis
c. blastomyces

A

Correct answer: a (histoplasma capsulatum)

b. coccidioides immitis –> thick walled nonbudding large speherules with endospore
c. blastomyces –> round to oval thick walled yeast, broad-based bud

24
Q

Pick the correct fungus with its general geographic endemic location:

a. histoplasma capsultum–> southwest US, Mexico
b. coccidioides immitis–> Ohio, Mississippi river valleys, Caribbean
c. blastomyces–> central/southeast US, Florida

A

C is correct

Correct pairings:

a. histoplasma capsultum–> Ohio, Mississippi river valleys, Caribbean
b. coccidioides immitis–> southwest US, Mexico
c. blastomyces–> central/southeast US, Florida

25
Q

Which opportunistic fungus is also an endogenous organism for humans?

A

Candida albicans

Small yeast with pseudo-hyphae

26
Q

Which opportunistic fungus causes invasive infections in immunosuppressed pts, diseminates systemically through the blood vessels, and is visualized by GMS stains?

A

Aspergillus spp

Also note:

  • septae hyphae branching @45 degrees
  • causes allergic bronchopulmonary aspergilosis
27
Q

Which opportunistic fungus has a mucicarmine positive mucoid capsule and is disseminated cereomeningeally from primary pulmonary focus?

(Hint: its harbored in GI tract of pigeons/birds)

A

Cryptococcus neoformans

Also note: small yeast

28
Q

Which opportunistic fungus is commonly implicated in nasal, pulmonary, and disseminated infection and infects diabetic and leukemia pts?

A

Mucor

Also note:

broad irregular, non-septae hyphae, 90 degrees bunching

29
Q

Which opportunistic fungus has diffuse pulmonary infiltrates, foamy alveolar exudate containing proliferating organisms, and commonly infects immunocompromised AIDS patients?

A

Pneumocystis jiroveci (carinii)

Y2 - Path - Exam 4 (13 decks)

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