Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPR II > (16.1) Pulmonary Pathology II (Singh) > Flashcards

(16.1) Pulmonary Pathology II (Singh) Flashcards

1
Q

Idiopathic pulmonary fibrosis

How does it damage pulmonary tissue?

A

IPF damages pulmonary tissue with waves of inflammatory injury leading to fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What would a CXR look like for a idiopathic pulmonary fibrosis pt?

A

Basilar infiltrates

“Honeycomb lung”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do the lungs sound like on auscultation for idiopathic pulmonary fibrosis?

A

Crackles on exam

“Velcro-like”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the contributing factors to idiopathic pulmonary fibrosis?

A

Enviornmental factors (SMOKING)

Genetic factors

Increasing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is unique about the histology of idiopathic pulmonary fibrosis?

A

Very different patterns due to the “wave like” nature of the disease

Some patches are normal, some have inflammation, others have fibroblast foci and some have peripheral honeycombing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do pathologists call idiopathic pulmonary fibrosis when found on pulmonary biopsy?

A

Usual Interstitial Pneumonia (UIP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do these images represent?

A

Honeycomb fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the prognosis for patients with idiopathic pulmonary fibrosis?

A

NOT GOOD

Most patients die from respiratory disease 3-5 years after diagnosis

Only truly effective treatment = lung transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some experimental medications being used to treat idiopathic pulmonary fibrosis?

A

These meds are used to arrest fibrosis

  • Tyrosine kinase inhibitors*
  • TGF-Beta inhibitors*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is non-specific interstitial pneumonia (NSIP)?

A

VERY SIMILAR TO UIP

Idiopathic

Has UNIQUE HISTOLOGY = uniform infiltrates and fibrosis

Has better prognosis than UIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is this lung disorder?

A

Non-specific interstitial pneumonia (NSIP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a cute way to remember what cryptogenic organizing pneumonia (COP) looks like histologically?

A

Looks like cotton candy… awwww

The “cotton candy” is fibroblast foci (Masson bodies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cryptogenic organizing pneumonia (COP)

Prognosis?

A

Very good!

Patient tend to have full recovery with oral steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you diagnose cryptogenic organizing pneumonia (COP)?

A

Diagnosis of exclusion

-Not an infection, drug- or toxin-induced, or related to connective tissue disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is this?

A

Granulomatous inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is sarcoidosis?

A

Systemic disease manifesting non-caseating (non-necrotizing) granulomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the clinical presentation of sarcoidosis?

A

Incidental abnormal radiograph

or

Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some of the hallmark granuloma inclusions of sarcoidosis?

A

Granuloma inclusions:

Asteroid body (A)

Schaumann bodies (B-D)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the demographic of sarcoidosis?

A

<40 years of age

African americans

Commonly involve LUNGS

Elevated ACE levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sarcoidosis

Do the stages occur in order?

A

NO!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is this?

A

Hypersensitivity Pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is hypersensitivity pneumonitis?

A

Immune reaction to inhaled antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are three examples of specific types of hypersensitivity pneumonitis?

A

Pigeon-breeder’s lung — protein from bird feces

Farmer’s lung — Actinomycetic spores in hay

Hot tub lung — Reaction to mycobacterium avium complex (MAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is one of the most imporant aspects of your clinical interaction w/ your patient that will allow you to diagnose hypersensitivity pneumonitis?

A

HISTORY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the pathology?

A

Desquamative Interstitial Pneumonia (DSIP)

*Notice that every alveolar space has macrophages inside. Also, a MISNOMER, these are NOT squamous cells lol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the demographic of desquamative interstitial pneumonia (DSIP)?

A

Smokers in 40s/50s

Restrictive lung disease presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the prognosis for desquamative interstitial pneumonia (DSIP)?

A

Good prognosis only IF THE PATIENT CAN STOP SMOKING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the pathology?

A

Respiratory Bronchiolitis-Interstitial Lung Disease

(RB-ILD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the demographic for respiratory bonchiolitis-interstitial lung disease?

A

Smokers

30s-40s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the pathology?

A

Langerhans cell histiocytosis (LCH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a major characteristic of langerhans cells histologically?

A

Langerhans cells ALWAYS stain CD1a positive

32
Q

What are some dead giveaways that you are looking at a langerhans cell histiocytosis (LCH) biopsy?

A

Langerhans cells with a TON of eosinophils

33
Q

What is pulmonary alveolar proteinosis?

A

Impairment of surfactant metabolism due to defect in granulocyte-macrophage colony stimulating factor (GM-CSF)

34
Q

What is the histology of pulmonary alveolar proeinosis?

A

*Frequently confused with pulmonary edema

35
Q

How do you treat pulmonary alveolar proteinosis?

A

Treat with SubQ GM-CSF

36
Q

What is this?

A

Bone marrow embolism

37
Q

What is this?

A

Talc embolism

Seen in IV drug users

38
Q

What is this?

A

Septic emboli

39
Q

Where do septic emboli frequently originate from?

A

From the heart!

From endocarditis, valve vegetations break off and manifest in other sites…LIKE THE LUNGS

40
Q

What is the definition of pulmonary hypertension?

A

Pulmonary artery pressure (PAP) is greater than 25mmHg

41
Q

What are the two manifestations of pulmonary hyptertension?

A

Plexiform lesion (left)

Medial hypertrophy (right)

42
Q

What is the pathology?

A

Pulmonary hemorrhage syndromes

43
Q

What is the pathology?

A

Goodpasture syndrome

*Notice how you can see the RBCs within the lung parynchema

44
Q

What is goodpasture syndrome?

A

Antibody-mediated disease that damages basement membranes in the lung and kidney

*Targets Collagen IV

45
Q

What is the demographic of goodpasture syndrome?

A

YOUNG MEN

20s/30s

46
Q

What is the pathology?

A

GPA : Granulomatosis w/ polyangiitis

47
Q

__________ is the second most common cause of hospital admissions

A

Pulmonary infections

48
Q

What is the diagnosis?

A

Right upper lobar pneumonia

49
Q

What are the 4 stages of lobar pneumonia?

A
  1. Congestion (vascular engorgement)
  2. Red hapatization (red cells and inflammation)
  3. Grey hepatization (inflammation and debris)
  4. Resolution (fibrosis, macrophage clean-up)
50
Q

What is the most common cause of pneumonia?

A

Streptococcus pneumonia

(Lancet shaped gram positive diplococci)

51
Q

What is “atypical” (“walking”) pneumonia?

A

Slower onset than typical pneumonia

Systemic symptoms predominate

Patchy infiltrates on CXR

Young adults/teens/older children

52
Q

What is the major bacterium that causes “atypical walking pneumonia”?

A

Mycoplasma pneumoniae

53
Q

What is so special about mycoplasma pneumoniae?

A

Smallest free-living, self-replicating microorganisms

NO CELL WALL

54
Q

Where would you find legionella pneumophila?

A

Grows in warm freshwater

  • Air conditioning units
  • Misters
  • Hot tubs
55
Q

What are the three major causes of community acquired viral pneumonia?

A

Influenza (H1N1)

SARS

Respiratory Syncytial Virus

56
Q

How are influenza viruses classified?

A

Classified by 2 proteins

Hemagglutinin

Neuraminidase

57
Q

What is antigenic drift?

A

Epidemics

MINOR changes to proteins on the virus, allowing increased spread

Similar enough to the orignial virus to allow for some immunity in many individuals

58
Q

What is antigenic shift?

A

Pandemics

Genomic alterations with MAJOR resulting changes to protein structure

Naive immunity for almost all people

***Remember = Shift is close to “shit”. Antigenic shit. Antigenic shift is WAY worse than drift.

59
Q

What are the bacterial associations you should make with neonates?

A

Group B strep

Gram negative bacilli

Listeria

60
Q

What viral and bacterial associations should you make with children >1month old?

A

Viral = RESPIRATORY SYNCYTIAL VIRUS, parainfluenza virus, Influenza A&B, Adenovirus, Rhinovirus

Bacterial = S.pneumoniae, H. influenzae, M. catarrhalis, S.aureus

61
Q

What is the pathology?

A

Respiratory Syncytial Virus (RSV)

62
Q

What are the symptoms of respiratory syncytial virus?

A

Rhinorrhea/cough

Wheezing

Dyspnea

Tachypnea

Cyanosis

63
Q

Histologically, what is the difference b/w bacterial and viral pneumonia?

A

Bacterial usually stays in alveolar spaces

Viral stays in the interstitum

64
Q

What are the differences b/w bacterial and viral pneumonia in terms of clinical presentation?

A
65
Q

What pathology is HIGHLY associated with TB?

A

Caseating granulomata

66
Q

What is the pathology?

A

Histoplasma capsulatum

67
Q

Where is histoplasma capsulatum endemic?

A

Midwest and caribbean

68
Q

Histoplasma capsulatum has a characteristic…

A

Pumpkin seed morphology

69
Q

What is it!?

A

Blastomyces dermatitides

70
Q

What is this?

A

Coccidiodes immitis

*Remember: Coccidioodes has a lot of “O”s in it. The Cocciodes immitis biopsy shows “O” shaped specimens

71
Q

Where is coccidiodes immitis endemic?

A

Southwestern US and Mexico

72
Q

What is this?

A

Pneumocystis jiroveci

73
Q

What is pneumocystis jiroveci associated with?

A

AIDS

74
Q

What is this?

A

Mycobacterium avium complex (MAC)

75
Q

Who typically gets mycobacterium avium complex?

A

Immunocompromised or elderly

76
Q

Why is it important to take a lung biopsy of a patient that you believe is undergoing transplant rejection?

A

Patient could have rejection, OR have an opportunistic infection

Determining which is occuring will determine the course of action

Tx for acute rejection = increase immunosuppression

Tx for opportunistic infection = target the organism

77
Q
A

CPR II (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions