#3 Zaman - Lung Pathology - 1 Flashcards
A 35 year old patient comes in with a 70 pack year history. What exacerbating factors of injury will likely be present?
Injury to mucociliary apparatus
Decreased phagocytic activity
Decreased protective mechanisms
Would you see pleural effusion in a patient with 40 years of exposure to asbestos?
No. Pleural effusion is seen early on in the disease.
What imaging would you order to confirm asbestosis?
Radiologic imaging
Which pulmonary lesions are required for a diagnosis of Asbestosis?
Pulmonary Fibrosis and Pulmonary Plaques (10-20 years)
Pleural calcification (end stage)
On the radiological imaging of the asbestosis patient, where would you expect to find the neoplasm?
The Malignant Mesothelioma is a neoplasm in the pleura of the lung.
Identify
Type 1 pneumocyte
Squamous pneumocyte
Thin area for gas exchange
susceptible to inhaled agents
Identify
Type II pneumocytes
Granular pneumocyte
Surfactant secreting alveolar epithelial cell
Identify
Asbestos exposure
Discrete fibrocalcific plaques on the pleural surface of the diaphragm.
Identify
Asbestos Body
Typical beading and knobbed ends
Ferrugenous body
Metaplasia of type I to type II pneumocytes
Identify
Silicosis
Fibrotic lesion of black
Hard coal miners
excessive release of fibrogenic cytokines
Identify
Coal worker’s pneumoconiosis
large blackened scars primarily in upper lobe
Identify
Hypersensitivity pneumonitis
Cough
Dyspnea
Fever
Rales
Non-caseating granulomas
A lawyer calls you up and asks about the mechanism of injury for his client who has mesothelioma. What would you say was the cause?
Asbestos fibers are inhaled and are not easily removed via the mucociliary route. As a result they impale the epithelial cells, the interstitium, the lymphatics and the lymph nodes. The person then gets a fibrotic response leading to pulmonary fibrosis.
One of your clients is in Egypt working on the restoration of the pyramids. What disease will likely be in his future?
Silicosis
Occupational Lung Disease (OLD)
Also seen in hard coal miners due to silicon dioxide
Silica is toxic to macrophages resulting in excessive release of fibrogenic cytokines.
You identify a noncaseating granuloma in the lung with hilar lymphadenopathy. What do you suspect?
Berylliosis
Increased risk of lung cancer
Not sarcoidosis
Patient’s culture just came back positive for actinomyces. What disorders could he have?
Farmer’s lung (chronic hypersensitivity/granulomas)
Bagassosis - hypersensitivity pneumonitis (actinomyces, sugar cane, hemp)
Bagasse is the leftover pulp from sugracane production.
Patient works at the local cotton gin and comes in wheezing and coughing with SOB. You diagnose him with Byssinosis. What is causing the reaction?
Probably due to interleukins produced by endotoxin exposure
Also known as “brown lung disease”
reversible allergic-type reaction
You originally diagnosed your patient with Farmer’s lung becuase he had recently stored a bunch of hay in his barn loft. He has not gotten better. His labs came back and MHb levels are increased due to NO2 inhalation. What is your new Ddx?
Silofiller’s lung
