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NYCC Visceral Pathology > ARDS, NRDS, Pneumonia, TB > Flashcards

ARDS, NRDS, Pneumonia, TB Flashcards

1
Q

What can cause Acute Respiratory Distress Syndrome (ARDS)?

A

Infection, sepsis, shock, aspiration, near-drowning, opioid drug use

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2
Q

What are the clinical features of a patient with ARDS?

A

Tachypnea and dyspnea
Hypoxemia
Hyaline membrane appearance on alveolar septa
Late cyanosis

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3
Q

A “Hyaline membrane” appearance on alveolar septa is indicative of what pathology?

A

Acute Respiratory Distress Syndrome (ARDS)

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4
Q

How will ARDS appear on a radiograph?

A

Bilateral alveolar infiltrates showing increased density

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5
Q

Adult patient presents to your office in Hawaii after a near-drowning experience two weeks prior on a fishing trip. They are experiencing shortness of breath during their runs lately. Biopsy of lung tissue shows a “Hyaline membrane” appearance to the alveolar septa. What is a likely diagnosis?

A

Acute Respiratory Distress Syndrome (ARDS)

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6
Q

What causes Neonatal Respiratory Distress Syndrome (NRDS)?

A

Immaturity of surfactant system at birth due to prematurity

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7
Q

What cells secrete surfactant?

A

Type II alveolar cells

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8
Q

A newborn baby presented with high APGAR scores at birth and the delivery went smoothly. It is noted after one hour that they are developing a heightened respiration rate and bellowing of their abdominal muscles. What is this baby likely suffering from?

A

Neonatal Respiratory Distress Syndrome (NRDS)

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9
Q

What are the vast majority of upper respiratory tract infections caused by?

A

Virus

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10
Q

What is the portal of entry for most pneumonias?

A

Respiratory tract

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11
Q

What is the most common etiologic agent of bacterial pneumonia?

A

Streptococcus pneumoniae

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12
Q

What are the two gross patterns of bacterial pneumonia?

A

Lobular bronchopneumonia and lobar pneumonia

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13
Q

What is the dominant gross characteristic of bronchopneumonia?

A

Patchy consolidation of the lung

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14
Q

What is lobar pneumonia?

A

Acute bacterial infection resulting in fibrinosuppurative consolidation of a large portion of the a lobe or of an entire lobe of lung

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15
Q

Patient presents with a fever measuring 102.5 degrees, a mucous-laden green cough, and general fatigue. A CBC shows 85% neutrophils and leukocytosis. What is a likely diagnosis for this patient?

A

Bacterial pneumonia

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16
Q

Red hepatization is indicative of (Early/Late) stage bacterial pneumonia?

A

Early

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17
Q

Gray hepatizaton is indicative of (Early/Late) stage bacterial pneumonia?

A

Late

18
Q

Bronchopneumonia is also known as ____ pneumonia?

A

Lobular

19
Q

Lobar bacterial pneumonia involves patchy consolidation along the roots of the bronchi (TRUE/FALSE)?

A

FALSE

20
Q

What are etiologic agents of viral pneumoniae?

A

Cytomegalovirus, measles, influenza, adenovirus

21
Q

Patient presents with a low grade fever of 100 degrees and a nagging cough. WBC count is slightly elevated. An alveolar biopsy shows thickened alveolar septal walls with moderate space inside of the alveoli. Radiograph shows a “Bat wing” appearance of the thoracic cavity. What is the likely diagnosis?

A

Viral pneumonia

22
Q

What form of pneumonia has an “interstitial” pattern of inflammation?

A

Viral pneumonia

23
Q

What form of pneumonia will present with heightened levels of IgG and lymphocytes?

A

Viral pneumonia

24
Q

A lung abcess is a(n) (Acute/Chronic) issue?

A

Acute

25
Q

What is a lung abscess?

A

Local suppurative process within the lung characterized by liquefactive necrosis of lung tissue

26
Q

What is the main mechanism for abscess formation in the lungs?

A

Aspiration of infective materials as in choking on your own vomit

27
Q

Septic emboli on the right side of the heart can trap in the lung and cause a lung abcess (TRUE/FALSE)?

A

TRUE

28
Q

Patient presents with a high fever and cough. CBC shows leukocytosis. The patient reports a bad stomach bug that he is still getting over in which he was vomiting often and even vomited while laying down on his back for a moment when it came on at night. Upon speaking to the patient you note that he has severe halitosis and sputum. What is the likely diagnosis based on this history?

A

Lung abscess

29
Q

What is the etiologic agent of pulmonary tuberculosis?

A

Mycobacterium tuberculosis

30
Q

Granulomas, Ghon lesions, and Ghon complex’s are indicative of what pathology?

A

Pulmonary tuberculosis

31
Q

A granuloma is a(n) (Acute/Chronic) issue?

A

Chronic

32
Q

What is the first lesion of primary tuberculosis?

A

Ghon lesion

33
Q

Where does a Ghon lesion often situate itself in the lungs?

A

Upper lobes

34
Q

What is a Ghon complex?

A

A Ghon lesion with associated mediastinal lymph node involvement

35
Q

What pattern of necrosis is present in a Ghon lesion of tuberculosis?

A

Caseous necrosis

36
Q

What can cause secondary tuberculosis?

A

Erosion of a bronchus by a necrotizing process

37
Q

A reactivated patient is visiting your office again for the first time in 6 months. His chief complain is a chronic nagging cough that has lasted for “At least a month”. He presents with mild chest pain and reports occasionally coughing up blood. When you last saw this patient he weighed 230 pounds. Currently, he is 170 pounds and reports no changes in diet or exercise habits. He is running a low fever. What pathology is likely being described?

A

Pulmonary tuberculosis

38
Q

What is miliary tuberculosis?

A

A disseminated TB infection leading to millet-sized granulomas and is highly virulent and less treatable than normal TB

39
Q

What is the giant cell present in pulmonary tuberculosis?

A

Langhan giant cell

40
Q

What cells are present in a granuloma?

A

Epitheloid cells, fibroblasts, lymphocytes, and Langhan giant cells

41
Q

What are the clinical features of neonatal respiratory distress syndrome?

A
  • high APGAR scores at birth
  • increased respiratory rate
  • forceful respirations using accessory mm
  • flaring of nostrils
  • cyanosis of lips

NYCC Visceral Pathology (40 decks)

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