exam 2 Flashcards
1
Q
Essential versus secondary HTN; linked to a disease, sustain incre. Pressure or a complex multigenic?
A
Essential only sustains incre. P (140/90) and complex multigenic disorder
Secondary is only linked to a dis.
2
Q
Which multigenic disorders help causes essential HTN
A
Environmental(stress, obese, smoke, physical attack and increase salt) and Genetic (genetically affecting Na+/fluid reabsorb in kidney)
3
Q
which disease are linked secondary HTN?
A
renal dysfunction, endocrine dysfunction cardiac and Neruon
4
Q
BP equation
A
CO(Peripheral resistance)
5
Q
Types of arteriosclerosis
A
hyaline and hyperplastic
6
Q
hyaline arteriosclerosis
A
Narrow lumen: protein deposits=increase sm. eosinophil
Assoc.: Benign hypertension
Damages endoth. yes b/c increase P. and plasma protein leak
7
Q
hyperplastic arteriosclerosis
A
Narrow Lumen: onion skin (incre. layer of smo. muscle BsM)
Assoc: severe hypertension
damage endoth.: NO
8
Q
Is Atherosclerosis a type of arteriosclerosis
A
yes
9
Q
what disease is assoc. w/ atheroma
A
Atherosclerosis
10
Q
Atherosclerotic plaque
A
AKA atheroma
Fibrous cap w/ lipid core
More stable=increase fibrous cap and less lipid
-stop thrombus
Lesion w/in Tunica intima=lumen pushed inward
11
Q
Basic pathogenesis of Atheroma
A
Endothelial cell dysfunction
formation of atherosclerosis plaque
T cells-MAC interaction
Fracture of the plaque and thrombosis
12
Q
endothelial cell dysfunction (atheromas)
A
OCCUR via hemodynamic distrub. or hypercholesterolemia
-Plaque that only form w/in intact endoth. to cause dysfunctional endoth.
LDL oxidize by excess ROS
Fatty streak b/c foamy cell
13
Q
hypercholesterolemia
A
Increase LDL while decre. HDL (or abnormal lipoprotein)
Chronic hyperlipidemia
-LDL Accum.=damage T. intima
-MAC cnt remove debris and form foamy cells
Foamy cells directly attack endoth. cells
14
Q
LDL oxidize by excess ROS
A
Directly damage endoth. cells Sp. recep. allow MAC digest LDL -incre. accum=foamy cells Activate cytokine/GF/chemokin secretion -monocyte recruit MAC relase ROS to incre. ROS -tissue injury and decre. NO which makes it difficult remove LDL
15
Q
Does a fatty streak b/c have a fibrous cap?
A
no fibrous cap
16
Q
Fibrous cap (atheroma)
A
Cytokine released during inflammation rxn induce sm. muscle prolif. and ECM prod.
-from intima–>lumen
-sm. muscle cell–>endoth.
Fib. cap form and coer fatty streak
ROS and cytokine cont’ to produce oxidize LDL
17
Q
T-cell MAC interaction/cell migration
A
Dysfunction endoth.=adhesive molec.
-leukocyte/Tcell migrate
Via chemokines w/in intima
T cell=chronic inflam.(relase inflamm. cytokine)
18
Q
Thrombosis(atheroma)
A
Frag. of plaq. Damage endoth. rovide focal pt. for platelet bind and activate accum platelet producing clots -BV microvess. -inflamm med.
19
Q
types of MI cuases ischemic heart disease
A
Necrotic damage to myocardium Biochem changes (incre. lactate and decre. ATP) Necrosis=1st 30min. (reverseible) 12 hrs. (lost)
20
Q
permeant or temporary occlusions impact myocardiocyte
A
both
21
Q
cardiac vascular disease
A
Hypertension
Atherosclerosis
22
Q
heart disease
A
Myocardial infarction Cardiac hypertrophy Conduction disorder s Myocarditis Carcinoid syndrome
23
Q
Hematopathology
A
Erythrocytes=anemia
Platelets=thrombocytopenia
Leukocytes=neutropenia
24
Q
what type of cardiac dis.=ischemic heart dis.
A
Myocardial infarction
25
MC of myocardiam ischemia
Decrease Perfusion=increasing need
| Affecting E production/Nutrient availability and removing waste
26
Can necrotic damage occur in myocardial infarction to the myocardium?
yes
Reversible (1st 30min.) and irreversible(12 hrs.)
can see troponin I and CK-MB
Myoglobin is not specific
27
Which Biochem. changes occur in MI?
increase in lactate and decrease in ATP
28
why does injury still occur after reperfusion tx?
before tx.=incre. glycolysisi which increase lactic acid-->increase stress and ROS
-this means there is a decrease in anti-oxid.
after perfusion=cells need time to catch up to crease anti-oxidation
29
salvage
degree to manage the cells that did not die
30
Is post-ischemic ventricular dysfunction reversible?
NO
31
2 types of infarction occur in ischemic reperfusion injury?
Hemorrhagic infarction
Microscopic infarction
-hem.
-contraction band=hypereosinophilic, cross-striation, due to Ca2+ influx (ischemia)
32
Causes of cardiac hypertrophy?
Increase. wrkload=incre. BP b/c moving incre. vol. which damage wall
Increase number of sarcomeres in myocardiocytes
MI
33
cardiac hypertrophy effects
Incre. heart size/mass
| Incre. prot. synth.=heart fail, arrhythmia and neur/hormal stim. `
34
conduction disorder
Arrythmia
35
2 types of arrythmia
Tachycardia=classified by QRS
-wide=supraventricular w/ conductance issues
-narrow=supraventricular (AV node) w/ atrial fib/flutter or sinus tachy
Bradycardia
-decre. SA node activity
slower pacemaker for contraction
cause=age, drug(Ca2+ channel blocker, beta-blocker),
sleep, fainting (vagus N. hypertension)
-block conduction=link to dis. and ~ cuases as above
36
define myocarditis
heart inflammation infection
37
MC of myocarditis
viral infection-->coxsockie A/B and Enterovirus
38
what type of non-infections causes myocarditis?
autoimmune/drug hypersent.
39
is carcinoid syndrome a cardiac dis.?
yes
40
what does the hormones cause in the in carcinoid synd. cancer?
fibrotic lesion
| thick endocardium
41
what type of disorder is considered anemia
Erythrocyte disorder
42
does anemia increase or decr. RBC
decre. RBC
43
Causes of anemia
lost blood, hemolysis, decre. erythropoiesis, or sickle cell
44
types of bleeding causes iron def. anemia
mensuration, GI bleed, and assoc. w/ prego.
45
iron sources
Dietary absorption in intestines
Iron recycled from aged RBC by MAC in spleen
-MAC=brsk dwn RBC from Hb
46
S/S of decre. Hb synth. and what type of anemia is it assoc. with
Iron def. anemia
Wkness
Fatigue
Malaise
47
decre. Hb. Synth. s/s and assoc. anemia
```
Iron def. Anemia
Rbc=decre. Hb content
Lower O2 level induce erythrop.
Stim. BnM=Platellets
RBC become microcytic
-smaller/varied size
-hypochromic (decre. color b/c Hb)
-varied shape
```
48
Pernicious anemia also known as
megaloblastic anemia
49
type of vitamin needed for pernicious
Vit. B12 for thyamidine synth.
| -failure of DNA synth. affect hematopoiesis
50
what does the blood look like histologically for megablastic anemia
megaloblastic=abnormal lrg blood cells and precursors
51
what does the PMN look like in megablastic anemia
hypersegmented
52
What part of the stomach is affected in megaloblastic anemia and why?
fundic glands b/c of absorption of vit. B12 for intrinsic factors
-parietal cells have fundic glands
53
what affect does autoimmune attack on gastric mucosa do within megaloblastic anemia?
```
Parietal cells are lost(primar)
AntBd blocks (secondary)
-binding IF
-binding to Recp.
-H+ pump
```
54
What type of disorder is thrombocytopenia and function?
Platelet disorder and causes a decrease in platelet
55
Causes of Thrombocytopenia
```
decrease in production
-Vit. B12 def and hereditary
decrease survivial
-immune-med./drug Associa. immune thrombocytopenia
-thrombotic thrombocytopenia purpura
```
56
Immune mediated/drug assoc. immune thrombocytopneia
Drug(quinine, quinidine, vancomycin)
-bind platele glycoprotein
-create antGN recog. by antiBD
Heprin I(direct) or II(venous/arterial thrombotic)
57
which heprin disorder causes thrombocytopenia
Heprin-induced Thrombocytopenia (HIT)
- aggregation=thrombosis(low risk w/ low MW heparin)
- clots in lrg arteries=vascular insuf., DVT, emboli (cuases fatal lung dis.)
58
def. of what in thrombotic thromboccyhtopenic purpura?
Def. ADAMTs13 def.=abnormal vwf complex adering to platelets
- thrombotic clots in microcirc.
- accum. of clots damages endoth.
59
types of symp. in thrombocytopenic purpura
Episodic
- unknown factors contirb.
- hemolytic anemia b/c shear stress on RBC
60
type of dis. is leukopenia and what does it caus
leukocyte dis.
lack of WBC=agranulocytosis
-depletion of PMN
-incre. bact/fungal infection
61
2 mech. in leukopenia
Infective/inhib. granulopiesis
| incre. removal/destruction of granulocyte from blood
62
types of Neutropenia
Absolute neutropenia
Agranulocytosis (granulocyte def.)
Cyclic neutropenia
63
Infective/inhib. granulopiesis
```
Inhib. hematopoietic stem cel
-accompanied by stem cells
:accompanied by anemia/thrombocytopenia
Detective precursors due in marrow
-megaloblastic anemia
Congenital disorder
-inherit detect prevent proper differentiation
Drug exposure
```
64
type of drug exposure in leukopenia
Chemotherapeutic agent
-alkylating agent/anti-metabolites
-predictable cuases, does depend destruction of hemeatopotic cause
-general effect=anemia and thrombocytopenia
Idiosyncratic effect of many drugs
-toxic effect on precursors =phenothiazines(chlorpromazones)
-AntBD-induced destruction of mature leukoctye=certain sulfonamides
65
PMN Removal
```
Immunologic
-idiopathic
-assoc. w/ immune dis. (SLE)
-drug exposure
splenomegaly
-incre. sequestion
-anemia/thrombocytopenia
Incre use by bact, fungal, rickett. infect.
```
66
types of neutropenia
Absolute neutropenia
Agranulocytosis (granulocyte def.)
cyclic neutorpenia
67
genetic onset for cyclic neutropenia
childhood onset
- rare/spontaneous mutation in adults
- autosomal dominant
68
mutation in cyclic neutropenia
Neutrophil elastase
- w/in primary azurophilic granules of PMN and monocyte
- mutation is excessively inhib causing excessive trough in production
69
PMN oscillation
PMN in blood are normal
Mature explains opposing cyclicity of peripheral PMN and monocyte
PMN elastase inhib. myeloblastic diff.
70
PMN hematopoiesis
```
2 wks to mature
peripheral survival=12 hrs.
precursors in marrow
PMN productions occurs in waves
-negative feedback inhib. PMN production
-"oscillations"
```
71
Non-specific lung dis.
Clear=cough/mucociliary escalator
-beat up mucus(anything attach to it (dust particles)
Secretions=tracheobronchial(mucus), Alveolar(surfactant), cellular component (RBC)
Cellular defense=not immune but +cytok.
-non-phagocytic (epith.)
-phagocytic (alveolar Mac)
:attack anything =nonspecific attack
Biochem. defense
-proteinase inhib.
-antioxidant(protect lung w/ inhalation sm. etc.)
-ej=transferrin, lactoferrin, glutathione albumin
72
Specific lung defense
```
AntiBD med
-secretory IgA(meningitis)
:complement/opsonization
:Serum Ig
AntGn presentation to lymphocytes
-MAC and monocyte/DC/Epith. cells
Cell mediated(T-lymphocyte-dependent) immunologic Response
-Cytokine mediated
-direct cellular cytoxicity
Non-lympho cell immune reponse
-mast cell/eosinophil dependent
```
73
Infectious Rhinitis, sinusitis, pharyngitis/tonsillitis type of respiratory tract infection?
acute upper resp.
74
Pathogens infectious rhinitis
Rhinoviruses
| Others=flu, coronavirus, adenoviruses, enterovirus
75
potential complication of infectious rhinitis
Bact. infect. b/c swelling, fluid accum
Otitis media
Sinus infection sinusitis
76
swelling and fluid for infections rhinitis
congestion and discharge
77
type of infections in sinusitis
bacterial and viral infections
78
complications in sinusitis
Infected neighboring structures(eye, skull, brain)
| Usually discomfort
79
For sinusitis the impairment of sinus drainage causes
Mucosal edema to inflammation
Obstruction might complete blockages
-result in accum. of infected mucus(suppurative exudate)=empyema
Acute-->chronic
80
viral or bacterial infections in pharyngitis/tosilitis
viral
81
S/s of pharyngitis/Tonsillitis
redness, edema, enlargment of tonsils/lymph nodes
82
Acute upper resp. tract infection
Infectious Rhinitis
Sinusitis
Pharyngitis/Tonsilitis
83
Define Atelectasis
```
Colapse prev. inflated lung
3 types
-reabsorb(block airway)
-compression (accum. in pleural space)
-contraction (fibrosis)
```
84
Define S/S atelectasis
hypoxemia
increase infection
reversible (except in fibrosis)
85
neonatal atelectasis
Incomplete expansion
86
Vascular resp. dis.
```
Pulmonary embolism
Pulmonary Infarction
Pulmonary HTN
Goodpasture Syndrome
Pulmonary Edema
```
87
Pulmonary obstructive dis.
Emphysema
Asthma
Cystic Fibrosis
88
Pulmonary Restrictive dis.
```
Pneumoconiosis
Granulomatous disorder(Hypersensitivity Pneumonitis)
Sarcoidosis
```
89
Pleural dis.
Pleural effusion
| pneumothorax
90
Pulmonary Embolism and caused by
Blocks lung vessel
| casued by=blood clot(MC), air bubble, fat deposits and other debris
91
Blockage of pulmonary embolism
ischemia downstream and incre. P. upstream
92
consequences of pulmonary embolism
pulmonary infarction
93
pulmonary infarctions consequences
```
Large block=quick kill
-no lung patho.
-incre. heart P. damage(Rt side heart failure=Cor pulmonale)
Signals to body control syst. to lower BP
-decre. CO
Lung cn collapse b/c
-lack of surfactant
-reduce movement in response to pain
```
94
Tx of pulmonary infarction
Anticoagulant (heparin)
| Thrombolytic (incre. hemm and should only be in hospital)
95
Pulmonary HTN-vascular changes
```
Medial hypertrophy
-muscular and elastic arteries in lung
-vital fibrosis in T. intima
Plexiform lesion
-advanced hypertension
-Tuft cap.
-dilated thin-walled arteries
```
96
Pulmonary HTN-pathogenesis
```
Chronic obstructive/ interstitial lung dis. (both incre. pulmonary BP)
-destroy alveolar cap.
-incre. pulmonary vascular R
Heart dis.
-lft side damage goes back to lung arteries
Recurrent emboli=incre. upstream P.
Obstructive sleep Apnea
Idiopathic=80% gene
```
97
Pulmonary HTN S/S
Detectable only when advanced
Dyspnea and fatique
Chest pain (rare)
Severe resp. distress and cyanosis (end stage)
98
Pulmonary HTN-Tx
Secondary dis.=Primary tx
Autoimmune/refractory=vasodilaters
Lung transplant
99
Goodpasture synd. Criteria
Pulmonary hemorrhage syndrome
AutoBD against type IV collagen(autoimmune dis.)
-Type IV collagen is in BsM (vasculature)
Kid. and lung Injury
-only affects kid=anti-glomerular BsM dis.
Inflam. mediated destruction of alveolar BsM
-environm. damage=expose deeply embedded protein epitopes(deep in memb.)
-epitope recog. by antBD
-genetic predeposition linked to certain HLA(complex dis.)
100
GPS pathology-S/S
```
Hemoptysis
-Xray=focal consolidation
-death=renal involvement
-tx: plasmapheresis to remove autantBD w/ immunosuppression
Lung=red/brown consolidations
```
101
GPS-histology
Intra-alveolar hemorrhage
Focal necrosis in alveolar walls
Mac accum. heme
102
GPS-late stages
Septal fibrosis (thickened)
Type II pneumocyte hypertrophy
Blood in alveolar spaces
103
Pulmonary edema and caused by
```
Leakage of fluid into. alveolar space
Hemodynamic disturbances
-incre. P. (MC)
-decre. P
Increased cap. permeability
-damage to microvascularture
-infection, gas inhalation, liq. aspiration
-drug/chem.
-shock, trauma, radiation transfusion
```
104
what type of heart failure causes pulmonary edema?
congestive heart failure
105
microvascular injury PULMONARY edema
```
Damage to cap. bed
-primary to vasc. endoth. cells
OR to alveolar sq. pneumocytes
Leakage of fluid and protein
-interstitial space-->restrictive dis.
-alveoli-->pneumonia
Acute Resp. distress syndrome(ARDS)
-b/c diffuse edema
```
106
ARDS=severe acute lung injury
Abrupt onset of hypoxemia
Bilateral pulmonary infiltrates
No cardiac failure
107
ARDS multiple causes
```
Mech. trauma
Near drowning
Sepsis(bact.)
Barbituates overdose
Gastric aspiration
```
108
ARDS-inflammatory dis. that produce diffuse alveolar damage (DAD)
Incre. pulmonary vascular permeability
Edema
Epith. cell death (type 1 pneumocyte)
109
ARDS pathogenesis
Stress
Initiate by MAC
-endoth.
-pneumocytes
PMN invade and debris accum(hylinzation=hyaline memb.)
Healing starts when MAC produces TGFB and PDG(activate fibroblast)
110
ARDS causes which pneumocytes loses?
sq. (I)
-incre. permeability (alveolar wall to blood and immune cell)
Cuboidal(II)
-incre. surfactant
-alveolar collapse
111
ARDS S/S
Lung=heavy and filled w/ fluid (wet)
Stiff lungs=lost surfactant
Dyspnea/tachypnea
Cyanosis/Hypoxemia
112
ARDS-tx
Oxygen
Mech. ventilation
Underlying causes (sepsis)
113
where does the fluid come from for pleural effusion?
resorbed(min. amount)
| drained (chest tube)
114
Accum. of pleural fluid is caused by pleural effusion?
```
Increased hydrostatic P. (CHF)
Incr. vascular permeability (pneumonia)
Decr. Osmotic P. (renal dis.)
Incr. intrapleural Neg. P. (atelectasis)
decreased lymphatic Drainage
```
115
Pneumothorax is gas/air or fluid?
air/gas
116
Causes of pneumothorax?
```
Spontaneous
-Idiopathic
-Rupture of an alveolus/abcess cavity
Traumatic
-injury to the chest wall that allows air in
Tension Pneumothorax
-flap valve=allow air in but not expire
-accum of air can cuase compression of structure
```
117
S/s pneumothorax
resp. distress(due to compression, collapse, atelectasis of lung)
118
Pneumoconioses that being a fibrosing disorders?
foreign particles that cnt be eliminated
119
dis. under pneumoconioses?
Coal workers pneumoconiosis (CWP)
Silicosis
Anthracosis
Asbestosis
120
Coalworker pneumoconioses aka
black lung
121
CWP can be complicated
yes and progressive massive fibrosis
122
S/S of CWP
Pulmonary dysfunction
Pulmonary hypertension
Cor Pulmonale
123
Silicosis
Incr. susceptibility to TB
| 2x risk of lung cancer
124
Asbestosis
Dyspnea
| Incr. risk of lung cancer and mesothelioma
125
Anthracosis
Innoculos CWP
| w/in urban dweller and tobacos smoke
126
Which disorder is hypersensitivity pneumonia?
granulomatous disorder(AKA=allergic alveolitis)
127
allergic alveolitis histology
Patchy infiltrates in interstitium
Loose granuloma w/o necrosis
Cell lymphocyte, plasma cells epith alveoli MAC
128
What does inflamm. alveoli in hypersensitvity cause?
decre. diffusion capacity, lung compliance and total lung vol.
129
Acute attack in granulomatous disorders. S/S
Result=inhale antGN dust
Fever
Dyspnea/cough
Leukocytosis(incre. WBC)
130
Chronic exposure in granulomatous disroders
progressive resp. failure
Dyspnea/cyanosis
Decre. lung capacity/complience
131
Which dis. is a granulomatous restrictive dis.
Sarcoidosis
132
Organs affected in sarcoidosis
```
Lung
Spleen/liver
BnM
Skin lesion
Eyes and muscle
```
133
What is etiology in Sarcoidosis
unknown
134
Charact. in Sarcoidosis
non-necrotizing granuloma
Freq. giant cells
Chromic=scar
135
Sarcoidosis-lung changes
Granuloma w/in lymphatics
-around bronchi/BV in alveoli and pleura
Lung lesion might heal=fibrotic/hylinized
-interstitial fibrosis
Lymph node involv MC
-hilar and mediastinal
-develop calcification
-tonsils are freq. affected
Clinical course=location, size, and number of granulomas
-lung=progressive fibrosisi and cor pulmonale
-spont. remission/steriod therapy
136
Emphysema can occur w/ which dis.
Chronic bronchitis and COPD
137
What occurs in the smaller airspaces in COPD
Permanent enlarged
- destroy the smaller air spaces walls
- no fibrosis
138
patterns of emphysema
Dis. in acinuc
Assoc. w/ tobacco smoke inhale
Major s/s=dypnea (trouble w/ reg. breathing)
139
Emphysema-destruction of Pathogenesis
Direct damage from toxing(tobacco smoke/alveolar walls)
Inflam. response
-MAC/epith. cell response release leukotrienese, IL-8, TNF
-Chemotaxis, inflam., structural changes (act as GF)
Protease relased from cell
-def. in protease inhib.
:alpha-1 anti-trypsin inhib. elastase
:genetic component to emphysema
-damage CT elastic fibers
Infection =not a major role=exacerbate inflamm. damage
140
Asthma a complex gen. dis.?
Yes
| Genetic w/ provoked of Adenosin/exercise/ For. particles
141
Charac. of Asthma
Episodic bronchoconstric.
Bronchial wall inflam.
Incr. mucus secretion
142
Asthma types
Atopic Classic hypersensitivity rxn IgE
Drug Induced(Asprin/Nsaids) affecting balance of COX acitvity
Occupational
143
how can asthma be chronic inflam. airway dis.?
recurrent episodes=wheez, breathlessness, chest tight, cough
144
Asthma IMMUNO. CELL triggers
B/T lympohcytes, IgE, Mast and Eosinophils
145
Asthma and mast cells
Sm. muscle constriction
Incre. mucus secretion
Vasodilation
-Endoth. Leakage and local edema
146
Asthma and epith./cytokines
leukotrienes
| prostaglandins
147
Asthma and eosinophil
```
Major basic protein
-AKA prostoglycan 2(PRG2)
-Cellular toxin (bact. mammalian)
-Possible by disording cell memb.
Eosinophil cationic pain
-AKA ribonuclease 3
-bind to cell suface heparan sulfate proteoglycan (endocytosis)
-Apoptosisi via casp. 8
-Necrosis depend
```
148
Cystic fibrosis- viscus mucus cuases
Obstruct passages
Glandular tissue
Digestive tract causing block
149
cystic fibrosis and channel mutation cuases
```
Chronic lung dis.
-incre. infection risk
-chornic bronchitis
Pancreatic insuf.
-steatorrhea(plug pancreatic duct)
-malnutrition
Hepatic necrosis
Interstial obstruction
Male infert.
```
150
CFTR
Cystic fibrosisi conductance regulator
Impaired secretion of Cl- ion impair w/ Na secretion
-no ionic balance
-decre. osmosis
151
Pneumonia infections
bact. Virus, myoplasm or fungi
- lymphatic infiltrate in alveoli
- produce pulmonary edema
152
pneumonia causes
Suppress cough reflex/inhib.
-coma, anesthesia, neuromuscular disorder
Mucociliary apparatus damage
-cig. smoke, hot gas, viral, genetic
Secretion Accum.
-cystic fibrosis, bronchial obstrusction
Decre. MAC activity
-alcohol, tobacco, anoxia and O2 intox. (not enought or too much)
Edema/cong.
153
Aspiration Pneumonia
```
Necrotizing Pneum.
-often fatal
-Chem
:low pH of gastric Acid damaging airway/alveoli
:tissue necrosis/ inflam.
-Bact.
:oral flowa-->more areobes than anerobes
:inflam.
Microaspiration
-need pre-existing dis.(asthma, interstial fibrosis or transplant regjection)
-MC w/ GERD
-may exacterbate w/
```
154
Typical vs. Atypical pneumonia
bact.=typical
| virus=Atypical
155
Bact. Pneumonia
```
Bronchopnemonia
-opaque spot
-patchy consolidation
-distract area of acute inflamm.
Lobar
-opaque lobe
-lung consolidaiton (hepitzaiton)
-fibrin/infection fill alveoli
```
156
Clinical response of bact. Pneumonia
Rapid onset=fever, chils, cough/muchs(infection)
Fibrinosuppurative pleuritis
-lung well=PMN infiltrates, fibrin aggregates
-Pleuritic pain/pleural friction rub(lung rub parietal)
157
acute pneumonia in stages
```
stg. 1=infection
Stg. 2=early red hepatizaiton
-PMN infiltrate
-Congestion of septal cap.
Stg 3.=gray hepatizaiton
-alveolar exudate in air spaces
Stg 4=resolution
-fibromyxoid masses
-MAC fibroblasts
```
158
Viral Pneumonia
Corona virus from china
Transmission via resp. secretion
Incubation 2-10dys
159
Viral pnuemonia aka
Server acute resp. syndrom=SARS
160
S/S of viral pneumonia
```
Malasie
Myalgia
Dry cough
Fever/chills
Virus infect Pneumocytes
```
161
complication of Covid-19(SARS-CoV-2)
```
pneumonia/trouble breathing
Organ fialure
Heart prob.
Acute resp. distress synd.
Blood clot
AKI
addi. bact/viral infect.
```
162
Histoplasmosis-infection
w/ histoplasma capsulation
- demorphic fungi
- T-cell mediated response containing infection
163
Histoplasmosis-clinical
Acute pulm. infection
Chronic infect. (granulomatous)
Disseminated miliary dis. (millary lesion=mellet seed)
164
histoplasmosis-path.
MAC aggregate filled w/ yeast
Colonize by lymph node
Eventually granuloma w/ giant cells -develop fibrosis/calcification (lymphoma/leukemia)
Gross appearance=perihilar mass lesion
165
diff. tissue affected and function test for obst. vs. restric lung dis.
```
Obstructive
-partia/complete obstruc
-incre. R air flow
:decre. lung inflam.
-pulm. fuction test=decre foreced exp. vol.
Restrictive
-reduced parenchyma expansion
-decre. total lung capacity
-pulm. funciton test=decre. FEV and vital cap.
```
166
community acq. pneumonia
typical and atypical
167
hospital acqp. pneuonia
mechanical ventialaiton
168
aspiration pneumonia
Markedly debilitated pt./stroke vict.
| Abnormal gag/swallowing reflex
169
chronic pneumonia
localized lesion
| immunocomp. pt.
