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Undeleted > Exam 2 Path > Flashcards

Exam 2 Path Flashcards

1
Q

Stages of lobar pneumonia

A

congestion
red hepatization
gray hepatization
resolution

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2
Q

Common causes of exacerbation of COPD (bugs)

A

haemophilus influenza

moraxella catarrhalis

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3
Q

Sputum in klebsiella pneumonia and reason why

A

gelatinous sputum

viscid capsular polysaccharide

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4
Q

Findings with atypical pneumonia

A

ulcerative bronchitis

viral infection with necrosis of epithelium

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5
Q

Complications of atypical pneumonia

A

Reye syndrome (virus + aspirin)
hepatic failure
noninflammatory encephalitis

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6
Q

Chronic pneumonia findings

A

granulomatous inflammation

immunocompetent pts

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7
Q

Findings with histoplasma

A

epithelioid granulomas
caseation necrosis with coalescence
tree bark appearance after tx

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8
Q

Findings with blastomyces dermatitidis

A

upper lungs

supparative granulomas

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9
Q

FIndings with coccidioidis immitis

A

erythema nodosum/erythema multiforme
spherules
macrophages/giant cells with endospores

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10
Q

Pulmonary diseases with HIV

A

below CD4 of 200- pneumocystic jirvocii

below CD4 of 50- CMV/MAC

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11
Q

Characteristics of idiopathic pulmonary fibrosis

A

hyperplasia of type II pneumocytes
fibroblast proliferation
TGF-beta driven process
from repeated cycles of injury

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12
Q

Tx of IPF

A

lung transplant

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13
Q

Appearance of IPF

A

cobblestone pleural surface
lower lobe
fibrosis (blue is early, pink is late)

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14
Q

Histo findings of IPF

A

smooth m. hyperplasia

squamous hyperplasia

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15
Q

Cryptogenic organizing pneumonia

A

aka BOOP
polypoid plugs of CT (Masson bodies)
no interstitial fibrosis

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16
Q

Anthracosis

A

coal macules/nodules
from pollution and carbon dust
asymptomatic
upper lungs

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17
Q

Coal Worker’s Pneumoconioses

A

dilation of alveoli
over may years over 2cm black scars
adjacent to respiratory bronchioles
no increase in cancer risk

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18
Q

Silicosis

A

foundries/sandblasters/stone cutters
decades of exposure
slow nodular fibrosis

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19
Q

Silicosis pathogenesis

A

crystalline silicone cause macrophage mediator release

fibroblasts/TNF/IL/ROS/cytokines cause damage

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20
Q

FIndings with silicosis

A

fine nodularity in upper lobes
progresses even with exposure removed
increased TB susceptibility
calcification of hilar LN’s

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21
Q

Histo of silicosis

A

hyalinized collagen

polarized light with birefringent needle like spicules

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22
Q

Types of abestos

A

serpentine- flexible, curly, soluble

amphiboles- straight, rigid, mesothelioma, more damaging

23
Q

Risk of abestosis

A

increased bronchogenic carcinoma and mesothelioma

24
Q

Pathogenesis of abestosis

A

macrophages ingest and release mediators

fibrosis distorts architecture (honeycombing)

25
Q

Findings with abestosis

A

lower lobes
golden-brown, fusiform rods (coated with Fe)
pleural plaques

26
Q

Caplan syndrome

A 
Rheumatoid arthritis + pneumoconioses
rheumatoid nodules (pallisading granulomatous inflammation)
27
Q

Sarcoidosis

A

noncaseating granulomas
increased in females/blacks/Southeast
immune disregulation

28
Q

Findings with sarcoidosis

A 
hilar lymphadenopathy
skin lesions
uveitis
phalangeal bone involvement
lacrimal/salivary gland involvement
29
Q

Microscopic exam of sarcoidosis

A

noncaseating granulomas
Schaumann bodies/Asteroid bodies
granulomata of spleen and liver
distribution along bronchi/lymphatics

30
Q

Hypersensitivity pneumonitis

A 
removal of agent stops progression
from prolonged exposure to organic dusts
type III hypersensitivity (immune complexes)
noncaseating granulomas (type IV HS)
31
Q

Simple pulmonary eosinophilia

A

Loeffler syndrome
transient pulmonary lesions
increased eosinophils in serum
intrapulmonary densities on CT

32
Q

Tropical eosinophilia

A

infection of Wuchereria bancrofti
only in tropical regions
hypersenitivity reaction

33
Q

Desquamative interstitial pneumonia

A

assc with smoking
4th/5th decade
dyspnea/dry cough

34
Q

Microscopy of DIP

A

intra-alveolar macrophage collections
dusty brown pigment
granular iron
emphysema/thick septa

35
Q

Pulmonary alveolar proteinosis

A

asymmetric pulmonary opacifications
accumulation of acellular surfactant
anti-GM-CSF Ab in acquired causes

36
Q

Pulmonary alveolar proteinosis sx

A

abundant gelatinous sputum with cough
increased risk of secondary infections
increased wt/size of lungs
granular precipitate in alveoli

37
Q

Genetics with lung carcinoma

A

p53-small and nonsmall cell lung ca
cMYC/RB-small cell carcinoma
p16/RAS-nonsmall cell carcinoma
other genes-EGFR/HER-2neu

38
Q

Finding with squamous cell carcinoma of the lung

A

intracellular bridging
keratinization
hypercalcemia

39
Q

Adenocarcinoma characteristics

A

most common lung cancer
peripheral location/pleural puckering
no smoking assc
signet ring lesions

40
Q

Bronchioloalveolar carcinoma findings

A

lepidic growth
noninvasive/nondestructive pattern
preserved architecture

41
Q

Small cell carcinoma characteristics

A

in central airways
early metastasis/rapid growth
assc with smoking
paraneoplastic syndromes

42
Q

Findings with small cell carcinoma

A

salt and pepper chromatin
round/oval cells
extensive necrosis

43
Q

Large cell carcinoma characteristics

A 
undifferentiated squamous or adenocarinomas
aggressive
peripheral lungs
spherical tumor
anaplastic cells
44
Q

Carcinoid tumors

A 
function lesions secreting hormones (5HT)
can be resected
do not metastasize
45
Q

Hamartoma

A

normal tissue in an abnormal spot
coin lesion on x-ray
often hyaline/CT/bone

46
Q

Inflammatory myofibroblastic tumor

A

in children
peripheral mass with calcium deposits
anaplastic lymphoma kinase gene

47
Q

Metastatic tumors to the lung

A

most common type of lung cancer

cannonball lesions

48
Q

Solitary fibrous tumor

A

attached to pleura via pedicle
Whorls of reticulin/collagen
interspersed spindle cells
confined to pleural surface

49
Q

Malignant mesothelioma

A

assc with abestos
abestos bodies/plaques
20-50yrs after exposure
low survival

50
Q

Other areas with mesothelioma

A

peritoneum
pericardium
tunica vaginalis
genital tract

51
Q

Indication for bilateral lung transplant

A

cystic fibrosis
bronchiectasis
remove infectious reservoir

52
Q

Contraindication for lung transplant

A

maligancy

53
Q

Infections post lung transplant

A

first couple weeks-bacterial

3-12mo post-candida/aspergillus

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