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Year 5 path SW > Histopathology 21: Respiratory Pathology > Flashcards

Histopathology 21: Respiratory Pathology Flashcards

1
Q

What does pulmonary oedema look like on histology ?

A

Intra-alveolar fluid

heavy watery lungs

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2
Q

What is the name of the neonatal disease in which preterm babies have insufficient surfactant production ?

A

Hyaline membrane disease of the newborn

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3
Q

“On post-mortem examination of the lungs they are heavier than normal, expanded and firm. They are plumb coloured and airless”

Which disease does this describe ?

A

Acute lung injuries: ARDS or hyaline membrane disease of the newborn

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4
Q

List 4 acute changes to the airways in asthma ?

A

Bronchospasm
Oedema
Hyperaemia
Inflammation

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5
Q

List 4 chronic changes to the airways in asthma ?

A

Muscular hypertrophy
Airway narrowing
Goblet cell hyperplasia
Scarring

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6
Q

What are the histological findings of asthma ?

A 
Eosinophils and mast cells 
Hypertrophic goblet cells 
Dilated vessels
Thick muscular layer 
Charcot-Leyden Crystals
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7
Q

What are the histological findings of Chronic bronchitis?

A

Dilated airways
Mucous gland hyperplasia
Goblet cell hyperplasia
Mild inflammation

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8
Q

What are the histological findings of emphysema ?

A

Centrilobular damage to alveolar tissue

Panacinar (if alpha 1 anti trypsin deficiency)

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9
Q

List 5 pathologies seen with cystic fibrosis ?

A 
Lungs- Thick mucous with recurrent infections
G.I tract- meconium ileus
Pancreas - pancreatitis 
Liver - cirrhosis 
Male reproductive system - Infertility
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10
Q

List histological features of Bronchopneumonia ?

A

Patchy bronchial/peri bronchial distribution often the lower lobes
Acute inflammation surrounding airways and in alveoli

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11
Q

List histological features of lobar pneumonia ?

A

Widespread fibrinosuppurative consolidation

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12
Q

Which tumours tend to arise in the airways ?

A

Squamous cell carcinomas

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13
Q

Which tumours tend to arise in the peripheral alveolar spaces ?

A

Adenocarcinomas

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14
Q

Which tumours tend to arise in the lung pleura ?

A

Mesothelioma

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15
Q

Which tumours tend to arise centrally or peripherally ?

A

Small cell lung cancer

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16
Q

Which lung cancers are more associated with smokers than non-smokers ?

A

Squamous cell carcinomas and small cell carcinomas

Whereas non-smokers tend to get adenocarcinomas

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17
Q

Which mutations are more common in smokers and non-smokers with adenocarcinomas of the lungs?

A

Smokers - K ras

Non-smokers - EGFR

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18
Q

Which has the worse prognosis: small cell lung cancer or non-small cell lung cancers ?

A

Small cell lung cancers

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19
Q

What is hypogammaglobulinaemia ?

A

An Immune disorder characterised by a reduction in all types of gamma globulins e.g antibodies that form part of the immune response.

Congenital, iatrogenic

SCID, Wiskott-Aldrich syndrome, CLL, nephrotic syndrome

20
Q

Which cancer is associated with asbestos exposure ?

A

Mesothelioma

21
Q

Which 3 cancers are considered NSCLC

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell carcinoma
22
Q

List 3 congenital causes of bronchiectasis ?

A
  • CF
  • Primary colliery dyskinesia
  • Hypogammaglobulinaemia
  • Yellow nail syndrome
23
Q

List 3 fibrosing causes of interstitial lung disease ?

A
  • Idiopathic pulmonary fibrosis
  • Pneumoconiosis
  • Radiation pneumonitis
24
Q

List 2 granulomatous causes of interstitial lung disease?

A
  • Sarcoidosis

- extrinsic allergic alveolitis

25
Q

Which part of the lung does asbestosis tend to affect ?

A
  • Lower lobe
26
Q

List 2 examples of extrinsic allergic alveolitis ?

A
  • Farmer’s lung

- Pigeon fancier’s lung

27
Q

List 3 examples of pneumoconiosis ?

A
  • Coal worker’s lung
  • Silicosis
  • asbestosis
28
Q

How is Extrinsic allergic alveolitis different to pneumoconiosis ?

A
  • Pneumoconiosis is caused by inhalation of mineral dust or inorganic particles leading to fibrosis
  • EAA is caused by inhalation of organic antigens which cause an allergic response leading to fibrosis
  • EAA has allergic symptoms when exposed to the organic antigen- SOB, fever, chest pain
29
Q

causes of pulmonary oedema

A

left heart failure
alveolar injury (drug, inhalation, pancreatitis)
neurogenic following head injury
high altitude

30
Q

causes of acute lung injury / diffuse alveolar damage

A

cause of rapid onset respiratory failure
adults - ARDS

  • infection
  • aspiration
  • trauma
  • inhaled irritant gases
  • shock
  • blood transfusions
  • DIC
  • drug overdose
31
Q

what is hyaline membrane disease of the newborn

A

insufficient surfactant production in premature babies
diffuse alveolar damage
lungs heavy, firm, plump coloured, airless
lungs congested - exudative phase - develop hyaline membranes - organising pneumonia

32
Q

features of COPD

A

chronic bronchitis and emphysema
80% are smokers
airway and alveolar pathology leading to progressive airway obstruction

33
Q

features of chronic bronchitis

A

cough productive of sputum for most days for at least 3 months over 2 consecutive years
complications: recurrent infections, chronic respiratory failure, cor pulmonale, increased risk of lung cancer

34
Q

features fo emphysema

A

permanent loss of the alveolar parenchyma distal to the terminal bronchiole

  • smoking
  • alpha-1 antitrypsin deficiency
  • rare = cadmium exposure

complications:

  • bullae
  • respiratory failure
  • pulmonary hypertension and RHF
35
Q

features of bronchiectasis

A

permanent, abnormal dilation of the bronchi with inflammation and fibrosis extending into adjacent parenchyma

complications:

  • recurrent infections
  • haemoptysis
  • pulmonary hypertension and R sided heart failure
  • amyloidosis
36
Q

features of CF

A

autosomal recessive
chromosome 7q3 = CFTR gene
delta F508 = most common mutation
generalised disorder of the exocrine glands - results in abnormally thick mucus secretions
recurrent lung infections - S pneumonia, H influenxae, P aeruginosa, B cepacia
lung transplant will prolong survival

37
Q

causes of CAP

A

strep pneumoniae
haemophilus inflenzae
mycoplasma

38
Q

causes of HAP

A

gram -ves eg klebsiella, pseudomonas

39
Q

features of lobar pneumonia

A

95% S. pneumoniae
widespread fibrosuppurative consolidation
congestion - red hepatisation - grey hepatisation - resolution

40
Q

features of granulomatous lung infection

A

granuloma = collection of macrophages and multi-nucleate giant cells
necrotisisng/ non-necrotising
think of TB

41
Q

features of pulmonary thromboembolism

A

small emboli present with pleuritic chest pain or chronic progressive SOB due to pulmonary hypertension
large emboli - sudden death, acute RHF, cardiogenic shock

42
Q

list types of lung tumours

A

most common are epithelial
non- small cell = SCC, adenocarcinoma, large cell carcinoma
small cell carcinoma

43
Q

multistep pathway to developing lung cancer

A

metaplasia
dysplasia
carcinoma in situ
invasive carcinoma

44
Q

what are the main molecular mutations involved in development of adenocarcinoma

A

K ras mutation
DNA methylation
p53

45
Q

cytology of adenocarcinoma

A

glandular differentiation

46
Q

features of cell carcinoma

A 
associated with smoking 
often central near the bronchi 
presents with advanced disease 
poor prognosis 
can cause paraneoplastic syndromes 
p53 and RB1 mutations
47
Q

features of mesothelioma

A

malignant tumour of the pleura
asbestos exposure
long lag
fatal

Year 5 path SW (106 decks)

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