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Leila's Yr 5 Pathology > Histopathology 7 - Respiratory pathology > Flashcards

Histopathology 7 - Respiratory pathology Flashcards

1
Q

Heart failure cells - also known as?

A

Iron laden macrophages

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2
Q

Iron laden macrophages seen in…

A

Pulmonary oedema

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3
Q

what is diffuse alveolar damage known as in adults and children?

A 
Adults = ARDS
Children = RDS
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4
Q

Causes of ARDS

A 
Infection
Aspiration
Trauma
Inhaled irritants
Shock
Blood transfusion
DIC

ACUTE RESPIRATORY FAILURE

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5
Q

Basic pathology in ARDS/RDS

A

Diffuse alveolar damage

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6
Q

Gross pathology in ARDS/RDS

A

Fluffy white infiltrates in lung fields
Plum coloured lungs
Heavy >1kg
lungs expanded/firm

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7
Q

Micro-pathology in ARDS/RDS

A
  1. Capillary congestion
  2. Exudative phase
  3. Hyaline membranes
  4. Organising phase
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8
Q

Chronic changes seen on pathology in asthma

A

Mucus plugging
Muscular hypertrophy
Airway narrowing

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9
Q

Eosinophils and goblet cell hyperplasia

A

Asthma

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10
Q

Definition of chronic bronchitis

A

Chronic cough productive of sputum; most days for >3 months >2 consecutive years

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11
Q

chronic bronchitis pathology

A

hypertrophy of mucous glands
goblet cell hyperplasia
Dilated airways + inflammation

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12
Q

Complications of chronic bronchitis

A

Recurrent infection
Chronic respiratory failure –> pulm HTN + RHF
Increased risk of lung cancer independent of smoking

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13
Q

Definition of emphysema

A

permanent loss of alveolar parenchyma distal to the terminal bronchiole

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14
Q

Causes of emphysema

A

Smoking
A1AT deficiency
IVDU
Marfan’s

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15
Q

Cause of centrilobular damage to the alveoli?

A

SMOKING

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16
Q

Cause of panacinar (throughout the long) damage to the alveoli?

A

A1AT deficiency

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17
Q

Pathophysiology of emphysema

A

Neutrophils and macrophages are activated by cigarette smoke and they release proteases which degrade tissues

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18
Q

Complications of emphysema

A

Bullae formation –> pneumothorax
Resp failure
Cor pulmonale

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19
Q

Definition of bronchiectasis

A

Permanent abnormal dilatation of the terminal bronchi

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20
Q

Congenital causes of bronchiectasis

A

CF, Ciliary dyskinesia (Kartagener’s syndrome)

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21
Q

Inflammatory causes of bronchiectasis

A

Post-infectious, asthma, obstruction, secondary to bronchiolar disease, interstitial fibrosis

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22
Q

3 complications of bronchiectasis

A

Recurrent infection
Haemoptysis/amyloidosis
Cor pulmonale, pulm HTN

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23
Q

Gene and chromosome involved in CF

A

Chromosome 7, CFTR gene

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24
Q

Most common mutation in CF

A

Delta F508

25
Q

GI tract + CF

A

Meconium ileus

26
Q

Common bacterial infections in people with CF

A

S.aureus, P.aeruginosa, H.influenza, B.cepacia

27
Q

Examples of organisms causing CAP

A

S.pneumonia
H.influenza
Mycoplasma

28
Q

Examples of HAP organisms

A

Gram -ve e.g. Kleb, pseudomonas

29
Q

2 main patterns of pneumonia

A

Bronchopneumonia

Lobar pneumonia

30
Q

Bronchopneumonia vs lobar pneumonia

A

Bronchopneumonia: elderly, low virulence organisms (strep, Haemophilus, staph) , infection around the airways, patchy bronchial and peribroncheal distribution)

Lobar: Infection focused in a LOBE OF A LUNG, PNEUMOCOCCUS (S.pneumoniae)

31
Q

StaGES of lobar pneumonia

A
  1. Congestion (hyperaemia and intra-alveolar fluid)
  2. Red hepatisation (neutrophils)
  3. Grey hepatisation (fibrosis)
  4. Resolution
32
Q

Examples of atypical pneumonia organisms

A

Chlamydia, Coxiella, Mycoplasma and viruses e.g. CMV

33
Q

Atypical pneumonia

A

Interstitial inflammation (pneumonitis) without without accumulation of intraalveolar inflammatory cells

34
Q

what is a granuloma?

A

Collection of macrophages +/- giant multinucleate cells

35
Q

What is your first differential when thinking of granulomatous lung disease?

A

TB

36
Q

Fungal causes of granulomatous lung disease

A

Cryptococcus, aspergillum

37
Q

Non infectious granulomatous lung disease causes

A

Occupational lung disease
Sarcoidosis
Inhaled foreign body
IVDU

38
Q

Preferential distribution of granulomas in sarcoidosis ?

A

Upper zones

39
Q

What does RHF do to the appearance of the liver?

A

Get nutmeg liver

40
Q

name 3 non small cell carcinomas of the lung

A

SCC, adenocarcinoma and large cell tumours

41
Q

which 2 lung tumours are common in smokers?

A

SCC and small cell lung cancers

42
Q

3 types of lung cancer in order of most to least common

A

Adenocarcinoma
SCC
Small cell lung cancer

43
Q

features of squamous cell carcinoma

A

smokers, central, spread locally, late mets, PTHrP

44
Q

Features of adenocarcinoma

A

Non smokers, peripheral, early mets

45
Q

Features of small cell carcinoma

A

Smokers, central, SIADH, LEMS, ACTH

46
Q

3 most common female cancers

A

Breast
Lung
bowel

47
Q

3 most common male cancers

A

Prostate
Lung
Bowel

48
Q

3 components of cigarette smoke –> cancer

A 
Tumour initiators (polycyclic aromatic hydrocarbons)
Tumour promoters (nicotine)
Carcinogens (nickel, arsenic)
49
Q

Keratinisation and intracellular ‘prickles’

A

SCC

50
Q

Describe the general changes in cells during development of SCC

A

Normal epithelium –> hyperplasia –> squamous metaplasia –> dysplasia –> carcinoma in situ –> invasive carcinoma

51
Q

Precursor lesion for adenocarcinoma

A

Atypical adenomatous hyperplasia

52
Q

MOLECULAR pathways in development of adenocarcinoma in non-smokers?

A

EGFR mutation

53
Q

Molecular pathways in development of adenocarcinoma in smokers?

A

kRAS, DNA methylation and p53

54
Q

Large cell carcinomas - what are they?

A

Large cells which are poorly differentiated, poor prognosis

55
Q

Mutations in small cell carcinoma

A

p53 and Rb1

56
Q

chemrsensitivity of small cell vs non small cel LCs

A

Small cell are chemosensitive but poor prognosis, non small cell are less chemosensitive and better prognosis

57
Q

Mainstay of treatment for small cell

A

Chemotherapy, surgery often not performed as usually metastasised

58
Q

Mesothelioma - what is it?

  • Epidem and time course?
  • Cause
  • Behaviour + prognosis
  • Sx?
A 
Malignant tumour of the pleura
4-50 years post asbestos exposure
More common in males
Fatal diagnosis
SOB + chest pain

Leila's Yr 5 Pathology (100 decks)

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