Lecture 18 - Infectious Disease of Lung Flashcards
______ pneumonia is considered INTERSTITIAL pneumonitis with alveolar damage, while ______ pneumonia is characterized by an intraALVEOLAR process (alveolar damage is not always present).
Viral –> Interstitial pneumonitis
Bacterial –> intra-alveolar pneumonitis
There are 2 phases of consolidation during the response and resolution of Lobar Pneumonia.
The first phase is _______ hepatization. Why is it called this?
The second phase is ______ hepatization. What is this phase characterized by?
Red Hepatization –> so called because of the red, liver-like appearance of the lung from infiltration of PMNs and RBCs.
Grey Hepatization –> characterized by lysis of RBCs and replacement of acute inflammatory cells with chronic (i.e. Macrophages) and fibrin.
Bronchopneumonia is characterized by patchy infection located around _____ airways. It is an _______ process, just like Bacterial pneumonia.
What are the three main organisms that cause Lobar and Bronchopneumonia?
Small airways
Intra-alveolar process (NOT Interstitial like Viral pneumonia)
Staph. aureus
H. influenza
Strep. pneumoniae
On autopsy, bronchopneumonia presents as red patches that feel like _______ streets as you pass your fingers over it. Remember that ACUTE Bronchopneumonia presents with _______ infiltrate early on.
Cobblestone streets
Patchy
If either lobar or bronchopneumonia is left untreated, it can progress to ______ pneumonia, characterized by fever, pleurisy, putrid sputum, and ______ (infection of the pleural space –> mortality at this point is 10-15%).
Necrotizing pneumonia
Empyema
TB is transmitted via ______. It can be inactivated, though not necessarily killed with ____, _____, or ______.
Inhalation
Heat, Light, or Drying
The hallmark of TB lung infection is Necrotizing granuloma (central Necrosis with surrounding _____ and _____ cells).
Necrotizing granuloma
Histiocytes
Giant cells
______ TB most often occurs in Children. It is a peripheral infection with granuloma formation that leads to local _______ dissemination of the bacteria with ______ adenopathy. This combination is termed ______ complex.
Primary TB
Lymphatic dissemination
Hilar adenopathy
Ghon complex
______ is better than Histology at identifying the causative agent for infections.
Microbiology
What type of stain is used to identify TB?
Acid Fast
______ TB is indicative of hematogenous dissemination.
Milliary TB
Candida, Blastomyces, H. capsulatum, and Cryptococci are all _____ forms of fungi (look for budding).
Aspergillus, Mucor, Petrolidium, and Penecillium are all _____ forms of fungi.
Yeast
Fillamentous
Apergillus is the MOST COMMON laboratory contaminant. It is identified as having _____ angle branching of filaments and septae.
ACUTE angle
Mycetomas produce a _____-like substance that destroys adjacent lung tissue over time. However, they are ______ (the way they obtain nutrients) and colonize previously destroyed lung tissue.
Trypsin-like
Saprophytic
In which patients are you most likely to see Invasive Apergillosis?
Immunocompromised
Allergic Aspergillosis (hypersensitivity reaction causing asthma-like symptoms) is caused by Aspergillus ________.
Aspergillus fumigatus
Cryptococcus neoformans is identified by _____ ink stain or _____ stain (the latter stains the wall of the fungus). Which animal’s feces is a reservoir for this organism?
India ink
Mucin
Pigeons
If patients with C. neoformans present with headache, what does this suggest?
Hematogenous dissemination to the brain.
Which regions are Blastomyces dermatitidis endemic to?
Central and Southern US
Blastomyces infection in the lung looks very similar to _____, causing granulomatus lung disease (necrotizing and non-necrotizing granulomas).
Blastomyces will show budding ______ on staining.
TB
Hyphae
Coccidiodes immitis (causative agent for valley fever) is endemic to the soil in the _______ US and Mexico (San Joaquin valley). Patients are typically infected after excavation or activities that move soil.
Southwest US
Histoplasma capsulatum is another granulomatus lung disease that mimics TB. Look for multiple ______ granulomas on radiography. It is common and worldwide.
Calcified granulomas
Pneumocystis jirovecii is an Opportunistic pathogen. It presents like ______ pneumonia bc it is an Interstitial disease. It cannot be _____, so bronchiolar lavage and/or lung biopsy are necessary to diagnose. ______ stain is used to identify it.
Viral pneumonia
Cultured
Silver stain
