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S3B1 Pathology > Lung Infections > Flashcards

Lung Infections Flashcards

1
Q

What is an acute inflammation of the tracheobronchial tree?

A

bronchitis

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2
Q

What is inflammation of bronchiolar epithelium?

A

bronchiolitis

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3
Q

What is inflammation of airways & alveoli?

A

pneumonia

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4
Q

What is focal infection/inflammation of parenchyma?

A

abscess

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5
Q

What are the 5 major risk factors for pneumonia?

A
  1. Loss/suppression of cough reflex
  2. Injury/dysfunction of mucociliary apparatus
  3. Accumulation of secretions
  4. Interference with phagocytic or bacterial action of alveolar macrophages
  5. Pulmonary congestion & edema
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6
Q

What are the predisposting conditions that make people more vulnerable to community-acquired pneumonia?

A
  • extremes of age
  • comorbid conditions
  • immunodeficiency
  • absent/decreased splenic function
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7
Q

What is the most common cause of communit-acquired pneumonia?

Describe the shape & gram stain of the bacteria.

A

Streprococcus pneumoniae

lancet-shaped, gram-positive diplococci

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8
Q

Is there a vaccine to protect against Streptococcus pneumoniae?

A

yes

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9
Q

What is the most common bacterial cause of acute exacerbation of COPD?

Describe the shape & gram stain of the bacteria.

What type is most virulent?

In what situation is pneumonia caused by this organism an emergency?

A

Haemophilus influenzae

  • Pleomorphic gram-negative coccobacilus
    • +/- capsule
  • Type b most virulent
  • Pneumonia in pediatric population is an emergency
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10
Q

Is there a vaccine to protect against Haemophilus influenzae?

A

yes

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11
Q

What type (gram stain & shape) of bacteria is Moraxella catarrhalis?

A

Gram-negative diplococci in clusters

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12
Q

What type (gram stain & shape) of bacteria is Staphylococcus aureus?

A

Gram-positive coccus in clumps

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13
Q

What type of bacteria is shown in the provided image of lung tissue?

What type of stain is this?

A

Gram-negative rods

Klebsiella pneumonia (specifically)

Brown-Hopps stain

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14
Q

Klebsiella pneumoniae is most commonly associated with what type of pneumonia?

What is a classic symptom associated with this infection?

A

Aspiration pneumonia

red-currant jelly sputum

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15
Q

What pathogen is the most common cause of hospital acquired pneumonia & community acquired pneumonia for CF and immunocompromised (neutropenic) patients?

Describe gram stain & shape of bacteia.

A

Pseudomonas aeruginosa

gram-negative rod

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16
Q

What is a major complication that can occur when immunocompromised patients develop pneumonia caused by Pseudomonas aeruginosa?

A

invasion of blood vessels and spread to a fulminant infection

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17
Q

What type (gram stain and shape) of bacteria is Legionella pneumophilia?

What special stain is used to identify this pathogen?

A

gram-negative rod

Silver stain

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18
Q

What is the most common cause of bacteial pneumonia in children and young adults?

Gram stain?

A

Mycoplasma pneumonia (walking pneumonia)

do not gram stain b/c no cell wall

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19
Q

What pattern of pneumonia is depicted in the provided image?

How do you know?

A

Bronchopneumonia

patchy

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20
Q

What pattern of pneumonia is depicted in the provided image?

How do you know?

A

Lobar pneumonia

wide-spread involvement of one lobe & consolidation of that inflammation and infection

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21
Q

What stage of lobar pneumonia is shown in the provided image?

Describe the features of this stage

A

Red hepatization (after congestion & before gray hepatization)

lobe is red and firm, with liver-like consistency

mostly airless, inflammation, red blood cells

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22
Q

What stage of lobar pneumonia is shown in the provided image?

Describe the features of this stage.

A

Gray Hepatization (after red hepatization)

consolidated, most of the RBC have lyced, lots of leukocytes, & varying degrees of necrosis

lots of fibrin and neutrophils

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23
Q

What stage of lobar pneumonia is shown in this image?

A

Red Hepatization

massive confluent exudation wth neutrophils, red blood cells and fibrin filling the alveolar spaces

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24
Q

Identify which photos are examples of early and advanced organizing pneumonia.

How do you know?

A
  • Left: Early
    • focally seem to be streamign through pore of Kohn
    • fluid being resorbed, macrophages, chronic inflammation
  • Right: Advanced
    • exudates converted to small nodular masses rich in macrophages adn fibroblasts
    • fibroblast pulgs within the airway
25
What factors favor viral pneumonia in adults?
old age, malnutrition, alcoholism, underlying debilitating illnesses
26
What tyep of pneumonia is shown in the provided image?
Viral (Influenza A) Left: intralumenal necro-inflammatory debris (variable) Right: Advanced case with hyaline membranes
27
The provided imae is an example of pneumonia caused by what pathogen? How do you know?
SARS-COV-2 extensive areas of congestion, edema (black curved arrows), and hyaline membranes (black solid arrows) all are compatable with diffuse alveolar damage, caused by the virus in severe infections
28
What are the most common organisms that cause hospital acquired pneumonia?
Gram positive cocci (*Staphylococcus aureus* & *Streptococcus pneumoniae*) Gram negative rods (*Enterobacteriales* & *Pseudomonas* species)
29
What are the most common organisms that cause atypical pneumonia?
not seen on gram stain & don't gro on standard bacteriology media * Mycoplasma pneumoniae* * Chlamydophila pneumonia* * Coxiella burnetti* Viruses
30
What are common complications associated with aspiration pneumonia?
lung abscess necrotizing pneumonia
31
What pathology is shown in the provide image?
Lung abscess
32
What are the most common causes of lung abscesses? Where do they most commonly occur in the lungs?
Aspiration of foreign material complication of pneumonia secondary infections of lung carcinomas _Most common_: (1) right lower lobe (2) right upper lobe (3) left lower lobe
33
What pathology is shown in the provided image? What features is indicated by the arrows?
Lung abscess notice necrotic debris, inflammation & neutrophils arrows: abscess wall
34
What pathology is shown in the provided image?
Diffuse alveolar damage, early phase Hyaline membranes and type 1 pneumocyte damage
35
Chronic pneumonia is most commonly caused by what type of etiological agents? What features are commonly seen with this type pneumonia? What are the most commonly affected demographics?
Usually caused by mycobacteria & fungi +/- regional lympho node involvement & granulomatous inflammation immunocompromised host
36
What features is indicated by the red arrow? What feature is indicatd by the blue arrow? This is characteristic of what pathology?
_Red arrow:_ Ghon compled - gray-white parenchymal focus under the pleura in the lower part of the upper lobe _Blue arrow:_ Hilar lymph nodes with caseating necrosis Primary Tuberculosis
37
What is secondary tuberculosis & what are its features?
Occurs in a previously sensitized host, usually reactivation of latent infection involves apices of upper lobes of one or both lungs -- cavitations occur readily
38
What pathology is shown in the provided image?
Secondary tuberculosis
39
What pathology is depicted by the provided images?
Miliary Tuberculosis
40
This histological slide is indicative of what pathology? Describe the features of the image.
* Left: * Tubercle * granuloma with central caseation surrounded by epithelial histiocytes & multinucleated gian cells * Right: * higher power of the tubercle rim -- showing giant cells & epitheliod histiocytes
41
The provided slide is an example of tuberculosis with what stain? What is the stain for?
Ziehl-Neelsen for AFB mycolic acid will retain the red stain
42
What pathology is indicated by the provided image?
Histoplasmosis concentric fibrosis
43
What pathology is shown in the provided image?
Histoplasmosis Concentric fibrosis
44
Where are budding yeasts commonly found during a histoplasmosis infection?
Often seen intracellularly Typically seen in macrophages -- they are NOT encapsulated
45
What pathology is shown in the provided image?
Blastomycosis epitheloid granuloma wiht central necrosis & many neutrophils
46
What are the cellular features of blastomycosis?
Thick-walled, broad-based organisms Not encapsulated
47
What patholgen is shown in the provided images?
Blastomycosis Left: yeast Right: fungus
48
What pathology is shown in the provided image?
*Coccidiodes immitis* Spherules -- start of empty with a thick membrane (right), then progress to thin capsule with numbeorus endospores (left)
49
What viral pathogens are immunocompromised patients most susceptible to cause pneumonia?
CMV, adenovirus
50
What fungal pathogens are immunocompromised patients most susceptible to?
1. *Pneumocystis jiroveci* 2. *Cryptococcus neoformans* 3. *Mucor* 4. *Rhizopus* 5. *Aspergillus* 6. *Candida*
51
What bacterial pathogens are immunocompromised patients most susceptible to?
* *Legionella pneumophila* * *mycobacteria* * *Listeria* * gram-negative rods
52
What pathology is shown in the provided image?
CMV pneumonia cell with cytomegaly wiht large, single-intranuclear inclusion surrounded by a clear halo in the periphery
53
What pathology is shown in the provided image? This stain helps with what differentiation?
*Pneumocystis* pneumonia Refractile organisms within the pap-stained casts Distinguishes it from mimivs ie. alveolar proeinosis
54
What organism is shown in the provided image?
Pneumocystis cysts central dot (black open) & collapsed "coffee cup" cross sectional contour (black curved)
55
What patological organism is shown in the provided image?
Candida albicans budding yeast pseudohyphae on gram stain
56
How would you describe the shape of *Cryptococcus neoformans*?
encapsulated yeast with very narrow base buds
57
What pathology is shown in the provided image?
Cryptococcomas in periphery of upper lobe they are sharply separated from the surrounding uninvolved parenchyma
58
What pathology is shown in the provided image?
*Cryptococcus neoformans* Halo-like capsules surround round/oval yeast (blue arrow) pink hisiocytes between the yeast
59
What pathogen is shown in the provided image?
Pulmonary Aspergillosis culsters of hyphal organisms septate hypae that show branching in acute angles

S3B1 Pathology (7 decks)

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