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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
Q

What factors favor viral pneumonia in adults?

A

old age, malnutrition, alcoholism, underlying debilitating illnesses

26
Q

What tyep of pneumonia is shown in the provided image?

A

Viral (Influenza A)

Left: intralumenal necro-inflammatory debris (variable)

Right: Advanced case with hyaline membranes

27
Q

The provided imae is an example of pneumonia caused by what pathogen?

How do you know?

A

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
Q

What are the most common organisms that cause hospital acquired pneumonia?

A

Gram positive cocci (Staphylococcus aureus & Streptococcus pneumoniae)

Gram negative rods (Enterobacteriales & Pseudomonas species)

29
Q

What are the most common organisms that cause atypical pneumonia?

A

not seen on gram stain & don’t gro on standard bacteriology media

  • Mycoplasma pneumoniae*
  • Chlamydophila pneumonia*
  • Coxiella burnetti*

Viruses

30
Q

What are common complications associated with aspiration pneumonia?

A

lung abscess

necrotizing pneumonia

31
Q

What pathology is shown in the provide image?

A

Lung abscess

32
Q

What are the most common causes of lung abscesses?

Where do they most commonly occur in the lungs?

A

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
Q

What pathology is shown in the provided image?

What features is indicated by the arrows?

A

Lung abscess

notice necrotic debris, inflammation & neutrophils

arrows: abscess wall

34
Q

What pathology is shown in the provided image?

A

Diffuse alveolar damage, early phase

Hyaline membranes and type 1 pneumocyte damage

35
Q

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?

A

Usually caused by mycobacteria & fungi

+/- regional lympho node involvement & granulomatous inflammation

immunocompromised host

36
Q

What features is indicated by the red arrow?

What feature is indicatd by the blue arrow?

This is characteristic of what pathology?

A

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
Q

What is secondary tuberculosis & what are its features?

A

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
Q

What pathology is shown in the provided image?

A

Secondary tuberculosis

39
Q

What pathology is depicted by the provided images?

A

Miliary Tuberculosis

40
Q

This histological slide is indicative of what pathology?

Describe the features of the image.

A
  • 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
Q

The provided slide is an example of tuberculosis with what stain?

What is the stain for?

A

Ziehl-Neelsen for AFB

mycolic acid will retain the red stain

42
Q

What pathology is indicated by the provided image?

A

Histoplasmosis

concentric fibrosis

43
Q

What pathology is shown in the provided image?

A

Histoplasmosis

Concentric fibrosis

44
Q

Where are budding yeasts commonly found during a histoplasmosis infection?

A

Often seen intracellularly

Typically seen in macrophages – they are NOT encapsulated

45
Q

What pathology is shown in the provided image?

A

Blastomycosis

epitheloid granuloma wiht central necrosis & many neutrophils

46
Q

What are the cellular features of blastomycosis?

A

Thick-walled, broad-based organisms

Not encapsulated

47
Q

What patholgen is shown in the provided images?

A

Blastomycosis

Left: yeast

Right: fungus

48
Q

What pathology is shown in the provided image?

A

Coccidiodes immitis

Spherules – start of empty with a thick membrane (right), then progress to thin capsule with numbeorus endospores (left)

49
Q

What viral pathogens are immunocompromised patients most susceptible to cause pneumonia?

A

CMV, adenovirus

50
Q

What fungal pathogens are immunocompromised patients most susceptible to?

A
  1. Pneumocystis jiroveci
  2. Cryptococcus neoformans
  3. Mucor
  4. Rhizopus
  5. Aspergillus
  6. Candida
51
Q

What bacterial pathogens are immunocompromised patients most susceptible to?

A
  • Legionella pneumophila
  • mycobacteria
  • Listeria
  • gram-negative rods
52
Q

What pathology is shown in the provided image?

A

CMV pneumonia

cell with cytomegaly wiht large, single-intranuclear inclusion surrounded by a clear halo in the periphery

53
Q

What pathology is shown in the provided image?

This stain helps with what differentiation?

A

Pneumocystis pneumonia

Refractile organisms within the pap-stained casts

Distinguishes it from mimivs ie. alveolar proeinosis

54
Q

What organism is shown in the provided image?

A

Pneumocystis cysts

central dot (black open) & collapsed “coffee cup” cross sectional contour (black curved)

55
Q

What patological organism is shown in the provided image?

A

Candida albicans

budding yeast pseudohyphae on gram stain

56
Q

How would you describe the shape of Cryptococcus neoformans?

A

encapsulated yeast with very narrow base buds

57
Q

What pathology is shown in the provided image?

A

Cryptococcomas in periphery of upper lobe

they are sharply separated from the surrounding uninvolved parenchyma

58
Q

What pathology is shown in the provided image?

A

Cryptococcus neoformans

Halo-like capsules surround round/oval yeast (blue arrow)

pink hisiocytes between the yeast

59
Q

What pathogen is shown in the provided image?

A

Pulmonary Aspergillosis

culsters of hyphal organisms

septate hypae that show branching in acute angles

S3B1 Pathology (7 decks)

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