Lung Pathology

Question 1

Infection of lung parenchyma that happens when normal defences are impaired
Presents with: fever chills, cough w/ yellow-green sputum (pus) or rusty sputum (blood), tachypnea, decreased breath sounds and dull percussions and elevated WBC

Answer 1

Pneumonia

Question 2

Pattern of pneumonia that is seen as a consolidation that runs along the the airways mostly seem as a patchy infiltrates

Answer 2

Bronchopneumonia

Question 3

Pneumonia pattern that is seen as consolidation of a whole lobe

Answer 3

Lobar pneumonia

Question 4

Pneumonia pattern that has no consolidation but has inflammation of the connective tissue surrounding the alveolar sacs (more visible in lung markings)

Answer 4

Interstitial pneumonia

Question 5

Bacteria infection usually causes which pneumonia patterns

Answer 5

Lobar pneumonia and bronchopneumonia

Question 6

Viral infections usually cause which pneumonia pattern

Answer 6

Interstitial pneumonia

Question 7

Consolidation of an entire lobe, usually bacterial (95% S pneumonia and klebsiella pneumonia) ~> results in currant jelly sputum

Answer 7

Lobar pneumonia

Question 8

What are the four classic phases of lobar pneumonia

Answer 8

1- congestion (congested vessels and edema)
2- red hepatization ( an exudate containing neutrophils and blood filling the alveolar spaces giving solid consistency- liver like
3- grey Hepatization eventually the RBCs are broken down giving a grey appearance
4- resolution solving the exudate - healing by type 2 pneumocytes

Question 9

Scattered patchy consolidation cantered around bronchioles often multifocal and bilateral
- caused by a variety of bacteria

Answer 9

Bronchopneumonia

Question 10

1st cause of secondary pneumonia- bacterial pneumonia super imposed on a viral upper RTI for bronchopneumonia

Answer 10

S aureus - often complicated with abscess or empeyema (pus in pleural space)

Question 11

Causes pneumonia super imposed on COPD (bronchopneumonia)

Answer 11

H. Influenza

Question 12

Causes pneumonia in cystic fibrosis patient (bronchopneumonia)

Answer 12

Pseudomonas arguenosa

Question 13

Pneumonia superimposed on COPD exacerbation (bronchopneumonia)

Answer 13

Moraxella

Question 14

Community acquired super imposed on COPD or immuno compromised pneumonias l. Arise from water source, best visualised with silver stain ( bronchopneumonia)

Answer 14

Legionella pneumonia

Question 15

This pneumonia is presented with
•diffuse interstitial infiltrates
•mild upper respiratory (minimal sputum, cough and low fever)

Answer 15

Interstitial (atypical) pneumonia

Question 16

Most common cause of interstitial (atypical) pneumonia that usually affects young adults such as military recruits or college students living in dormitories. Can lead to autoimmune haemolytic anaemia due to IvM agains I antigens on RBCs causes cold haemolytic anemia and is not visible on gram stain due to lack of cell wall

Answer 16

Mycoplasma pneumonia

Question 17

2nd most common cause of atypical (interstitial) pneumonia

Answer 17

Chlamydia pneumonia

Question 18

Atypical pneumonia with post transplant immunosuppressive therapy

Answer 18

CMV

Question 19

Atypical pneumonia in elderly, immuno compromised increases the risk for super imposed S aureus or H influenzae

Answer 19

Influenza virus

Question 20

typical pneumonia with high fever (Q fever) seem in farmers and vets

Answer 20

Coxiella Burnetti

Question 21

Most common cause of atypical pneumonia in infants

Answer 21

RSV- respiratory sensitial virus

Question 22

• pneumonia in patients which are alcoholics and coma patients
• due to anaerobic bacteria in oropharynx
• results in right lower lobe abscess

Answer 22

Aspiration pneumonia

Question 23

Inhalation of aerosolised M tuberculosis Causes

Answer 23

Tuberculosis

Question 24

Results in focal caseating necrosis in lower lobe of the lung and hilar lymph nodes, the foci undergo fibrosis and calcification forming Ghon complex

Answer 24

Primary TB which arises after initial exposure (it is generally asymptotic but is PPD +)

Question 25

Reactivation of ghon complex can get reactivated leading to secondary TB due to aids and it usually occurs at the apex of the lung due to higher concentration of O2 which leads to

Answer 25

Military pulmonary TB or tuberculous bronchopneumonia

Question 26

Presents with fever night sweats cough with hemoptysis, weigh miss and on biopsy revealing caseating granulomas Also AFB stain reveals Real acid fast bacilli

Answer 26

Secondary TB

Question 27

• airway obstruction
• Decreased forced vital capacity
• Greater decrease in forced expiratory volume 1
• decrease in FEV1:FVC ratio (key finding)
• increase in total lung capacity (air trapping)

Answer 27

COPD