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Pathology > Lung Pathology > Flashcards

Lung Pathology Flashcards

1
Q

How do you differentiated between lower and upper respiratory tract?

A 
Upper= above larynx 
Lower= below larynx
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2
Q

What is the epithelium associate with respiratory tract?

A

Ciliated columnar epithelium

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4
Q

What happens to the alveolar in pneumonia?

A

Fill with oedema fluid, fibrin and inflammatory cells which forms CONSOLIDATION

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5
Q

What is opportunistic pneumonia and who is most at risk?

A

Pneumonia caused by atypical organism

People with weakened/under-developed immune system:
Young
Elderly 
Infirm 
Immunosuppressed
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6
Q

What are the 2 types of pneumonia?

A

Lobar pneumonia and bronchopneumonia

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7
Q

What is the cause of lobar pneumonia and what are the characteristic features?

What are the disease stages if left untreated?

A

Organism causes wide spread inflammation in whole lobe via spread through inter-alveolar pore (Kohn)

Features:

  • well demarcated airless lobe compaction
  • acute inflammation filling up alveoli

Stages:
Day 1= congestion
Day 2-4= Red hepatisation i.e. lungs resemble liver tissue
Grey hepatisation i.e. fibrin and WBC infiltrates
1-2 weeks= resolution

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8
Q

What are the complications associated with pneumonia?

A
  • Death
  • Hypoxaemia
  • Septicaemia
  • Metastatic infection via blood borne infection i.e. endocarditis/cerebral abscess
  • Fibrosis
  • Bronchiectasis
  • Cavitation
  • Abscess
  • Fistula i.e. Broncho-pleural or broncho-vascular
  • Empyema
  • Pericarditis= infection spreads to local anatomical region
  • Effusion
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9
Q

What causes bronchopneumonia?

A

Impaired host resistance due to:

  • debility i.e. hypostasis due to being bedbound or elderly or aspiration
  • lung disease i.e. chronic bronchitis/lung carcinoma/lung fibrosis
  • systemic disease i.e. immunosuppression/organ failure/ neurological disease
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10
Q

Bronchopneumonia of the right lung is most likely caused by what?

A

Aspiration= easier route of access due to right bronchus being wider and shorter

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11
Q

What parts of the lungs are affected in bronchopneumonia?

A

Small bronchi with extension into adjacent tissue

Basal parts of lungs preferentially affected

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12
Q

What are 2 features seen in primary TB?

A

Ghon focus- small peripheral lung lesion

Ghon complex- hilar lymph node involvement

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13
Q

What can secondary TB result in?

A

Larger apical lesions

Pleural effusion with empyema

TB pneumonia

Miliary TB

Intestinal TB

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14
Q

How can you differentiate between primary and secondary TB?

A

Primary:
Lower-lobe (atypical)
Pleural effusion

Secondary:
upper lobe
Cavitation

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15
Q

What is the cause of pulmonary infarction? What contributes to an increased risk?

A

DVT i.e. termed a venous thrombo-embolism

Virchow’s triad for risk of clotting (vessel wall/blood flow/coagulability)

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16
Q

What normally prevents pulmonary infarct from occurring? Why then is it normally associated with patients who also have heart failure?

A

Lungs have dual blood supply from pulmonary artery and bronchial arteries meaning bronchial arteries can compensate when embolus in pulmonary artery to prevent infarct

HF= bronchial artery BF compromised -> infarct

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17
Q

When does a pulmonary infarction present?

A

24 hrs after survival of PE i.e. dependent on whether dual blood supply intact to maintain sufficient blood supply

18
Q

What causes bronchial obstruction?

A

Inhaled foreign body

Tumour (carcinoid/carcinoma/lymphadenopathy)

19
Q

What are the consequences of bronchial obstruction?

A

Mucostasis
-bronchial secretions collect distal to obstruction

Pneumonia
-infection due to retain secretions

Bronchiectasis
-weakening + dilation of bronchial walls

20
Q

What are the 4 main causes of obstructive airways disease?

A

Asthma

Inflammation affecting bronchial mucous or hyper reactivity of SM

Chronic bronchitis

Emphysema

COPD/COAD (long standing air way restriction)

21
Q

What is the definition of chronic bronchitis and what factors can lead to it’s development?

A

Productive cough lasting at least 3 months in 2 consecutive years

Cigarette smoking
Air pollution
Fumes

22
Q

What pathological changes occur in chronic bronchitis?

A

Weakened bronchial walls
Hyperplasia of mucous glands
SM hyperplasia
Mucous plugs in lumina

23
Q

What signs might someone with chronic bronchitis present with?

A 
Reduced peak flow 
Raised residual volume 
Reduced maximum residual volume 
Recurrent low grade bronchial infections 
Hypoxaemia 
Cyanosis
24
Q

What is emphysema and what are the consequence for the air ways?

A

Dilation of alveoli +/- respiratory bronchioles

Small airways collapse during exhalation due to loss of lung tissue causing the tension keeping the airways open to be lost

25
Q

What is the difference between centrilobular and panacinar emphysema?

A

Centrilobular

  • respiratory bronchioles affected
  • cause= airborne irritants (cigarette smoke and occupational dusts)

Panacinar

  • respiratory bronchioles and alveolar
  • cause unknown but associated with alpha-1-antitrypsin deficiency
  • prone to damage from proteolytic enzymes release from inflammatory cells by cigarette smoke
26
Q

What is the role of cigarette smoke in centrilobular and panacinar emphysema?

A 
C= acts as irritant
P= stimulates proteolytic enzyme release from inflammatory cells which causes damage
27
Q

What are the 2 major types of lung carcinoma? How is the treatment different for these cancers?

A

Small cell neuroendocrine carcinoma (SCUNC i.e. oat cell)
Chemo

Non-small cell carcinoma (NSCLC i.e. large cell)
Surgery/radiotherapy

28
Q

What route does lung cancer spread and where does it metastasis to?

A

Lymphocytes-vascular spread

Mediastinal LN
Liver
BM
Brain 
Pleural metastases 
Ipsilateral or contralateral lung
29
Q

What are the paraneoplastic effects of lung carcinoma?

A

Epilepsy- due to cerebral metastasis

Bone pain and fractures

Finger clubbing- due to hypoxia

Ectopic hormone secretion = Increased ACTH and ADH= due to SCUNC secreting hormones

Weight loss + Cachexia (substantial loss of skeletal muscle due to cancer altering metabolism)

30
Q

What are the local affects of lung carcinoma?

A

Destruction of bronchial wall and lung tissue

BV erosion

Bronchial obstruction

Pleural invasion= leads to malignant effusion

Pneumonia

31
Q

What is the definition of pneumonia? What are the main causes?

A

Inflammation of lung parenchyma

Bacterial (most often)
Viruses
Fungi
Parasites

Pathology (12 decks)

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