lung pathology 3

Question 1

what is responsible for 1/6 of all deaths in US?

Answer 1

pneumonia

Question 2

pyogenic bacteria w/ neutrophils in alveoli

Answer 2

acute pneumonia

Question 3

not pyogenic, “atypical pneumonia” often viral or mycoplasmal

Answer 3

pneumonitis

Question 4

what are some predisposing conditions for community acquired acute bacterial pneumonia?

Answer 4

age extremes, chronic diseases, immune deficiencies, decr splenic fxn

Question 5

bacterial pneumonia often follows?

Answer 5

viral URI

Question 6

which lobes are usually affected in bacterial pneumonia?

Answer 6

lower lobes or right middle lobe

Question 7

what type of sputum will you get with bacterial pneumonia?

Answer 7

blood tinged sputum

Question 8

most common cause of lobar pneumonia?

Answer 8

streptococcus pneumoniae (pneumococci)

Question 9

congestion->red hepatization->gray hepatization->resolution assc’d wtih what type of pneumonia?

Answer 9

lobar pneumonia morphology

Question 10

indications for hospitalization of CAP patient?

Answer 10

1. severe dyspnea or hypoxemia
2. empyema’
3. CHF or COPD
4. delirium

Question 11

lack of alveolar exudate, modestly incr WBC, very little sputum, acute febrile respiratory disease with patchy inflammation in lung

Answer 11

primary atypical pneumonia; AKA interstitial pneumonitis

Question 12

primary atypical pneumonia is largely confined to where?

Answer 12

alveolar septa & interstitium

Question 13

what is the most common cause of primary atypical pneumonia (walking pneumonia)

Answer 13

mycoplasma

Question 14

what is the 2nd most common cause of atypical pneumonia?

Answer 14

chlamydia pneumoniae

Question 15

military, college students, schools, prisons, hospitals - what bug?

Answer 15

mycoplasma

Question 16

coryza?

Answer 16

cold

Question 17

pathogenic mechanism of atypical pneumonia

Answer 17

organisms attach to respiratory epithelium–>cells necrose–>inflammatory response–>can extend to alveoli & interstitial inflammation

Question 18

thickening of the alveolar wall will be seen in what sort of pneumonia?

Answer 18

interstitial (atypical) pneumonia

Question 19

systemic disease that causes classic well formed non-caseating granulomas in many tissues and organs

Answer 19

sarcoidosis

Question 20

how to dx sarcoidosis?

Answer 20

dx of exclusion

Question 21

nonsmoker, af am female, SE US, young adults - what disease?

Answer 21

sarcoidosis

Question 22

if sarcoidosis has an acute onset, what is it?

Answer 22

fever, erythema nodosum, polyarthritis, incr IgG, incr Ca, incr ACE

Question 23

interstitial & intraalveolar accumulation of CD4, incr levels of IL2 & IFN gamma, IL8, TNF

Answer 23

sarcoidosis

Question 24

what type of bodies can be found in sarcoidosis bodies?

Answer 24

1. schaumann bodies

2. asteroid bodies

Question 25

lamellated calcified structures, usu in giant cells

Answer 25

schaumann bodies

Question 26

star shaped eosinophilic bodies mad eup of compressed intermediate filaments

Answer 26

asteroid bodies

Question 27

what is the prognosis for ppl with sarcoidosis?

Answer 27

65-75% recover (favorable prognosis)

Question 28

occupational disease, moldy hay, involves primarily alveoli

Answer 28

hypersensitivity pneumonitis

Question 29

inhalation of what sort of Ag induces hypersensitivity pneumonitis?

Answer 29

spores of thermophilic bacteria, true fungi, animal proteins, bacterial products

Question 30

acute presentation of hypersensitivity pneumonia

Answer 30

severe dyspnea, cough, high fever, chills within 4-6 hrs, resolves spontaeously

Question 31

chronic presentation of hypersensitivity pneumonia

Answer 31

prolonged exposure to small amts of Ag; insidious onset of dyspnea, cough, fatigue, respiratory failure

Question 32

what type of hypersensitivity rxn is acute hypersensitivity pneumonitis?

Answer 32

type III

Question 33

what type of hypersensitivity rxn is chronic hypersensitivity pneumonitis?

Answer 33

type IV

Question 34

when hypersensitivity pneumonitis is caused by the spores of thermophilic actinomyces in hay?

Answer 34

farmers lung

Question 35

silo filler’s disease is due to?

Answer 35

NO2 gas

Question 36

DIP (desquamative interstitial penumonia) is due to overabundance of___________?

Answer 36

smokers macrophages

Question 37

what is desquamative interstitial penumonia? how to tx?

Answer 37

respiratory bronciolitis; tx with steroids

Question 38

due to accumulation of acellular surfactant; cough up white jelly sputum; will see homogenous granular ppt within alveoli

Answer 38

pulmonary alveolar proteinosis (PAP)

Question 39

how to tx PAP when it progresses?

Answer 39

whole lung lavage