lung pathology 3 Flashcards
what is responsible for 1/6 of all deaths in US?
pneumonia
pyogenic bacteria w/ neutrophils in alveoli
acute pneumonia
not pyogenic, “atypical pneumonia” often viral or mycoplasmal
pneumonitis
what are some predisposing conditions for community acquired acute bacterial pneumonia?
age extremes, chronic diseases, immune deficiencies, decr splenic fxn
bacterial pneumonia often follows?
viral URI
which lobes are usually affected in bacterial pneumonia?
lower lobes or right middle lobe
what type of sputum will you get with bacterial pneumonia?
blood tinged sputum
most common cause of lobar pneumonia?
streptococcus pneumoniae (pneumococci)
congestion->red hepatization->gray hepatization->resolution assc’d wtih what type of pneumonia?
lobar pneumonia morphology
indications for hospitalization of CAP patient?
- severe dyspnea or hypoxemia
- empyema’
- CHF or COPD
- delirium
lack of alveolar exudate, modestly incr WBC, very little sputum, acute febrile respiratory disease with patchy inflammation in lung
primary atypical pneumonia; AKA interstitial pneumonitis
primary atypical pneumonia is largely confined to where?
alveolar septa & interstitium
what is the most common cause of primary atypical pneumonia (walking pneumonia)
mycoplasma
what is the 2nd most common cause of atypical pneumonia?
chlamydia pneumoniae
military, college students, schools, prisons, hospitals - what bug?
mycoplasma
coryza?
cold
pathogenic mechanism of atypical pneumonia
organisms attach to respiratory epithelium–>cells necrose–>inflammatory response–>can extend to alveoli & interstitial inflammation
thickening of the alveolar wall will be seen in what sort of pneumonia?
interstitial (atypical) pneumonia
systemic disease that causes classic well formed non-caseating granulomas in many tissues and organs
sarcoidosis
how to dx sarcoidosis?
dx of exclusion
nonsmoker, af am female, SE US, young adults - what disease?
sarcoidosis
if sarcoidosis has an acute onset, what is it?
fever, erythema nodosum, polyarthritis, incr IgG, incr Ca, incr ACE
interstitial & intraalveolar accumulation of CD4, incr levels of IL2 & IFN gamma, IL8, TNF
sarcoidosis
what type of bodies can be found in sarcoidosis bodies?
- schaumann bodies
2. asteroid bodies
lamellated calcified structures, usu in giant cells
schaumann bodies
star shaped eosinophilic bodies mad eup of compressed intermediate filaments
asteroid bodies
what is the prognosis for ppl with sarcoidosis?
65-75% recover (favorable prognosis)
occupational disease, moldy hay, involves primarily alveoli
hypersensitivity pneumonitis
inhalation of what sort of Ag induces hypersensitivity pneumonitis?
spores of thermophilic bacteria, true fungi, animal proteins, bacterial products
acute presentation of hypersensitivity pneumonia
severe dyspnea, cough, high fever, chills within 4-6 hrs, resolves spontaeously
chronic presentation of hypersensitivity pneumonia
prolonged exposure to small amts of Ag; insidious onset of dyspnea, cough, fatigue, respiratory failure
what type of hypersensitivity rxn is acute hypersensitivity pneumonitis?
type III
what type of hypersensitivity rxn is chronic hypersensitivity pneumonitis?
type IV
when hypersensitivity pneumonitis is caused by the spores of thermophilic actinomyces in hay?
farmers lung
silo filler’s disease is due to?
NO2 gas
DIP (desquamative interstitial penumonia) is due to overabundance of___________?
smokers macrophages
what is desquamative interstitial penumonia? how to tx?
respiratory bronciolitis; tx with steroids
due to accumulation of acellular surfactant; cough up white jelly sputum; will see homogenous granular ppt within alveoli
pulmonary alveolar proteinosis (PAP)
how to tx PAP when it progresses?
whole lung lavage
