Lung Pathology III

Question 1

chronic diffuse interstitial lung disease

Answer 1

restrictive

end stage - honeycomb

CXR - reticulonodular and ground glass

problem at alveoli

Question 2

pneumoconioses

Answer 2

inhale things that tear up your lung

Question 3

idiopathic pulmonary fibrosis

Answer 3

usual interstitial pneumonia

aka cryptogenic fibrosing alveolitis

type II cell hyperplasia

interstitial around bronchi and subpleural**

Question 4

TFG-beta1

Answer 4

in idiopathic pulmonary fibrosis

-reduce telomerase and inhibit caveolin (more collagen and fibrosis)

Question 5

telomerase mutations in idiopathic pulmonary fibrosis

Answer 5

TERT and TERC

-LOF mutations

Question 6

dyspnea, dry cough, hypoxemia, cyanosis, digital clubbing

idiopathic pulmonary fibrosis

Answer 6

repeated cycles of alveolitis

end in honeycomb lung

mean survival <3 years

Question 7

nonspecific interstitial pneumonia

Answer 7

non-smoking females
-better prognosis than IPF

dyspnea and cough for several months

mild patchy or diffuse interstitial fibrosis

no honeycombing

Question 8

bronchiolitis obliterans organizing pneumonia

Answer 8

BOOP
aka cryptogenic organizing pneumonia

organizing - all CT of same age and no interstitial fibrosis

Tx oral steroids > 6 months

fibrous deposits in distal bronchioles and alveolar spaces

CXR reticulonodular

Question 9

caplan syndrome

Answer 9

rheumatoid arthritis and pneumoconiosis

work in mine > breathe in junk > scar lungs

Question 10

soluble particle

Answer 10

acute problem

Question 11

insoluble particle

Answer 11

chronic problem

Question 12

bagasse

Answer 12

paper mill - plant fiber exposure

-people who make rum

Question 13

farmers lung

Answer 13

mildy hay

Question 14

anthracosis

Answer 14

coal dust - carbon

Question 15

silicosis

Answer 15

silica

metal casting
sandblasting
stone cutting

Question 16

asbestosis

Answer 16

asbestos

mining, milling, fabriction, insulation removal

Question 17

coal workers pneumoconiosis

Answer 17

three types:
1 asymptomatic anthracosis - enter macrophage - doesn’t cause problems

2 simple CWP - coal macules and nodules and centrilobular emphysema

3 complicated CWP - progressive massive fibrosis

• pulmonary HTN and dysfunction
• to cor pulmonale
• SYMPTOMATIC - SOB

Question 18

most prevalent chronic occupational disease in world

Answer 18

silicosis
-sandblasters, miners

slowly progressive

macrophage ingest silica - and killed - release TNF

worse - fresh cracked silica

Question 19

polarizing crystals

Answer 19

silicosis

Question 20

amphiboles

Answer 20

stiff brittle asbestos

-more harmful

Question 21

chrysotile

Answer 21

serpentine asbestos

-less harmful

Question 22

Dx of asbestosis

Answer 22

take lung and count asbestos in it

Question 23

asbestos disease

Answer 23

pleural effusion
pleural plaques
lung cancer
laryngeal carcinoma
mesothelioma

Question 24

beading and knobbed ends on with prussian blue stain

Answer 24

asbestos

-prussian blue - for iron

Question 25

with asbestos

Answer 25

calcified plaques on pleura

will not find asbestos on plaques

Question 26

calcified pleural plaques

Answer 26

asbestos**

Question 27

chronic radiation pneumonistis

Answer 27

pulmonary fibrosis

Question 28

acute radiation pneumonitis

Answer 28

within 6 months- effusions, infiltrates

Question 29

methotrexate

Answer 29

chemo drug

can lead to hypersensitivity pneumonitis

Question 30

sarcoidosis

Answer 30

non-caseating granulomas
-along bronchi

Dx of exclusion

more in african americans**

better prognosis - confined to lungs and lymph nodes

Question 31

elevated ACE

Answer 31

seen in sarcoidosis**

Question 32

asteroid body

Answer 32

sarcoidosis

Question 33

schvaumann body

Answer 33

calcified laminiated structure

-in sarcoidosis

Question 34

acid humidifier lung

Answer 34

thermophilic bacteria

Question 35

hypersensitivity pneumonitis

Answer 35

at alveolar level**

fever, cough, dyspnea, leukocytosis after exposure

chronic - fibrosis

non-caseating granulomas in distal lung

Question 36

micropolyspora faeni

Answer 36

moly hay

farmers lung

Question 37

aureobasidium pullulans

Answer 37

humidifier lung

cool-mist humidifier