Miscellaneous Disorders of the lungs

Question 1

Collapse of previously inflated lung, producing
areas of relatively airless pulmonary parenchyma

Answer 1

Acquired Atelectasis

Question 2

Types of Acquired Atelectasis

Answer 2

Resorption (or Obstruction) Atelectasis
Compression Atelectasis
Contraction Atelectasis

Question 3

Occurrence when local or generalised fibrotic changes in the lung or pleura prevent full expansion

Answer 3

Contraction atelectasis

Question 4

Results whenever the pleural cavity is partially or
completely filled by fluid exudate, tumour, blood or air
Shift of the mediastinum away from the affected lung

Answer 4

Compression atelectasis

Question 5

Consequence of complete obstruction of an
airway → Resorption of the oxygen trapped in
the dependent alveoli, without impairment of
blood flow through the affected alveolar walls

Answer 5

Obstruction atelectasis

Question 6

Obstruction atelectasis causes

Answer 6

Excessive secretions (e.g. mucous plugs)
or exudates within smaller bronchi (e.g. bronchial
asthma, chronic bronchitis, bronchiectasis, etc.)

Question 7

Failure of alveolar spaces to expand adequately at birth

Answer 7

Atelectasis Neonatorum

Question 8

Pathogenesis of Atelectasis Neonatorum

Answer 8

Failure of initial aeration of the lungs at birth →
Persistence of collapsed alveoli → Respiration never
fully established

Question 9

Atelectasis Neonatorum is ass w

Answer 9

prematurity & intrauterine foetal anoxia

Question 10

Accumulation of amorphous (sometimes surfactant), PAS (+) material in the alveolar spaces

Answer 10

Pulmonary Alveolar Proteinosis

Question 11

Causes of pulmonary alveolar proteinosis

Answer 11

Most often idiopathic
Rare secondary forms: Occurrence in patients with
acute silicosis, Pneumocystis jiroveci infection,
haematological malignancies, significant inhalation
exposures to aluminium, titanium, cement &
cellulose dusts

Question 12

Symptoms & Signs of pulmonary alveolar proteinosis

Answer 12

Progressive exertional dyspnoea
Weight loss
Fatigue
Malaise
Cough, occasionally producing chunky or gummy
sputum (less common)

Question 13

Chest x-ray of pulmonary alveolar proteinosis

Answer 13

Bilateral mid- & lower-lung field opacities in a butterfly distribution w normal hila

Question 14

CT of pulmonary alveolar proteinosis

Answer 14

Ground-glass opacities
Thickened intra-lobular structures & interlobular septa in typically polygonal shapes

Question 15

DD of pulmonary alveolar proteinosis

Answer 15

Lipoid pneumonia, bronchoalveolar carcinoma &
Pneumocystis jirovecii pneumonia

Question 16

Broncho-alveolar lavage:

Answer 16

Milky or opaque
PAS (+) staining
Presence of scattered surfactant-engorged
macrophages
Increase in T-cells