Other Pulmonary Pathology

Question 1

State the four stages of lobar pneumonia

Answer 1

Consolidation, red hepatisation (neutrophilia), grey hepatisation (fibrosis), resolution

Question 2

State at least five risk factors for pulmonary embolism

Answer 2

Female gender, immobility, cardiac disease, cancer, cOCP, pregnancy, primary hypercoagulable states, secondary hypercoagulable states

Question 3

What % of pulmonary embolisms originate from deep vein thromboses?

Answer 3

95%

Question 4

Describe the symptoms of large pulmonary emboli

Answer 4

Acute cor pulmonale, cardiogenic shock, death if >60% of pulmonary bed occluded

Question 5

What is a saddle embolus?

Answer 5

A large pulmonary embolus occluding the pulmonary trunk

Question 6

What is cor pulmonale?

Answer 6

Abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels

Question 7

Describe the consequences of small pulmonary emboli

Answer 7

Peripheral wedge infarctions. Repeated small pulmonary emboli may cause pulmonary hypertension

Question 8

State at least three non-thrombotic emboli

Answer 8

Bone marrow, amniotic fluid, tumour, air, foreign body

Question 9

What is pulmonary hypertension?

Answer 9

Mean pulmonary arterial pressure >25mmHg at rest

Question 10

Describe the aetiology of class 1 pulmonary hypertension

Answer 10

Primary pulmonary arterial hypertension - idiopathic, hereditary, drugs, congenital heart disease

Question 11

Which group is primary pulmonary arterial hypertension most common in?

Answer 11

Women aged 20-40

Question 12

Describe the aetiology of class 2 pulmonary hypertension

Answer 12

Pulmonary hypertension associated with left heart disease (systolic dysfunction, diastolic dysfunction, valve disease)

Question 13

Describe the aetiology of class 3 pulmonary hypertension

Answer 13

Pulmonary hypertension due to lung disease

Question 14

Describe the aetiology of class 4 pulmonary hypertension

Answer 14

Chronic thrombotic pulmonary hypertension

Question 15

Describe the aetiology of class 5 pulmonary hypertension

Answer 15

Unclear multifactorial mechanisms, e.g. metabolic disorders, systemic disorders, haematological disorders

Question 16

State the main complication of pulmonary hypertension and its consequences

Answer 16

Right heart failure, leading to venous organ congestion including nutmeg liver, and peripheral oedema

Question 17

Describe the histology of pulmonary oedema

Answer 17

Intra-alveolar fluid, iron laden macrophages (heart failure cells)

Question 18

Describe the histology of acute respiratory distress syndrome

Answer 18

Expanded lungs, firm, plum-coloured, airless

Question 19

What is hyaline membrane disease?

Answer 19

Diffuse alveolar damage in neonates, often due to insufficiency surfactant production in preterm babies