Path of Infectious and non-infectious inflammatory disease Flashcards
What are the different types of Pneumonia?
Acute:Pyogenic with neutrophils in alveoli
Pneumonitis: not pyogenic “atypical”
Chronic: TB, Fungi, parasites, Odd bacteria(nocardia, actinomyces)
What factors predispose to Pneumonia?
Dec Cough Reflex? injury to mucocilliary escaltor Dec immunity of alveolar macrophages Pulm edema Accumulated secretions
What are the different pneumonia syndromes?
Community acquired Acute Community acquired Atypical Nosocomial Aspiration Chronic Pneumonias Necrotizing pneumonias and lung abcess Immunocompromized
What causes consolidation in pneumonia?
Alveoli filled with inflammatory exudate.
What are the different morphologies of pneumonia?
Broncho-pneumonia (more diffuse)
Lobar Pneumnia: dense in a single lobe (hear rales)
What is the gross appearance of Pneumonia?
Dispersed elevated 3-4cm lesions of palpable consolidation
Filled with neutrophils
What causes the majority of Lobar Pneumonia?
Strep Pneumo
What are the classic stages of Pneumonia?
Congestion
Red Hepatization
Gray Hepatization
Resolution
What are the compications of Bacterial Pneumonia?
Abcess Empyema Org of exudate with fibrosis Bacteremic dissemination to Heart valves, brain, etc Pleuritis Pleural Effusion Bronchopleural fistula
What is Community Acquired Atypical Pneumonia?
Lack of alveolar exudate Inc WBCs Acute febrile respiratory disease Largely confined to alveolar septa and interstitium Mycoplasma Chlamidia
What is the common presentation of 1^ atypical Pneumonia?
Like common cold or LRI with lots of nasal discharge and pharyngitis Sputum changes to green or yellow Spontaneous res(or with erythromycin)
What are the immune mediators that cause sarcoidosis?
CD4+ Th1 cells
Increased cytokines IL-2 and IFN-gamma
Inc IL-8 and TNF lead to recruitment of addl T cells and monocytes which leads to Granulomas
What is seen in granulomas in Sarcoidosis?
Schaumann Bodies: Lamellated calcified structures with giant cells.
Asteroid bodies: Star shaped eosinophilic bodies made of compressed intermediate filaments
What is Acute vs Chronic Hypersensitivity Pneumonitis?
Acute: Large exposure to antigen => severe dyspnea, cough, high fever and chills
Chronic: Prolonged exposure to small amounts of antigen => dyspnea, cough and fatigue, resp failure
What are the most common types of Hypersensitivity Pneumonitis?
Farmer’s Lung: thermophilic actinomyces in hay
Pigeon Breeder’s lung
Humidifier of AC lung
