Pathology Flashcards
What are the four stages of pneumococcal pneumonia (Strep. pneumoniae)
1) Engorgement 4-12 hrs. Serous exudate pours into the alveoli from leaky blood vessels
2) Red Hepatization: next 48 hrs the lungs assume a red liver-like appearance, as RBC, fibrin, and PMNs fill the aveoli
3) Gray Hepatization: Days 3-8, lungs become grayish as WBC and fibrin consolidate in the alveoli
4) Resolution: Days 7-11 the exudate is lysed and reabsorbed by macrophages, restoring the tissue.
One of the complications of pneumonia is abscess formation. What organisms cause abscess formation in the lungs?
Staphlococcus causes abscesses in the lungs which destroy parenchyma and suppuration. When pus gets into the bronchi it can cause bronchiectasis (dilated bronchi)
Another complication is chronic lung disease
Compare and contrast interstitial vs alveolar pneumonia
Alveolar pneumonia is characterized by intra-alveolar inflammation, either as bronchopneumonia (groups or single alveoli are effected in various lobes; patchy), or lobar pneumonia (entire terminal bronchioles and alveolar sacs are effected within one lobe); white out on CXR. Focal or diffuse. Usually bacterial infection in someone who already has pulmonary edema or CHF.
Interstitial pneumonia primarily involves the alveolar septum, which is thickened. (Microscopically the leukocytes are contained in septum). Diffuse and bilateral. Usually viral in nature
How do you distinguish between an eympiema and a pyothorax
Pyothorax pus fills the entire pleural cavity, or its encapsulated by fibrous tissue into pockets called empyema (more common)
Both are complications of pneumonia-pleuritis: inflammation in pleural space that leads to effusion.
Compare the sputum of Strep. pneumo and Klebsiella pneumonia
Strep. pneumo-rusty sputum
Kleb. pneumo: current jelly sputum
What’s the most common route of pneumonia?
air droplets. Typical way viruses and TB are spread. Then aspiration of infected secretions from URT, aspiration of infected particle in gastric contents (ETOH, neuro defect, or unconscious), hematogenous spread.
Describe the gross and microscopic findings of histoplasma capsulatum
This fungal infection can lead to a systemic granulomatous infection in the immunosuppressed (AIDS)
Soil contaminated with bat droppings
Inhailed spores (microconidia) engulfed by MO develop into yeast forms inside the lungs. surrounded by clear halo best identified by silver stains.
Inside MO the yeast buds Spread widely throughout the body to the liver and spleen especially
Cryptococcus has what major virulence factor?
polysaccaride capsule; ID india ink. pigeon droppings
Cool red stain
how does Coccidioidomycosis cause disease in the lung and can you ID it histologically?
Necrotizing infection similar to TB; called valley fever. Inhaled Arthrospores enter the lungs and form spherules filled with endospores. Upon rupture these endospores are released and form new spherules. These can spread by blood or direct extension, forming caseating granulomas much like TB, all over the body.
What is pneumocystis jiroveci?
Fungal infection of the immunocompromised. Transmission by inhalation pneumonia in AIDS patients; leading cause of death.
Boat shaped cyst in alveoli (silver stain), induces inflammation, frothy eosinophilic edema that blocks gas exchange.
Bilateral rales and rhonchi, diffuse interstitial pneumonia. Isolated in lungs
Kawasaki disease is also know as what?
Mucocutaneous LN syndrome
What’s an endardectomy?
Surgical removal of plaque. Presented to us as claudication of peripheral leg during exercise followed by endardectomy.
What’s the progression of a plaque from formation to rupture?
Fatty streak, 3D atheroma with fibrous cap and soft fatty core (impinges the lumen), plaque rupture
If you have atherosclerosis of the aorta what’s likely to happen?
Increase bp, AAA, or dissecting aneurysm
Major risk factors for atherosclerosis?
Diabetes- damage small vessels toes, fingers, esp. kidneys!
Htn
Familial Htn- B100, or LDLR
Smoking
