Pathology Flashcards
what is lobar pneumonia and what is it most often caused by
Confluent consolation involving a complete lung lobe
Streptococcus pneumonia
what is the classical acute inflammatory response
exudation of fibrin rich fluid
neutrophil infiltration
macrophage infiltration
resolution
what is bronchopneumonia and when does it most often occur
Infection starting in airways and spreading to adjacent alveolar lung.
In the context of pre-existing disease (i.e. often seen in hospitals)
what is a lung abscess and when is it often seen
Localise collection of pus
After aspiration for pneumonia
what is the pathology of bronchiectasis
Abnormal fixed dilatation of the bronchi usually due to fibrous scarring following infection
what is TB
a type IV hypersensitivity
what does t-cell response cause
granulomatous inflammation, tissue necrosis and scarring
hypersensitivity (type IV)
what is primary TB pathway
1 - inhaled organism phagocytosed and carries to hilar lymph nodes
2 - immune activation
3 - granulomatous response in nodes
what is secondary TB
reinfection or reactivation of disease in a person with some immunity
disease tends initially to remain localised, often in apices of lung
what are the primary tissue changes in TB
Small focus (Ghon focus) in periphery of mid zone of lung Large hilar nodes (granulomatous)
what are the secondary tissue changes in TB
Fibrosing and cavitating apical lesion
why does disease reactivate
Decreased T-cell function
due to - age, HIV, immunosuppressive therapy
what is the early stage of ILD
alveolitis
what is the later stage of ILD
fibrosis
what are the clinical affects of ILD due to
hypoxia (resp failure) and cardiac failure
where is the pathology of idiopathic pulmonary fibrosis
subpleural and basal fibrosis
Terminal lung structure replaced by dilated spaces surrounded by fibrous wall (Honeycombing)
what is the early and late stage of IPF
early - fibrosing alveolitis
late - honeycombing
what are complications in fibrosing alveolitis
plural surface much thicker; resistant to inflation for breathing and gas transfer.
what are complications in honeycombing
difficult for gas exchanged, and for inflation.
what types of hypersensitivity is EAA
Type III hypersensitivity - antibody mediated
Type IV hypersensitivity - T cell chronic hypersensitivity reaction
what fibres of asbestos are curved and are they safe or dangerous
Serpentine
Safe
what fibres of asbestos are amphibole and are they safe or dangerous
Straight
dangerous
what is the pathogenesis of ARDS
1 - Injury - inflammatory cells, cytokines, oxygen free radicals, injury to cell membrane
2 - Fibrinous exudate lining alveolar walls
3 - Cellular regeneration
4 - Inflammation
what is Virchow’s triad
stasis of blood flow, endothelial injury, hyper-coagulability
what causes pulmonary infarct (ischaemic necrosis)
Bronchial artery supply compromised (e.g. cardiac failure)
who gets primary pulmonary hypertension
young women
what are causes of pulmonary hypertension
- Hypoxia (vascular constriction)
- Increased flow through pulmonary circulation (congenital heart disease)
- Blockage (PE) or loss (emphysema) of pulmonary vascular bed
- Back pressure from left sided heart failure
what is Cor Pulmonale
Pulmonary hypertension complicating lung disease
Right ventricular hypertrophy
Right ventricular dilatation
Right heart failure
what is the pleura
A mesothelial surface lining the lungs and mediastinum
what are mesothelial cells designed for
fluid absorption
what are two possible causes of pneumothorax
trauma
rupture of bulla
what is the cell type of mesothelioma
Mixed epithelial/mesenchymal differentiation
