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pathology Flashcards

1
Q

what is pneumonia?

A
  • infection involving the distal airspaces, usually with inflammatory exudation
  • fluid filled spaces lead to consolidation
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2
Q

what is community acquired pneumoina?

A

getting it by clinical setting

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3
Q

what organisms cause pneumonia?

A
  • mycoplasma

- pneumococcal

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4
Q

what morphology classes pneumonia?

A
  • lobar pneumonia

- bronchopneumonia

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5
Q

what is lobar pneumonia?

A
  • confluent consolidatio involving a compete lung lobe
  • casued by streptococcus pneumoniae
  • can be seen with other organisms eg klebsiella, legionella
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6
Q

who gets lobar pneumonia?

A
  • community acquired

- otherwise healthy young adults

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7
Q

what is the pathology of lobar pneumoina?

A
  • acute inflammatory response
  • exudation of fibrin-rich fluid
  • neutrophil infiltration
  • macrophage infiltration
  • resolution
  • antibodies lead to opsonisation and phagocytosis of bacteria
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8
Q

what are the complications of lobar pneumonia?

A
  • organisation (fibrous scarring)
  • abscess
  • bronchiectasis
  • empyema
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9
Q

what in bronchopneumonia?

A
  • infection starting in the airways and spreading to adjacent alveolar lung
  • most often seen in the context of pre-existing disease eg COPD, cardiac failure, complication of viral infection and aspiration of gastric contents
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10
Q

what organisms are involved in bronchopneumoina?

A
  • strep. pnuemoniae, haemophilus influenza, staphylococcus, anaerobes, coliforms
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11
Q

what organisms are seen in aspiration?

A
  • staph
  • anaerobes
  • coliforms
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12
Q

what are the complications of bronchopneumoina?

A
  • organisatoin
  • abscess
  • beonchiectasis
  • empyema
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13
Q

what is a lung abscess?

A
  • localised collection of pus
  • tumour-like
  • chronic malaise and fever
  • context = aspiration
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14
Q

what is bronchiectasis?

A
  • abnormal fixed dilation of the bronchi
  • usually due to fibrous scarring following infection eg pneumoina, TB, CF
  • also seen with chronic obstruction (tumour)
  • dilated airways accumulate purulent secretions
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15
Q

what is tuberculosis?

A
  • mycobacterial infection
  • chronic infection in many site eg lungs, gut, kidneys etc
  • pathology is charactersed by delayed type IV hypersensitivity (granulomas with necrosis)
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16
Q

what organisms are associated with TB?

A
  • M. tuberculosis/M. bovis
  • others cause atypical infections in immunocompromised hosts. pathogenicity due to ability to avoid phagocytosis and to stimulate a host T cell response
17
Q

what is immunity and hypersensitivity of TB?

A
  • T-cell response to organism enhances macrophage ability to kill mycobacteria - this ability constitutes immunity
  • T-cell response causes granulomatous inflammation, tissue necrosis and scarring, this is hypersensitivity type IV
  • commonly both processes occur together
18
Q

what is the pathology of primary TB?

A
  • first exposure and up to 5 years afterwards
  • inhaled organism phagocytosed and carried to hilar lymph nodes. immune activation leads to granulomatous response in nodes, usually with killing of organism
  • in a few cases infection is overwhelming and spreads
19
Q

what is the pathology of secondary TB?

A
  • reinfection or reactivation of disease in a person with some immunity
  • disease tends to initially remain localise as, often in apices of lung
  • can progress to spread by airways and/or bloodstream
20
Q

what tissue changes occur in primary TB?

A
  • small focus (ghon focus) in periohery of mid zone of lung

- large hilar nodes (granulomatous)

21
Q

what are the tissue changes in secondary TB?

A
  • fibrosing and cavitating apical lesion (cancer important differential diagnosis)
22
Q

why does disease reactivate?

A
  • decreased T-cell function due to age, coincident disease (HIV), immunosuppressive therapy (steroid, cancer chemotherapy)
  • reinfection at high dose or with more virulent organism
23
Q

what is the pulmonary interstitial?

A
  • thin-elastic rich connective component containing capillary blood vessels
  • alveolar lining calles (types 1&2)
24
Q

what is interstitial lung disease?

A
  • early stage = alveolitits
  • late stage = fibrosis
  • clinical effects due to hypoxia and cardiac fail
25
Q

what are the causes of interstitial lung diseases?

A
  • environmental eg minerals, drugs, radiation, postARDS

- idiopathic

26
Q

what biopsys can you carry out for interstitial lung disease?

A
  • transbronchial biopsy = special forceps used at bronchoscopy
  • thoracoscopic biospy = more invasive but more reliable and generates far more tissue
27
Q

what is idiopathic pulmonary fibrosis?

A
  • progressive interstitial fibrosis of unknown cause
  • variable associated inflammation
  • finger clubbing
28
Q

what is the pathology of idiopathic pulmonary fibrosis?

A
  • sub-pleural and basal fibrosis
  • inflammatory component variable
  • terminally lung structure replaced by dilated spaces surrounded by fibrous walls
  • as it progressises you get bigger white spaces and gas exchange gets worse and lungs cant expant because they have shrunk due to the fibrosis (honeycombing)
29
Q

what is extrinsic allergic alveolitis (hypersensitivity pneumonitis)?

A

chronic inflammatory disease = small airways, interstitium, occasional granulomas
allergic origin = type 3 hypersensitivity, type 4 hypersensitivity

30
Q

what are the causes of EAA?

A
  • thermophilic bacteria - farmers lung
  • avian proteins - bird fanciers lung
  • fungi - malt workers lung

precipitins (antibodies) can often be detected in the serum , unusual cases come to a biopsy

31
Q

what is sarcoidosis?

A
  • multi system granulomatous disorder of unknown cause
  • pulmonary involvement is common but it isnt a lung disease
  • most cases mild and self-limiting
32
Q

what are some manifestations of sarcoidosis?

A
  • uveitis
  • erythema nodosum
  • lymphadenopathy
  • hypercalcaemina
33
Q

what is pneumoconiosis?

A
  • lung disease caused by mineral dust exposure
  • asbestosis
  • coal workers lung
  • silicosis (silica)
34
Q

what is asbestos associate with?

A
  • parietal pleural plaques
  • interstitial fibrosis (asbestosis)
  • bronchial carcinoma
  • mesothelioma
  • straight (amphibole) asbestos highly dangerous

Resp (30 decks)

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