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Wrap Up > Pathology - Lung > Flashcards

Pathology - Lung Flashcards

1
Q

Forms of acute bacterial pneumonias

A

Bronchopneumonia and lobar pneumonia

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2
Q

Brochoopneumonia

A

Patchy and involves more than one lobe

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3
Q

Lobar pneumonia

A

Part or all of a lobe filled with exudate that can be seen as lobar or segmental

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4
Q

What organism is responsible for 90% of lobar pneumonia

A

Streptococcus pneumoniae

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5
Q

Origin of most community acquired pnemoniae

A

Bacterial

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6
Q

Most common cause of community acquired pneumoniae

A

S. pneumoniae (lobar )

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7
Q

Four stages of lobar pneumonial evolvement in lobes

A

Congestion, Red hepatization, Gray hepatization, Resolution

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8
Q

Congestion Stage

A

Lobe is red, heavy,boggy,proteinous fluid, neutrophils and bacteria lasting for few days

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9
Q

Red hepatization

A

lung has liver-like consistency, alveolar spaces packed with neutrophils, red cells, fibrin

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10
Q

Gray hepatization

A

lung is dry, gray, firm due to RBCs lysing out

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11
Q

Resolution

A

enzymes digest exudate,debris eating by macrophages, fibroblasts growing around it

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12
Q

Empyema

A

is suppurative accumulate in the pleural cavity

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13
Q

Complication of pneumoniae occurs through

A

Type 3 serology

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14
Q

Gram positive lancet shaped diplococci is good evidence for

A

S. pneumoniae but be careful of false positive

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15
Q

Community acquired acute pneumoniae

A

S. pneumoniae, H. influenza, Moraxella catarrhalis, S. aureus, Legionella, Klebsiella and Pseudomonas

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16
Q

Community acquired atypical pneumoniae

A

Mycoplasma, Chlamydia, Coxiella, RSV, Parainfluenza, Influenza A and B, adenovirus

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17
Q

Nosocomial pneumoniae

A

G- rods - Klebsiella, Serratia, E. coli and Pseudomonas,S aureus

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18
Q

Aspiration pneumoniae

A

anaerobic oral flora - bacteroides, prevotella, fusobacterium, peptostreptococcus admixed with S. pneumoniae, S aureus, H. influenza, Pseudomonas. Caused mainly by aerobes

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19
Q

Chronic pneumoniae

A

Nocardia, Actinomyces, Granulomatous-Mycobacterium, Atypical Mycobacteria, Histoplasma, Coccidiodes, Blastomyces

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20
Q

Necrotizing pneumoniae and lung abscess

A

anaerobic bacteria, S aureus, Klebsiella, S. Pyogenes, Type 3 pneumococcus

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21
Q

Pneumonia in the immunocompromised

A

CMV, pneumocystis, Mycobacterium avian, invasive aspergillosis, invasive candidiasis,

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22
Q

Most common bacteria causing acute exacerbation in COPD

A

H. influenza, secondly M. catarrhali

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23
Q

3 most common causes of otitis media

A

S. pneumoniae, H. influenza, M. catarrhalis

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24
Q

IV drug use causing right sided endocarditis by which organism

A

S. aureus

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25
Q

Most common cause of G- bacteria pneumoniae, affecting alcoholics

A

Klebsiella

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26
Q

Rapid diagnosis of legionella

A

Antigen in urine or PCR

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27
Q

Atypical pneumonia means

A

means moderate amount of sputum produced, no consolidation, moderate WBC count, no exudates, inflammation in alveolar septa only

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28
Q

Most common atypical pneumoniae organisms

A

Mycoplasma pneumoniae occurring in closed communities

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29
Q

What type of Influenza causes most pandemic and epidemic

A

Type A by mutations of the hemagglutinin and neuraminidase

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30
Q

Epidemics of Influenza A due to

A

antigenic drift

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31
Q

Pandemics of Influenza A due to

A

antigenic shift. Recombination with other RNA viruses

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32
Q

what organism seen in Cystic Fibrosis, burn and neutropenic patients

A

Pseudomonas

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33
Q

What organism is secondary to viral respiratory infections

A

S. aureus

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34
Q

What organism is seen in organ transplants

A

Legionella

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35
Q

All lung abscess possess what kind of organism

A

Anaerobes - Fusobacterium, Bacteroides, Peptostreptococcus and microaerophilic streptococcus

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36
Q

What side of lung is aspirations more common on

A

Right side, at posterior segment of upper lobe and in the apical segments of the lower lobe

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37
Q

Most important organism in chronic pneumonias

A

TB - center undergoing caseous necrosis

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38
Q

Most important risk factor for developing TB

A

HIV infection

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39
Q

Infection

A

seeding of a tissue with an organism without any damage

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40
Q

Disease

A

Damage caused to a tissue by an organism

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41
Q

Positive tuberculin test signifies

A

cell mediated hypersensitivity

42
Q

Features of Tuberculosis

A

Caseating granulomas with cavitation due to destruction of tissue by host immune

43
Q

how long is primary pulmonary tuberculosis

A

0-3 weeks ( proliferation of TB in pulmonary macrophages) with mild flu and asymptomatic

44
Q

NRAMP I ( natural resistance assoc. macrophage protein I)

A

transmembrane ion transport found in lysosome and endosome to help with TB killing

45
Q

How long for cell mediated immunity to develop in TB

A

3 weeks after exposure

46
Q

What cytokines needed for macrophage/dendritic cells to get help

A

IL-12, CD4+ of the Th1 type( secretes IF-gamma)

47
Q

Role of CD4+ -Th1 subtype in TB control

A

Secretes IF-gamma needed to activate macrophage

48
Q

Role of Activated macrophage in TB control

A

secrete TNF ( recruit monocytes),express inducible NO synthase and ROS

49
Q

What are the total cytokines needed to effectively deal with TB

A

IL-12, IFN-gamma, TNF, NO production

50
Q

What primarily mediates immunity response to TB infection

A

TH1 cells to stimulate macrophages

51
Q

Ghon focus

A

gray white inflammatory consolidation after unsensitized person encounter first TB

52
Q

Ghon Complex

A

parenchymal lesion and nodal involvement of TB. TB traveling i the lymph to regional nodes

53
Q

Ranke complex

A

Progressive fibrosis and calcification of Ghon complex

54
Q

Progressive primary TB

A

seen in HIV+ people with CD count of <200

55
Q

Primary TB

A

TB that develops in a person previously unexposed and therefore unsensitized

56
Q

Secondary TB ( Reactivation TB)

A

pattern of disease seen in a previously sensitized person

57
Q

Location of secondary pulmonary TB

A

one or both upper lobes

58
Q

Does cavitation occur in primary or secondary TB infection and why?

A

Secondary because individual already sensitized and they quickly mount immune response to fibrocase the TB in that upper lobe

59
Q

Miliary pulmonary disease

A

TB drains through lymphaticsand gets into ride side of heart and into pulmonary arteries

60
Q

Most frequent form of extrapulmonary tuberculosis

A

lymphadenitis usually in the cervical region

61
Q

Hallmark of host reaction to TB in immunocompromised persons is

A

Granulomas presence

62
Q

Cavity lesion in lung apices means

A

secondary or reactivation

63
Q

Features of Mycobacterium avium

A

Disseminated non-tuberculous disease

64
Q

Epidemiology of Histoplasma

A

Ohio and Central Mississippi Rivers enriched by bats and birds small yeast

65
Q

Epidemiology of Coccidioides

A

Western US….San Joaquin Valley, thin walled, non budding spherules with endospores

66
Q

Epidemiology of Blastomyces

A

Overlaaping areas with histoplasmosis - broad-based budding, larger than Histo

67
Q

“Owl eye” -giant cell, within the nucleus an enlarged inclusion with a celar halo

A

Cytomegalovirus

68
Q

Cause of infectious mononucleosis type infection

A

CMV

69
Q

Most common opportunistic viral pathogen in AIDS

A

CMV, yet it spares the CNS system

70
Q

NAme of most opportunistic CMV

A

CMV retinitis

71
Q

Diagnosis of CMV

A

viral inclusions in tissue cultures

72
Q

What is Pneumocystis pneumoniae

A

fungus

73
Q

When AIDS person get Pneumocystis pneumoniae

A

CD4+ <200cells/uL

74
Q

Most sensitive test for diagnosing Pneumocystis pneumoniae

A

Identify organism in induced sputum

75
Q

Most common disease causing fungus

A

Candida albicans with pseudohyphae

76
Q

What players defend against Candida

A

TH17, CD4+

77
Q

Mutation on TH17

A

Job syndrome

78
Q

Most common fungal endocarditis

A

Candida

79
Q

Diagnosis of Crytococcus

A

Gelatinous capsule in a clear halo with India Ink

80
Q

Non-septate hyphae, at right angle causing Mucormycosis

A

Zygomycetes

81
Q

Septate branched at acute angles causing Mucormycosis

A

Aspergillus

82
Q

Wha molds invade blood vessels causing vascular necrosis

A

Aspergillus and Rhizopus and Mucor

83
Q

What mold invades diabetic patient

A

Mucor and Rhizopus

84
Q

CD4+ >200cell/uL in AIDS patient

A

Bacterial and TB infections

85
Q

CD4+<200cells/uL in AIDS patient

A

Pneumocystis pneumoniae

86
Q

CD4+<50cells/uL in AIDS patient

A

CMV and M. avium

87
Q

Animal reservoirs of cholera

A

Shellfish and plankton

88
Q

What causes disease by cholera

A

preformed enterotoxin interacting with ADP ribosylation factors and activate Gs opening the CFTR which releases Cl ion to the lumen

89
Q

Source of Campylobacter

A

improper cooked chicken, unpasturized milk,

90
Q

Organisms in self limited colitis

A

Campylobacter, Shigella, Salmonella, Yersenia, E. coli

91
Q

Low infective doses

A

Shigella, Salmonella and Campylobacter

92
Q

Site of Shigella in body

A

Left colon

93
Q

Triad of arthritis, urethritis and conjunctivitis( reactive artritis) - what organism

A

Shigella

94
Q

HUS organisms

A

Shigella and EHEC

95
Q

Sources of Salmonella

A

Raw meat, poultry, eggs and milk

96
Q

Rose spots

A

Salmonella

97
Q

What organisms go by M cells

A

Shigella, Salmonella

98
Q

Pseudomonas membrane

A

Clostridium difficle

99
Q

Most common cause of severe childhood diarrhea

A

Rotavirus

100
Q

Most common pathogenic parasitic in humans

A

Giardia

101
Q

Most common bacterial enteric pathogen in developed countries

A

Campylobacter

Wrap Up (11 decks)

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