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Respiratory Exam 2 > Pathology of Lung Infections > Flashcards

Pathology of Lung Infections Flashcards

1
Q

neutrophils are characteristic of what kind of inflammation

A
  • acute inflammation
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2
Q

neutrophils respond to what infection

where are the neutrophils located?

A
  • bacterial

- in alveoli

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3
Q

lymphocytes are characteristic of what kind of inflammation

A
  • chronic inflammation
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4
Q

lymphocytes respond to what infection

where are the lymphocytes located?

A
  • viruses

- in septae

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5
Q

granulomatous inflammation is in response to what

A
  • fungi

- mycobacteria

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6
Q

what is a characteristic cell seen in granulomata in mycobacterial pneumonia

A
  • langhans giant cells
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7
Q

bronchopneumonia pattern

A
  • scattered foci of consolidation in either a single lobe or multiple lobes
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8
Q

in which patients do we normally see bronchopnuemonia

A
  • terminally ill patients
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9
Q

what is lobar pneumonia

A
  • complete consolidation of a lobe
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10
Q

usual etiologic agent of lobar pneumonia

A
  • strep pneumo
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11
Q

pneumococcal pneumonia is caused by

A
  • strep pneumo
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12
Q

composition of strep pneumo

A
  • encapsulated
  • gram +
  • diplococci
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13
Q

strep pneumo infections are often preceded by

A
  • viral infection that alters bronchial secretions
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14
Q

what pneumococcal pneumonia looks like on days 3-4

A
  • intra-alveolar accumulation of neutrophils and erythrocytes
  • red hepatization
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15
Q

which pneumococcal pneumonia looks like on days 5-7

A
  • serum and fibrinous exudates
  • macrophages
  • gray hepatization
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16
Q

anaerobic bacteria are normal inhabitants of

A
  • oral cavity
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17
Q

how people get anaerobic bacterial infections

A
  • aspiration
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18
Q

result of actinomycetes infection

A
  • abscesses with colonies of organisms

- sulfur granules

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19
Q

result of nocardia infections

A
  • abscesses, often in immunocompromised
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20
Q

how do we distinguish infections from actinomyces and nocardia

A
  • use an AFB stain
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21
Q

common predisposing factor for complications of bacterial pneumonias

A
  • alcoholism
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22
Q

what a pyoxthorax/empyemia

A
  • infection of pleural fluid
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23
Q

in which stage of TB do you see the granulomatous host response and Ghon complex

A
  • primary TB
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24
Q

what is a Gohn complex

A
  • Gohn focus + infected lymph node
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25
Q

what a Gohn focus

A
  • granulomatous inflammation near fissure
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26
Q

what is miliary spread of TB

A
  • TB organisms that disseminate hematogenously
27
Q

why do we get hemoptysis with TB infection

A
  • inflame response erodes into pulmonary artery
28
Q

people most at risk for fungal pneumonia

A
  • immunocompromised patients
29
Q

host response for histoplasma fungal pneumonia

A
  • granulomatous host response
30
Q

detection of fungal pneumonia in tissue sections

A
  • silver stains
31
Q

where in the US do we find histoplasma

A
  • Mississippi and Ohio river valleys

- bird droppings

32
Q

where in the US do we find coccidiodes immitis

A
  • southwestern US

- San Joaquin valley

33
Q

where in the US do we find cryptococcus infections

A
  • pigeon droppings
34
Q

where in the US do we find blastomycyes dermatidiis

A
  • mississippi, Ohio, and Missouri River basins
35
Q

histoplasmosis is indistinguishable from ______ without

A
  • TB

- silver stains or culture

36
Q

3 diseases caused by aspergilla

A
  • invasive aspergillosis
  • aspergilloma (fungus ball)
  • allergic bronchopulmonary aspergillosis
37
Q

what happens in invasive aspergillosis

A
  • organisms invade blood vessels
38
Q

where does an aspergilloma grow

A
  • within a preexisting cavity
39
Q

blood test results in a patient with allergic bronchopulmonary aspergillosis

A
  • eosinophils of blood and sputum

- increased serum IgE

40
Q

what is useful for diagnosis in pneumocystis pneumonia

A
  • broncho-alveolar lavage
41
Q

what do you see histologically in pneumocystis pneumonia

A
  • frothy exudation within alveolar spaces
42
Q

what does CMV viral infection look like histologically

A
  • Owl Eye bodies

- large cells with large intranuclear inclusions

43
Q

3 M’s of herpes virus on histological stain

A
  • multi-nucleation
  • margination
  • molding
44
Q

Bacterial pneumonia patterns

A

(1) bronchopneumonia - patchy (focal) areas of consolidation
- virtually any bacteria capable of producing this pattern

(2) lobar pneumonia - complete consolidation of lobe
- usually s. pneumoniae

45
Q

Most bacteria are normal inhabitants of the

A

nasopharynx and oropharynx

46
Q

Bacteria reach the alveoli by

A
  • aspiration/inhalation
  • hematogenous seeding
  • direct spread from adjacent site
47
Q

does s. penumo have a capsule?

A

yes

encapsulated gram + diplococci

48
Q

pneumococcal pneumonia often preceded by

A

viral infection

49
Q

Pathology of pneumococcal pneumonia

A

Early (3-4 days) = red hepatization
-neutrophils come in

Later (5-7 days) = gray hepatization
-macrophages come in

50
Q

anaerobic bacteria often cause

A

necrosis +/- abscesses

foul-smelling sputum

51
Q

which bacteria RARELY cause pneumonia

A

filamentous bacteria

ex: actinomyces israelii & nocardia asteroides

52
Q

difference between actinomyces and nocardia

A

actinomyces: AFB stain - (not acid fast)
nocardia: AFB stain + (acid fast)

53
Q

Major pre-disposing factor for abscesses (complication of bacterial pneumonia)

A

alcoholism (because they have abundant anaerobic oral bacteria)

54
Q

Complications of bacterial pneumonia

A 
A = abscesses
B = bacteremia
P = pyothorax/empyema
55
Q

Mycoplasma infection can result in

A

acute pneumonia

tracheo-bronchitis

56
Q

mycobacterium tuberculosis (TB) radiology

A

gohn complex, multiple nodules, cavitites

57
Q

mycobacterium tuberculosis (TB) pathology

A

small, acid-fast AFB

  • slow growing (3-6 weeks to culture)
  • AFB stains for detection in tissue sections
58
Q

Primary Tuberculosis - type of inflammatory response

A

Granulomatous host response

59
Q

When does ghon complex form

A

Primary Tuberculosis

60
Q

Symptoms of Primary Tuberculosis

A

90% asymptomatic (granulomas confide the organisms)

61
Q

Secondary Tuberculosis

A

New infection in a “previously” sensitized patient, or

“reactivation” of primary tuberculosis (from decreased immune resposne)

62
Q

Granulomas in Secondary Tuberculosis

A

in apical/posterior upper lobes

63
Q

Complications of Tuberculosis

A
  • Miliary TB
  • Hemoptysis
  • Broncho-plural fistula
  • Cavity –> home for future aspergilloma
64
Q

Fungal pneumonia host response

A

Granulomatous host response

Respiratory Exam 2 (18 decks)

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