Pathology of Lung Infections Flashcards
1
Q
neutrophils are characteristic of what kind of inflammation
A
- acute inflammation
2
Q
neutrophils respond to what infection
where are the neutrophils located?
A
- bacterial
- in alveoli
3
Q
lymphocytes are characteristic of what kind of inflammation
A
- chronic inflammation
4
Q
lymphocytes respond to what infection
where are the lymphocytes located?
A
- viruses
- in septae
5
Q
granulomatous inflammation is in response to what
A
- fungi
- mycobacteria
6
Q
what is a characteristic cell seen in granulomata in mycobacterial pneumonia
A
- langhans giant cells
7
Q
bronchopneumonia pattern
A
- scattered foci of consolidation in either a single lobe or multiple lobes
8
Q
in which patients do we normally see bronchopnuemonia
A
- terminally ill patients
9
Q
what is lobar pneumonia
A
- complete consolidation of a lobe
10
Q
usual etiologic agent of lobar pneumonia
A
- strep pneumo
11
Q
pneumococcal pneumonia is caused by
A
- strep pneumo
12
Q
composition of strep pneumo
A
- encapsulated
- gram +
- diplococci
13
Q
strep pneumo infections are often preceded by
A
- viral infection that alters bronchial secretions
14
Q
what pneumococcal pneumonia looks like on days 3-4
A
- intra-alveolar accumulation of neutrophils and erythrocytes
- red hepatization
15
Q
which pneumococcal pneumonia looks like on days 5-7
A
- serum and fibrinous exudates
- macrophages
- gray hepatization
16
Q
anaerobic bacteria are normal inhabitants of
A
- oral cavity
17
Q
how people get anaerobic bacterial infections
A
- aspiration
18
Q
result of actinomycetes infection
A
- abscesses with colonies of organisms
- sulfur granules
19
Q
result of nocardia infections
A
- abscesses, often in immunocompromised
20
Q
how do we distinguish infections from actinomyces and nocardia
A
- use an AFB stain
21
Q
common predisposing factor for complications of bacterial pneumonias
A
- alcoholism
22
Q
what a pyoxthorax/empyemia
A
- infection of pleural fluid
23
Q
in which stage of TB do you see the granulomatous host response and Ghon complex
A
- primary TB
24
Q
what is a Gohn complex
A
- Gohn focus + infected lymph node
25
what a Gohn focus
- granulomatous inflammation near fissure
26
what is miliary spread of TB
- TB organisms that disseminate hematogenously
27
why do we get hemoptysis with TB infection
- inflame response erodes into pulmonary artery
28
people most at risk for fungal pneumonia
- immunocompromised patients
29
host response for histoplasma fungal pneumonia
- granulomatous host response
30
detection of fungal pneumonia in tissue sections
- silver stains
31
where in the US do we find histoplasma
- Mississippi and Ohio river valleys
| - bird droppings
32
where in the US do we find coccidiodes immitis
- southwestern US
| - San Joaquin valley
33
where in the US do we find cryptococcus infections
- pigeon droppings
34
where in the US do we find blastomycyes dermatidiis
- mississippi, Ohio, and Missouri River basins
35
histoplasmosis is indistinguishable from ______ without
- TB
| - silver stains or culture
36
3 diseases caused by aspergilla
- invasive aspergillosis
- aspergilloma (fungus ball)
- allergic bronchopulmonary aspergillosis
37
what happens in invasive aspergillosis
- organisms invade blood vessels
38
where does an aspergilloma grow
- within a preexisting cavity
39
blood test results in a patient with allergic bronchopulmonary aspergillosis
- eosinophils of blood and sputum
| - increased serum IgE
40
what is useful for diagnosis in pneumocystis pneumonia
- broncho-alveolar lavage
41
what do you see histologically in pneumocystis pneumonia
- frothy exudation within alveolar spaces
42
what does CMV viral infection look like histologically
- Owl Eye bodies
| - large cells with large intranuclear inclusions
43
3 M's of herpes virus on histological stain
- multi-nucleation
- margination
- molding
44
Bacterial pneumonia patterns
(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
Most bacteria are normal inhabitants of the
nasopharynx and oropharynx
46
Bacteria reach the alveoli by
- aspiration/inhalation
- hematogenous seeding
- direct spread from adjacent site
47
does s. penumo have a capsule?
yes
encapsulated gram + diplococci
48
pneumococcal pneumonia often preceded by
viral infection
49
Pathology of pneumococcal pneumonia
Early (3-4 days) = red hepatization
-neutrophils come in
Later (5-7 days) = gray hepatization
-macrophages come in
50
anaerobic bacteria often cause
necrosis +/- abscesses
foul-smelling sputum
51
which bacteria RARELY cause pneumonia
filamentous bacteria
ex: actinomyces israelii & nocardia asteroides
52
difference between actinomyces and nocardia
actinomyces: AFB stain - (not acid fast)
nocardia: AFB stain + (acid fast)
53
Major pre-disposing factor for abscesses (complication of bacterial pneumonia)
alcoholism (because they have abundant anaerobic oral bacteria)
54
Complications of bacterial pneumonia
```
A = abscesses
B = bacteremia
P = pyothorax/empyema
```
55
Mycoplasma infection can result in
acute pneumonia
| tracheo-bronchitis
56
mycobacterium tuberculosis (TB) radiology
gohn complex, multiple nodules, cavitites
57
mycobacterium tuberculosis (TB) pathology
small, acid-fast AFB
- slow growing (3-6 weeks to culture)
- AFB stains for detection in tissue sections
58
Primary Tuberculosis - type of inflammatory response
Granulomatous host response
59
When does ghon complex form
Primary Tuberculosis
60
Symptoms of Primary Tuberculosis
90% asymptomatic (granulomas confide the organisms)
61
Secondary Tuberculosis
New infection in a "previously" sensitized patient, or
| "reactivation" of primary tuberculosis (from decreased immune resposne)
62
Granulomas in Secondary Tuberculosis
in apical/posterior upper lobes
63
Complications of Tuberculosis
- Miliary TB
- Hemoptysis
- Broncho-plural fistula
- Cavity --> home for future aspergilloma
64
Fungal pneumonia host response
Granulomatous host response
