Pathology of pneumonia

Question 1

What are the layers of the trachea?

Answer 1

Lumen 
Mucosa 
Sub mucosa 
Fibrocartilage 
Adventitia

Question 2

what are the layers of the bronchioles?

Answer 2

mucosa, submucosa, adventitia

Question 3

What kind of epithelium lines the bronchioles?

Answer 3

ciliated epithelial cells and clara cells

Question 4

what are the roles of type 1 and type 2 pneumocytes

Answer 4

1: gas exchange
2: surfactant production

Question 5

What are type 1 pneumocytes made of?

Answer 5

squamous epithelial cells

Question 6

What are the 3 main components of acute inflammation?

Answer 6

vascular dilation
endothelial activation
neutrophil activation

Question 7

How is bacteria normally cleared from the airways?

Answer 7

Nasal clearance 
Trachobronchial clearance (muco-ciliary action) 
Alveolar clearance (alveolar macrophages)

Question 8

What is bronchopneumonia and when does it usually occur?

Answer 8

Patchy consolidation of the lunch which is an extension of a preexisting bronchitis
It is most common at the extremes of life

Question 9

What is lobar pneumonia and what usually causes it?

Answer 9

Acute infection of an entire lobe usually due to a virulent organism

Question 10

what are the four morphological changes in lobar pneumonia?

Answer 10

Congestion
red hepatisation
grey hepatisation
resolution

Question 11

what cases red hepatisation in lobar pneumonia?

Answer 11

Neutrohils and inflammatory exudate
coagulation of fibrinogen
leaky nature of capillaries

Question 12

what causes grey hepatisation in lobar pneumonia?

Answer 12

the vascular response decreasing

Question 13

what will you see in the congestion phase of lobar pneumonia?

Answer 13

Enlarged lobe, heavy, capillaries dilated with blood, air spaces filled with pale fluid, scattered red blood cells, occasional bacteria

Question 14

What will you see in red hepatisation of lobar pneumonia?

Answer 14

cut surface is dry and red, resembles the liver, increased number of neutrophils, fluid contained fibrinogen clotted in the alveolar spaces, bacteria more numerous

Question 15

What will you see in grey resolution of lobar pneumonia?

Answer 15

the grey colour will start at the hilum and move out, migration of the large numbers of neutrophils, decrease in capillary congestion, decrease in blood flow through the unventilated lobe

Question 16

what will you see in resolution of lobar pneumonia?

Answer 16

Liquefication of previously solid exudate, fibrinolytic enzymes, apoptosis of neutrophils, fluid contents removed

Question 17

What are possible complications of bronchopneumonia?

Answer 17

healing by fibrosis

abscess formation

Question 18

What are possible complications of lobar pneumonia

Answer 18

pleuritis 
Empyema 
abscess formation 
hematogenous seeding 
death

Question 19

What is pleuritis

Answer 19

Occurs when inflammation extends into the pleura giving rise to typical pleuritic pain

Question 20

What is empyema

Answer 20

A collection of pus in the pleural cavity

Question 21

What are the symptoms and signs of bacterial pneumonia?

Answer 21

fever 
Leukocytosis 
Cough 
Sputum 
Pleuritic chest pain 
increased respiratory rate 
cyanosis