Pathology Review

Question 1

what type of cells make up the alveolus?

Answer 1

Type I pneumocytes

Question 2

functions of type II pneumocyte

Answer 2

produces surfactant and has role in proliferation

Question 3

examples of acute patterns of lung injury

Answer 3

• Inflammation (Neutrophils)
• Edema/Pleural Effusion
• Acute Lung Injury (ARDS/DAD)
• Pulmonary Hemorrhage (Infarct/Vasculitis)

Question 4

examples of chronic patterns of lung injury

Answer 4

• Inflammation (lymphocytes/macrophages)
• Fibrosis
• Emphysema

Question 5

pulmonary inflammation pattern - -acute

Answer 5

(polys)-infection (bacterial) also: infarct, abscess, DAD,any necrosis

Question 6

pulmonary inflammation pattern – chronic

Answer 6

(lymphs)-infection (viral or chronic) also: any chronic lung disease (non-specific)

Question 7

pulmonary inflammation pattern – granulomatous

Answer 7

• infection (TB or Fungal) also: sarcoid, Foreign Body, HP, Wegeners; takes a little while to develop (subacute or chronic); Macrophages/giant cells and lymphocytes
• Sarcoidosis has “naked”, bland granulomas -TB with CASEATING GRANULOMAS (necrosis) -Chronic or remote fungal granulomas calcify

Question 8

pulmonary inflammation pattern – Eosinophilic

Answer 8

–infection (parasitic) also: asthma, allergy, Eosinophilic Syndromes

Question 9

the two patterns of bacterial pneumonia

Answer 9

1. bronchopneumonia – spots
2. lobar pneumonia – whole lobe infected

Question 10

what is a pulmonary abcess and what causes it

Answer 10

a localized suppurative process -oral anaerobes (60%), Staph, Gram (-) -aspiration, septic embolus, traumatic

Question 11

definition of sarcoidosis and features of it

Answer 11

Multiorgan granulomatous disease of unknown etiology which frequently affects the lungs but also commonly involves lymph nodes, liver, spleen, skin, heart, eye and other organs

Granulomas of sarcoidosis are non-caseating, often well defined (bland or “naked”), and are not associated with acute inflammation, necrosis, foreign material or demonstrable infectious agents

Question 12

take a moment to look at this fungal pneumonia

Answer 12

Question 13

the branching fungi

Answer 13

• aspergillis
  
  • can cause atelectasis
  • can be seen in neutropenic patients
• mucor
  
  • looks like twisted ribbons

Question 14

how can we confirm tuberculosis on histology?

Answer 14

AFB (Acid-Fast) stains mycobacterium red; can see macrophages filled with the mycobaterium tuberculosis

Question 15

types of emphysema

Answer 15

centriacinar (centrilobular) – due to smoking; affects just respiratory bronchioles

panacinar (panlobular)– alpha-1-antitrypsin deficiency

both from protease-antiprotease imbalance

Question 16

types of pulmonary edema

Answer 16

1. Hemodynamic -increased hydrostatic pressure (heart failure) -decreased oncotic pressure (protein loss) -vascular permeability NOT increased
2. Microvascular (alveolar) Injury -increased vascular permeability due to injury -infection/sepsis, trauma, shock, drugs

Question 17

summarizes some Pulmonary Hemorrhage Syndromes we talked about

Answer 17

• Goodpasture Syndrome
• Wegener Granulomatosis
• Both involve lung and kidney (hemoptysis)
• Goodpasture-antibody against type IV collagen
• basement membrane damage (lung and kidney)
• Type II (antibody mediated) reaction
• Linear deposition of antibody along BM
• Most common cause of death is uremia (RF)
• Treat with plasmapheresis to remove antibody