Pathoma TidBits Flashcards
Profuse epistaxis in a teen boy should make me think of…
Angiofibroma
Nasal polyps are associated with which two conditions?
CF, aspirin-induced asthma
What virus is associated with nasopharyngeal carcinoma? Biopsy?
EBV, pleomorphic keratin pos epithelial cells, background of lymphocytes
Cause of laryngeal papilloma? # in kids vs adults?
HPV 6 and 11; single in adults. Multiple in kids.
Risk factors for laryngeal carcinoma?
Squamous cell; alcohol and tobacco
Four phases of lobar pneumonia?
Congestion; red hepatization (exudate, neutrophils, and hemorrhage into alveolar spaces); gray hepatization (RBC breakdown); resolution
What are the two most common causes of lobar pneumonia?
Strep pneumo, klebsiella (can have currant jelly sputum, can be complicated by an abscess)
What are 5 causes of bronchopneumonia? Which are seen post-influenza? In COPD?
Staph (most common secondary), H flu (secondary and COPD), Pseudomonas, Moraxella (COPD), legionella (water source, seen on silver stain since its intracellular)
What are important features of Mycoplasma pneumo?
Autoimmune hemolytic anemia (cold agglutinin), erythema multiforme, not visible on gram stain
How does coxiella differ from other rickettsial diseases?
Causes pneumonia, no skin rash, no vector
How does primary TB present?
Lower lobe caseating necrosis with hilar lymph node fibrosis/calcification
Whats the pathophys of chronic bronchitis? Presentation?
Hypertrophy of mucinous glands (Reid index > 50%); blue bloaters inc PaCO2 and low PaO2, productive cough, risk of infection and cor pulmonale
Whats the pathophys of emphysema?
Destruction of alveolar air sacs from imbalance of proteases and antiproteases
What area of the lung is fibrotic? What causes fibrosis? Where does the fibrosis start? End stage description?
Cyclical lung injury; TGF-Beta;
Starts in subpleural patches, honeycomb
What pneumoconiosis causes diffuse fibrosis? What career? Whats the feature of mild exposure?
Carbon dust; coal miners
Anthracosis: carbon laden macrophagrs
Which pneumoconiosis presents with fibrotic nodules in upper lobes? Profession? Important feature?
Silicosis, seen in sandblasters and silica miners; impairs phagolysosome formation by macrophages causing inc risk of TB
Which pneumoconiosis causes noncaseating granulomas in the lung, hilar lymph nodes? What does it inc the risk of?
Beryllium in miners and aerospace; inc risk of lung cancer
What pneumoconiosis presents with fibrosis of lung and pleura? Which professions? What does it inc the risk of? Biopsy?
Asbestosis; construction workers, plumbers, and shipyard workers; inc risk of lung carcinoma and mesothelioma; asbestos bodies
What are the characteristic biopsy findings?
Asteroid bodies and noncaeating granulomas
What are the clinical features of sarcoidosis?
Elevated ACE, hypercalcemia (1-alpha hydroxylase activity activates vit D)
What are the characteristics of pHTN? Cause of primary?
Atherosclerosis of the pulm trunk; smooth muscle hypertrophy, and plexiform lesions (capillary tufts); BMPR2 inactivation causing smooth muscle proliferation
Whats the hallmark of ARDS? Which cells are damaged?
Leakage of protein rich fluid causing hyaline membranes; type I and II
How is lung maturity screened?
Phosphatidylcholine (lecithin: major component of surfactant) : sphingomyelin ratio > 2
What is a calcified bronchial mass on imaging? Composition?
Hamartoma; cartilage and lung tissue
