Pneumonia and Pulmonary TB Flashcards
Patchy exudativeconsolidation of the lung parenchyma
Bronchopneumonia
Stages of pneumonia
Congestion
Red Hepatziation
Grey hepatization
Resolution
Gross: lung is heavy, boggy and red
Microscopy: vascular engorgemnt, inta alveolar fluid with a few neutrophils, usually presence of numerous bacteria
Congestion
Gross: lung mimics liver consistency because of consolidation
Microscopy: Congested septal capillaries and extensive neutrophilic and RBC exudation
Red hepatization
Attempt at repair of damaged lung tissue
Gross: gray brown appearance (doesnt look as reddish as the previous stage)
Microscopy: RBCs disintegrate, fibrinosuppurative exudation persists. Increased deposit of fibrin -> becomes paler . Exudation through pore of khon
Grey hepatization
Microscopy: granular semi-fluid debris -> (1) resorbed and ingestd by macrophages (2) expectorated, or more often (3) organized by fibroblasts growing in it
Resolution
Common Isolated bacteria in children
Hemophilus B.
Common isolated bacteria in adults
Streptococcus pneumoniae
Common isolated bacteria in COPD
Streptococcus, Moraxella catarrhalis
Common isolated bacteria in alcoholics
Klebsiella
Common isolated bacteria in Elderly
Streptococcus, Legionella
Inflammation breaks through the pleural surface and fills the thoracic cavity with pus
Empyema thoracis
Clinically used to detrmine whether the fluid is an exudate and not a transudate
Light’s Criteria
Light’s criteria
Effusion protein/serum protein ration >0.5
Effusion LDH/ serum LDH ration >0.6
Effusion LDH >2/3 of the reference range for LDH
Etiologic agents that can give rise to pulmonary abscess
S. aureus, klebsiella, G(-) organisms), anaerobes
Interstitium is widened with mononuclear cells present
Interstitial pneumonitis
Comon viral agents causing intestitial pneumonia
RSV, adenovirus, rhinovirus, Rubella, Varicella, CMV, MEasles
Cytopathic effects caused by RSV
Formation of multinucleated syncitial cells; sheath form; mask of cells coalesce share the same cell membrane
cytopathic effects caused by CMV
huge cell with large nucleus, para-nuclear clearing (halo), and abnormal inclusions located intranuclear and intrcytoplasmic, or structural changes. Owl’s eye appearance
cytopathic effects of measles
multinucleate giant cells with eosinophilic nuclear and cytoplasmic inclusion bodies (Warthin finkeldey cells)
Bacterial agent that can present as interstitial pneumonia
Mycoplasma pneumoniae
Chlamydia trachomatis
Coxiella burnetti
Mycoplasma tuberculosis
Mucor characteristics that differentiate it from Aspergillus
Aseptate hyphae
non-acute branching
thick hyphal elements
Most common cause of fungal pneumonia
Aspergillus
cysts with small circles inside
Histoplasma capsulatum
Broad based after budding compared to candida which has a construction
Blastomyces dermatitidis
Sunny side up na egg; in brain; gelatinous due to capsule; in lungs mass or pneumonia
cryptococcus
Parenchymal foci/ ghon foci + hilar lymphadenopathy
Ghon complex
- seen in primary TB
- located at the peribronchial lymph node
Seen in healed TB, comprised of ghon lesion: calcified parenchymal tuberculoma and ipsilateral calcified hilar node
Ranthke
Glod standard for diagnosis of TB
culture and isolation
Improtant histologic features of a TB granuloma
Casseation necrosis, epitheloid histiocytyes and langhan’s giant cell
Focus of chronic inflammation consisting of microscopic aggregate of macrophages that are transformed into epithelium lke cells
