Pulm- pathoma Flashcards
Kid with nasal polyps. Diagnosis?
cystic fibrosis
Adult with nasal polyps. Diagnosis?
aspirin intolerant asthma
Pathophysiology of aspirin intolerant asthma?
Aspirin -> inhibition of COX pathaway
Some people are sensitive to this aspirin action, leading to OVERSTIMULATION OF LEUKOTRIENES
-> bronchoconstriction
- Goljan: ASA induced asthma is NOT hypersensitivity reaction!! It is due to chemical effect of ASA
Angiofibroma in nasal mucosa
- what population is most commonly affected?
- clinical presentation?
- adolescent males
- massive epitaxis
nasopharyngeal carcinoma
- What infection?
- most commonly affected populations (2)
- histologic finding
- EBV
- Chinese adults and African children
- pleomorphic keratin positive epithelial cells
Laryngeal papilloma
- What infection?
- different presentations: kids vs. adults
- HPV-6 and HPV-11
kids: multiple papillomas
adults; single papilloma
What are 4 types of pneumonia
- lobar
- bronchopneumonia
- interstitial (atypical)
- aspiration
What two infections are associated with lobar pneumonia?
Strep. pneumo
Klebsiella
- For lobar pneumonia, only think about these two bugs
Strep. pneumoniae: what is this bug special?
most common community acquired pneumonia
Klebsiella: what is this bug special?
abscess: air fluid level lesion on chest x-ray
current jelly sputum
nocosomial pneumonia
S.Aureus: what is this bug special regarding pneumonia?
most common secondary pneumonia (superimposed infection with previous URI)
lung abscess
Cystic fibrosis: what type of pneumonia? what bug?
pseudomona
bronchopneumonia (not lobar)
Name 5 bugs that cause atypical pneumonia
- mycoplasma
- chlamydia
- coxiella
- RSV
- CMV
RSV: what is this bug special?
most common atypical in neonates
CMV: what is this bug special regarding pneumonia?
transplant patients
Coxiella burnetii
- potential buzzwords regarding occupation?
- infection route?
- special presentation?
- what type of pneumonia?
- what are three special features of this bug?
- farmers or veterinarians
- aerosol (coxiella spores in animal feces)
- high fever (Q fever)
- atypical pneumonia
- most common culture negative endocarditis
- NO RASH
- NO anthropod vector
Reid index: normal vs. chronic bronchitis
normal: <40%
chronic bronchitis: > 50%
alpha-1- antitrypsin deficiency
- what two organs should I think about? what does A1AT deficiency cause on these organs?
- important histologic finding?
- inheritance pattern?
- liver and lung
liver: cirrhosis (accumulation of misfolded A1AT)
lung: panacinar emphysema - even though it is A1AT deficiency, somehow it is still expressed in liver (I don’t get it, but whatever)
- liver biopsy: PAS postitive eosinophilic globules
- codominant
Patient breathing pursed lips. What disease is this?
emphysema
Wheezing. What two diseases?
- asthma
- chronic bronchitis
List 5 causes of bronchiectasis
- cystic fibrosis
- Kartagener syndrome
- Aspergilios
- necrotizing infection
- tumor or foreign body
List 3 pulmonary status that may lead to cor pulmonale
Obstructive lung disease
Pneumoconioses
pulmonary HTN
- hypoxic pulmonary vasoconstriction -> RV hypertrophy and failure
Two complications of bronchiectasis?
- cor pulmonale (just like other COPD)
- secondary amlyoidosis
Two key histologic findings in asthma
- Charcot-Leyden crystals: eosinophilic crystals
- Curschmann spirals: spiral shaped mucus plugs
Which mediator mediates fibrosis in pulmonary fibrosis?
TGF-beta
Explain why pneumoconioses are considered as restrictive lung disease
alveolar macrophage eats foreign materials and induce fibrosis
Define anthracosis
urban dwellers breathing polluted air
carbon laden macrophage
What is the only pneumoconiosis that has increased risk for TB? occupations of this pneumoconiosis?
- silicosis
- sand blasting, foundries, slica mines
Histologic finding in Berylliosis? Presents very similarly to what disease?
non- caseating granulomas in lung tissue and hilar lymph node
presents very similarly to sarcoidosis
Histologic finding in Abestosis? What is it composed of?
abestosis body- dumbell shaped
Sarcoidosis may mimic what autoimmune disease?
Sjogrens
Histologic finding of pulmonary HTN? Describe how it looks like and why.
plexiform lesion- bundles of arteries
vascular remodeling
What gene is associated with hereditary pulmonary HTN?
BMPR2
What is treatment for ARDS? What does it do?
PEEP (positive end expiration pressure)
: leaving some pressure behind even at the end of expiration -> preventing alveolar collapse due to intralveolar hyaline
Which two compounds in cigarette smoke is particularly mutagenic for lung cancer?
- polycyclinc aromatic hydrocarbon
- arsenic
Bronchial hamartoma
- comprised of what two types of tissue?
- imaging finding?
- lung tissue and cartilage
- calcification
Which lung cancer produces PTHrP?
squamous cell carcinoma
Which lung cancer is associated with Eaton-Lambert syndrome?
small cell carcinoma
Which lung cancer is most common in non-smokers?
adenocarcinoma
Two histologic findings in squamous cell lung cancer?
- keratin pearls
- intracellular bridges
Bronchioloalveolar carcinoma
- subtype of which lung cancer
- imaging finding
- prognosis
- adenocarcinoma
- x ray: hazy infiltrate similar to pneumonia
- good prognosis
location of metastasized tumor that is unique to primary lung cancer?
adrenal gland
