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My Pathology > Pulmonary Disorders > Flashcards

Pulmonary Disorders Flashcards

1
Q

Obliterative bronchiolitis

A
  • Caused by adenovirus

* Bronchiolitis —> healing by fibrosis

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2
Q

RSV

A
  • Nosocomial infection of children
  • Usually self-limited
  • May cause disorganized epithelium and severe distention (? displaced surfactant)
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3
Q

Whooping cough

A
  • Bordetella pertussis

* May cause bronchiectasis

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4
Q

Candida albicans

A

•May produce mucosal ulceration

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5
Q

Bronchocentric granulomatosis

A
  • In asthmatic pts: allergic aspergillosis

* Non-asthmatic pts: TB or histoplasma; often coincides w/ autoimmune disease

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6
Q

Right middle lobe syndrome

A

Collapse of R middle bronchus from hilar lymphadenopathy

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7
Q

Strep pneumoniae

A
  • Young to middle-aged adults
  • Lobar PNA
  • S/p aspiration of pneumococci or viral URI
  • “Rusty” sputum, alveolar filling on CXR
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8
Q

Klebsiella pneumoniae

A
  • Lobar PNA

* Mucoid lung surfaces, bulging lobes, tissue necrosis/abscesses —> bronchopleural fistula

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9
Q

Staph aureus

A
  • Common in CF pts, nosocomial infection

* Many small abscesses; may create pneumatoceles (cystic spaces)

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10
Q

Group B strep

A

Newborns; Sx look like respiratory distress syndrome; w/ severe toxemia, rapid death

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11
Q

Legionella

A
  • Hard to Cx
  • Contaminated water
  • Widespread bronchopneumonia w/ necrosis of inflammatory cells
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12
Q

Pseudomonas aeruginosa

A
  • Immunocompromised, burns, CF

* Occurs w/ vasculitis

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13
Q

Mycobacterium

A
  • Ghon lesion: granuloma at periphery of lung
  • Miliary TB: multiple small granulomas in many organs
  • M. avium-intracellulare: immunocompromised, extensive macrophage infiltrate w/ innumerable acid-fast orgs
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14
Q

Actinomycosis

A
  • Multiple small lung abscesses
  • Gram + filamentous bacteria
  • Sulfur granules
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15
Q

Nocardia

A
  • Beaded, thin filaments w/ R angle branching

* Pts w/ lymphomas, neutropenia, chronic granulomatous disease, alveolar proteinosis

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16
Q

Histoplasmosis

A
  • Midwest & South
  • Inhalation of bird droppings
  • Resembles TB
  • Granulomas prone to calcification
17
Q

Aspergillosis

A
  • AIDS pts or pts on cytotoxic therapy
  • Invasive: blood vessel invasion —> thrombosis, lung infarcts
  • Aspergilloma: fungus ball grows in pre-existing cavity
  • Allergic bronchopulmonary aspergillosis: eosonophilia, increased serum IgE, proximal bronchiectasis
18
Q

Pneumocystitis jiroveci

A
  • Fungus
  • Interstitial infiltrates, type 2 pneumocyte hyperplasia
  • Alveoli filled w/ foamy exudate
19
Q

CMV

A
  • Interstitial infiltration

* Cytomegaly w/ nuclear inclusion

20
Q

Diffuse alveolar damage

A
  • Causes ARDS
  • Triggered by variety of insults
  • Hyaline membranes and collagen deposition in alveolar walls
  • Leakage of plasma proteins
  • “Honeycomb lung”
21
Q

Goodpasture syndrome

A

Diffuse alveolar hemorrhage, glomerulonephritis, Ab to basement membrane

22
Q

Eosinophilic PNA

A
  • Loeffler syndrome: Mild or asymptomatic PNA with eosinophilia
  • Acute/chronic: allergy association
  • Infectious: parasites
23
Q

Lipid PNA

A
  • Endogenous: secondary to bronchial obstruction

* Exogenous: aspirated oils

24
Q

Alpha 1-antitrypsin deficiency

A
  • A1AT is an inhibitor of proteinases including elastases
  • Lack of inhibition leads to alveolar wall destruction
  • Possible liver disease
25
Q

Silicosis

A
  • Simple nodular: progression of 10-40 yrs; “whorled” collagen nodules containing needle-shaped silicates; possible “eggshell calcification” of nodes
  • Progressive massive: nodules 2-10 cm wide w/ central cavitation
  • Acute: progression of a few yrs; no nodules; alveoli contain eosinophilic material
26
Q

Coal workers’ pneumoconiosis

A
  • Anthracosis or anthracosilicosis
  • Scattered 1-4 mm black foci
  • Carbon-laden macrophages
27
Q

Asbestos

A
  • Diffuse interstitial fibrosis
  • Asbestos bodies: long, thin fiber surrounded by iron-protein coat
  • Plaque on parietal pleura
  • Mesothelioma
28
Q

Berylliosis

A
  • Aerospace, industrial ceramics, or nuclear industries

* Noncaseating granulomas

29
Q

Talcosis

A
  • Variable pathology
  • FB granulomas w/ plate-like particles
  • Associated w/ IV drug use
30
Q

Acute hypersensitivity pneumonitis

A
  • Acute or chronic interstitial inflammation

* Chronic may have poorly formed granulomas, organizing PNA

31
Q

Sarcoidosis

A
  • Can also involve nodes, skin, eye
  • More common in African-Americans
  • CD4 helper cells form multiple noncaseating granulomas
  • Along pleura, interlobular septa, around bronchovascular bundles, bronchial submucosa (diagnose via bronchoscopic biopsy)
  • Can progress to onion-skin fibrosis around giant cells
32
Q

Idiopathic pulmonary fibrosis

A
  • Patchy interstitial fibrosis adjacent to normal lung
  • Loose fibroblastic tissue adjacent to dense collagen
  • Epithelium grows into dilated airspaces
  • Gradual DOE and dry cough over 1-3 yrs
33
Q

Desquamative interstitial PNA

A
  • Smokers
  • Alveolar architecture is preserved w/ minimal fibrosis
  • Intra-alveolar macrophages contain golden-brown pigment
34
Q

Respiratory bronchiolitis

A
  • Smokers

* Pigmented macrophages centered on bronchioles

35
Q

Langerhans cell histiocytosis

A
  • Smokers 20-40
  • Nodular infiltrates w/ stellate border
  • Langerhans cells: eosinophilic cytoplasm, grooved nuclei
  • Eosinophils
36
Q

Lymphangioleiomyomatosis

A
  • Women of childbearing age
  • Abnormal proliferation of smooth muscle in lung (? hormonal control)
  • Tuberous sclerosis gene complex mutation
37
Q

Pulmonary HTN

A
  • L to R shunt
  • Recurrent PEs
  • Hypoxemia
  • LV failure
38
Q

Pulmonary hamartoma

A
  • Usu. at periphery
  • Popcorn calcification
  • Several types of tissue interspersed w/ respiratory epithelium-lined clefts
39
Q

Small cell carcinoma

A

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My Pathology (12 decks)

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