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Pathology > Pulmonary Infections > Flashcards

Pulmonary Infections Flashcards

1
Q

Inflammatory process of infectious origin affecting the pulmonary parenchyma

A

Pneumonia

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2
Q

Clinical Features of pneumonia

A

Chills and fever
Productive cough
Blood-tinged or rusty sputum
Pleuritic pain
Hypoxia with shortness of breath
Cyanosis (sometimes)
Neutrophilic leukocytosis (if bacterial cause)

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3
Q

What are the types of pneumonia?

A

Lobar pneumonia
Bronchopneumonia
Interstitial pneumonia
Viral pneumonia
Rickettsial pneumonia
Ornithosis pneumonia

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4
Q

Cause of Lobar pneumonia

A

Streptococcus pneumonia

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5
Q

Macro/Microscopic picture of Lobar pneumonia

A
  • Intra-alveolar exudate (involving an entire lobe of lung) → Consolidation Stages:
  • Congestion
  • Red Hepatisation
  • Gray Hepatisation
  • Yellow Hepatisation
  • Resolution
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6
Q

Causes of Bronchopneumonia

A

Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, Streptococcus pyogenes

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7
Q

Macro/microscopic features of bronchopneumonia

A

Extension of acute inflammatory exudate from the
bronchioles into the adjacent alveoli Patchy distribution, involving one or more lobes

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8
Q

Causes of interstitial pneumonia

A

Viruses, mycoplasma pneumoniae

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9
Q

Macro\Microscopi features of of interstitial pneumonia

A

Involvement of more than one lobes
Diffuse, patchy inflammation localised to interstitial areas of the alveolar walls

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10
Q

Most common form of interstitial pneumonia

A

mycoplasma pneumonia

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11
Q

Clinical features of mycoplasma pneumonia

A

Insidious onset
Mild, self-limited course

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12
Q

Lab test of mycoplasma pneumonia

A

ass w nonspecific cold agglutinins reactive to erythrocytes

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13
Q

Macro-/Microscopic findings of mycoplasma pneumonia

A
  • Inflammatory reaction limited to the interstitium
  • NO exudate in the alveolar spaces
  • Intra-alveolar hyaline membranes
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14
Q

What is the most common type of pneumonia in childhood?

A

Viral pneumonias

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15
Q

Causes of viral pneumonias

A

Influenza viruses, Adenoviruses, Rhinovirus, Expiratory Syncytial Virus, Varicella Zoster Virus (Chickenpox & Shingles) or Rubeola (Measles)

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16
Q

How is ornithosis transmitted

A

Chlamydia species
Transmission by inhalation of dried excreta of infected birds.

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17
Q

What is the most common rickettsial pneumonia?

A

Q-fever

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18
Q

What causes Q-fever?

A

Coxiella burnetii

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19
Q

How is Q-fever transmitted?

A

Inhalation of dust particles containing the organism.
Contamination through infected cattle or sheep.

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20
Q

Localised area of suppuration within the parenchyma

A

Lung abscess

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21
Q

Causes of lung abscess

A

Staphylococcus
Pseudomonas
Klebsiella
Proteus, combined with anaerobes

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22
Q

Pathogenesis of lung abscess

A
  • Bronchial obstruction
  • Aspiration of gastric contents (due to loss of consciousness; from alcohol or drug overdose, neurologic disorders, general anaesthesia)
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23
Q

Complications of lung abscess

A

Bacterial pneumonia

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24
Q

Clinical Features of lung abscess

A

Fever Foul smelling purulent sputum Fluid-filled cavity (X-ray)

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25
Q

Causative agent of nocardiosis

A

Nocardia

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26
Q

What type of infection is nocardiosis?

A

Opportunistic infection

27
Q

Where can nocardiosis disseminate to?

A

Brain and meninges

28
Q

Describe nocardia?

A

Gram-positive, aerobic, filamentous, weakly acid-fast bacteria

29
Q

Causative agent of aspergillosis

A

Aspergillus fumigatus

30
Q

How is aspergillus fumigatus transmitted?

A

Airborne conidia

31
Q

What is the major portal of entry of aspergillosis?

A

Lung

32
Q

Pathogenesis of aspergillosis

A

Aspergillus spores (2-3 μm) reach alveoli → Engulfment & killing of Aspergillus conidia by alveolar macrophages → Secretion of cytokines & chemokines (by macrophages), thus stimulating adaptive immune responses T lymphocytes confer protective immunity

33
Q

Causative agent of candidiasis

A

Candida albicans

34
Q

What is the most frequent cause of human fungal infections?

A

Candida albicans

35
Q

How can fungal infections manifest

A

Superficial lesions in healthy persons
Disseminated infections in immuno-compromised patients (severe disseminated candidiasis associated with neutropenia, secondary to leukaemia or anticancer
therapy, immunosuppression after transplantation, etc.)
Pulmonary, renal and hepatic abscesses and vegetative endocarditis
Invasive form (Invasive Candidiasis) → Blood-borne dissemination (Candida can be directly introduced into the blood by i.v. lines, catheters, i.v. drug abuse, etc.)

36
Q

Causative agent of Actinomycosis

A

Actinomyces israelii

37
Q

Macro/Microscopic features of Actinomycosis

A

Formation of abscess & sinus tract
Exudate, with sulphur granules (yellow clusters of the organism)

38
Q

Describe actinomyces israelii

A

Gram-positive, anaerobic, filamentous bacteria

39
Q

Causative agent of coccidioidomycosis

A

Coccidioides immitis

40
Q

10% of people have symptoms like coccidioidomycosis

A

Lung lesions, fever, cough and pleuritic pain, erythema nodosum or erythema multiforme

41
Q

Morphology of coccidioidomycosis

A

Primary & secondary lesions similar to granulomatous lesions of Histoplasma
Presence of thick-walled non-budding spherules, often filled with small endospores
Pyogenic reaction, when rupture of spherules & release of endospores

42
Q

Causative agents of cryptococcosis

A

Cryptococcus neoformans

43
Q

Primary manifestation of cryptococcosis

A

Lungs

44
Q

If a patient of cryptococcus with AIDS what do u see in them

A

Fungal meningitis and encephalitis

45
Q

Visualisation of the capsule in cerebral spinal fluid

A

INDIA INK

46
Q

Staining of polysaccharide cell wall in tissue

A

Mucicarmine stain

47
Q

What causes Histoplasmosis?

A

Histoplasma capsulatum

48
Q

How is Histoplasmosis transmitted?

A

Inhalation of dust particles from soil contaminated with bird or bat droppings containing microconidia (small spores)

49
Q

What are the clinical forms of Histoplasmosis?

A

Self-limited, often latent primary pulmonary involvement (coin lesions on chest radiography).
Chronic progressive secondary lung disease:
Localised to lung apices.
Symptoms: Cough, fever, night sweats.
Localised extra-pulmonary lesions: Mediastinum, adrenals, liver, meninges.
Widely disseminated disease: Occurs in immunocompromised patients.

50
Q

What is the typical morphology in healthy adults with Histoplasmosis?

A

Formation of epithelioid cell granulomas.
Caseation necrosis.
Coalescence into large consolidation areas or liquefaction forming cavities (in COPD patients).
Fibrosis and concentric calcification (“tree-bark appearance”).

51
Q

What is observed in fulminant disseminated Histoplasmosis?

A

Focal accumulations of mononuclear phagocytes filled with fungal yeasts (in immunosuppressed individuals).

52
Q

What is the causative agent of Tuberculosis?

A

Mycobacterium tuberculosis

53
Q

How is Tuberculosis transmitted in its pulmonary and non-pulmonary forms?

A

Pulmonary form: Inhalation of droplets containing the organism.
Non-pulmonary form: Ingestion of infected milk.

54
Q

Summarize the pathogenesis of Tuberculosis.

A

Ingestion of M. tuberculosis by macrophages.
Presentation of antigens to CD4+ T-helper cells.
CD4+ T-cells proliferate & secrete cytokines.
Attraction of lymphocytes & macrophages.
Formation of epithelioid cells & Langhans multinucleated giant cells.

55
Q

What is a Ghon complex?

A

A combination of:
Peripheral sub-pleural parenchymal lesion.
Hilar lymph node involvement.

56
Q

What are the clinical features of primary Tbc?

A

Typically asymptomatic.
No clinically evident disease.

57
Q

What is the histopathology of the Tbc tubercle?

A

Central caseous necrosis.
Langhans giant cells.

58
Q

What causes secondary Tuberculosis?

A

Reactivation of a prior Ghon complex, with spread to new pulmonary or extra-pulmonary sites.

59
Q

What are the clinical features of secondary Tbc?

A

Progressive disability.
Fever.
Haemoptysis.
Bloody pleural effusion.
Generalised wasting.

60
Q

What macroscopic findings are seen in secondary Tbc?

A

Localised lesions in apical or posterior segments of the upper lobes.
Involvement of hilar lymph nodes.

61
Q

What are the key microscopic findings in secondary Tbc?

A

Liquefaction and cavitary lesion formation (unique to secondary Tbc).
Caseation (seen in both primary and secondary Tbc).
Scarring and calcification.

62
Q

What is Miliary Tbc?

A

Secondary Tbc complicated by lymphatic and haematogenous spread, leading to small, seed-like lesions in distal organs.

63
Q

Name common forms of extra-pulmonary Tbc.

A

Tuberculous meningitis.
Pott disease of the spine.
Para-vertebral or psoas abscess.

Pathology (26 decks)

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