Pulmonary Pathology 2

Question 1

T/F. Any organism can cause pneumonia in the right setting.

Answer 1

True. bacterial, viral, fungal, parasites

Question 2

What are some predisposing factors of bacterial pneumonia?

Answer 2

a. loss of cough reflex
b. injury to cilia
c. decreased phagocytosis
d. pulmonary edema
e. immunocompromised condition

Question 3

Bronchopneumonia is a ___ process that begins around the ___ bronchi and is common in the very young & ___.

Answer 3

patchy; small; old

Question 4

Lobar pneumonia involves an ___ lobe and is common in ___ adults.

Answer 4

entire; healthy

Question 5

Streptococcus pneumoniae is in ___ % of ___ pneumonia cases.

Answer 5

90; lobar

Question 6

What are the stages of inflammation associated with pneumonia?

Answer 6

1. Congestion
2. Red Hepatization
3. Gray Hepatization
4. Resolution

Question 7

Which stage of pneumonia is considered the early stage? What is characteristic of this stage?

Answer 7

red hepatization

with purulent exudate with many red blood cells

Question 8

___ hepatization occurs later and involves exudate with ___ and macrophages.

Answer 8

Grey; fibrin

Question 9

What are the potential outcomes of PNA?

Answer 9

abscess, pleuritis, pericarditis, bacteremia

Question 10

___ or ___ PNA is caused by viruses or Mycoplasma pneumoniae.

Answer 10

Atypical; interstitial

Question 11

What disease has interstitial inflammation, mononuclear cells, congestion and hyaline membranes (diffuse alveolar damage)?

Answer 11

Atypical (interstitial) PNA

Question 12

T/F. Pulmonary abscess is a rapidly developing serious condition with same histologic features as interstitial pneumonia.

Answer 12

False, Acute respiratory distress syndrome (ARDS) is a rapidly developing serious condition with same histologic features as interstitial pneumonia.

Question 13

In ARDS, there is injury to the ___ and alveolar epithelium and increased endothelial ___ (leaky).

Answer 13

endothelium; permeability

Question 14

What is the overall mortality of ARDS?

Answer 14

30%

Question 15

Bronchiectasis, aspiration, septic emboli, airway obstruction, and dental sepsis are predisposing factors to what condition?

Answer 15

pulmonary abscess

Question 16

What is the course of pulmonary abscess?

Answer 16

scar, may progressively enlarge or cavitate (make a hole in the tissues)

Question 17

___ ___ infects about 1/3 of the world population and is the most common infectious cause of death.

Answer 17

Mycobacterium tuberculosis

Question 18

Tuberculosis (TB) is a ___ (rod), ___, ___-___, ___ growing that has ___ coat to resists acid destaining (Acid Fast Bacillus (AFB)).

Answer 18

bacillus; aerobe; non-motile; slow; waxy

Question 19

What is the classic tissue reaction associated with TB?

Answer 19

caseating granuloma inflammation

Question 20

How is TB acquired? What is found at the site of early infection?

Answer 20

inhalation

Ghon lesion

Question 21

What is the Ghon complex?

Answer 21

parenchymal lesion + hilar lymph nodes

Question 22

Cavitary TB can be found in the ___ of the lung and causes significant ___. What areas could it seed? What can it cause a direct extension to?

Answer 22

apex; scarring

large airways, lymph nodes or blood

pleura - effusion

Question 23

T/F. TB may become inactive or progress and 90-95% of primary cases resolve.

Answer 23

True.

Question 24

What happens when TB is reactivated?

Answer 24

It induces type IV hypersensitivity and tissue necrosis.

Question 25

What type of TB widely disseminates? How does this happen? What term is unique to this disease?

Answer 25

Miliary TB

from spread via lymphatics or blood (lymphohematogenous)

Millet seeds

Question 26

What is the leading cause of cancer? What are the risk factors?

Answer 26

lung cancer

cigarette smoking**
asbestos
radon gas
nickel, chromates, pollutants, lung scar

Question 27

What has decreased the rate of lung cancer deaths in men? What has increased the rate of lung cancer deaths in women?

Answer 27

men - declining smoking rates

women - increasing smoking rates

Question 28

T/F. Lung cancer tumors may produce hormones (or hormone-like substances).

Answer 28

True.
Paraneoplastic syndromes
ADH, ACTH, PTH and others

Question 29

What two carcinomas make up 50% of all lung cancers?

Answer 29

squamous cell carcinoma (25-30%)**

adenocarcinoma (30-35%)

Question 30

What are the other types of lung cancers?

Answer 30

small cell (oat cell) (20-25%)**
large cell (10-15%)
bronchioloalveolar carcinoma
others: mesothelioma (asbestos), carcinoid

Question 31

What is the 5 year survival rate of all types of lung cancers? If it is localized, how does the rate change?

Answer 31

5-year survival all types = 16%

If localized when found = 45%

Question 32

___ is a group of lung disorders caused by inhalation of dusts/particles.

Answer 32

Pneumonconioses

size, shape, concentration of particles are important factors

Question 33

What is the most dangerous particles size?

Answer 33

1-5 um diameter

Question 34

Inhaled particles induces ___.

Answer 34

fibrosis (scarring)

Question 35

What is seen with Coal Worker’s pneumonconiosis?

Answer 35

1. nodular or diffuse fibrosis with coal macules

2. progressive massive fibrosis

Question 36

What is the most prevalent form of occupational disease worldwide?

Answer 36

silicosis

Question 37

What are abestos bodies?

Answer 37

crystal and fibers of asbestos covered with iron