Pulmonary Pathology II Flashcards
Idiopathic Pulmonary Fibrosis Risk Factors (3), Presentation (3) and Diagnosis (4)
Urban Living
Smoking
Older age
SOB
Velcro-like lung crackles
Honeycomb basilar infiltrates
Bad prognosis
Biopsy shows:
Normal areas, inflammation, fibroblast foci, Peripheral honeycombing fibrosis
Non-Specific Interstitial Pneumonia
Associated Group, Histology (2)
Older non-smoking females
Bilateral, symmetrical infiltrates and fibrosis
Cryptogenic Organizing Pneumonia
Presentation, Histology, Prognosis
Pneumonia-like consolidation in 50s and 60s
Fibroblast foci called Masson Bodies
Very good when treated with corticosteroids
Sarcoidosis Histology (3), Diagnosis, Presentation (4)
Non caseating granuloma
Asteroid Body
Schaumann Body
Diagnosed with incidental radiograph
Lymphadenopathy
Dyspnea
Fibrosis
Increased serum ACE**
Hypersensitivity Pneumonitis
Types with Exposures (3) and Diagnosis
Pigeon Breeder’s Lung: protein in feces
Farmer’s Lung: actinomyces in hay
Hot Tub Lung: mycobacterium avium complex
Diagnosed with detailed history
Desquamative Interstitial Pneumonia
Population, Histology, Prognosis
Smokers in 40s/50s
Alveoli stuffed with Macrophages**
Good with corticosteroids and smoking cessation
Respiratory Bronchiolitis-Interstitial Lung Disease
Population, Diagnosis (3)
Smokers in their 30s/40s
Peribronchiolar metaplasia**
Macrophages in alveoli
Fibrosis
Langerhans Cell Histocytosis
Population, Pathogenesis (3) and Histology (2)
Young smokers
Stellate shaped lesions scar
Cysts form that rupture
Hemorrhage causes pneumothorax
CD1A+ histiocytes
Abundant eosinophils
Pulmonary Alveolar Proteinosis
Pathogenesis (2) and Diagnosis
Impaired GM-CSF production (mostly autoimmune)
Surfactant accumulates in alveoli
Bronchioalveolar lavage yields copious milky fluid
Pulmonary Embolism Risk Factors (3), Complications (2)
Immobilization (DVT)
IV Drug Use (Talc embolus, Septic embolus)
Trauma (Marrow/Fat embolus)
Pulmonary infarct: wedge shaped necrosis
Cor pulmonale (saddle embolus)
No pulmonary infarct with saddle embolus
Pulmonary Hypertension
Pressure, Causes (3) and Lesion
> 25 mmHg
Mostly secondary to CHF or Chronic Pulmonary Dz
Can see Primary Pulmonary HTN
Plexiform lesion (knot of blood vessels)
Pulmonary Hemorrhage Syndromes
Types (3)
Goodpasture Syndrome
Type II hypersensitivity - Ab to collagen subunit in lung/kidney basement membrane
Granulomatosis with Polyangitis
Idiopathic Pulmonary Hemosiderosis
Lobar Pneumonia
Complications (3) and Stages (4)
Abscess
Empyema
Bacteremia (sepsis)
Congestion: vessels enlarge
Red Hepatization: RBCs and inflammation
Gray Hepatization: Inflammation and Debris
Resolution: Fibrosis and Macrophages
Typical Bacterial Pneumonia
Bacteria with Descriptions (6)
Streptococcus pneumoniae
Lancet shaped diplococci, most common cause
Haemophilus influenzae
Highly virulent in kids, vaccine to Protein B
Staphylococcus aureus
mostly in IVDU, forms abscesses
Klebsiella pneumoniae
mostly alcoholics, red currant jelly sputum
Pseudomonas aeruginosa
mostly cystic fibrosis patients
Moraxella catarrhalis
Mostly elderly patients
Atypical Bacterial Pneumonia
Bacteria with Descriptions (2)
Mycoplasma pneumoniae
smallest organism, no cell wall
Legionella pneumophila
Grows in warm fresh water and is airborne
(AC units, hot tubs)
Pneumonia Presentation
Typical (3) vs Atypical (4)
Typical: Abrupt onset, Pulmonary sx, Consolidation on CXR
Atypical: Slow onset, Systemic Sx, Patchy infiltrates on CXR, Younger population
Antigenic Shift (2) vs Drift (3)
Drift: minor changes that increase spread, people maintain immunity so only epidemics
Shift: major genomic alterations that cause pandemics, associated with animal gene products
Viral Pneumonia Causes (4)
Influenza virus Type A
Respiratory syncytial virus
Human Metapneumovirus
Corona Virus (severe acute respiratory syndrome)
Respiratory Syncytial Virus
Presentation (3) and Complications (2)
Wheezing, grunting cough
Dyspnea
Cyanosis
Bronchiole inflammation and mucus occludes airway
Influenza A Symptoms (6)
Abrupt onset 3-4 day Fever Severe aches Chills Fatigue Headache
Bacterial vs Viral Pneumonia
Histology (2) and Presentations (3/4)
Bacteria in alveoli
Virus in interstitium
Bacteria: high fever, crackles, lobar distribution
Virus: Epidemics, no fever, wheezes, diffuse infiltrate
Lung Abscess
Description and Causes (3)
Suppurative destruction of the lung parenchyma within the central area of cavitation
Aspiration pneumonia (elderly and alcoholics)
Staphylococcus aureus or Klebsiella pneumoniae infections
Pulmonary Tuberculosis
Primary and Secondary
Initial infection forms primary complex (Ghon complex)
Good immune system scars over and heals
Bad immune system makes it go latent
Latent Tb can progress to secondary Tb
Caseating granulomatous inflammation
Disseminated Miliary Tb
Chronic Pneumonia Fungal Infections
Fungus (3), Locations, Morphology and Presentation
Histoplasma capsulatum
Endemic to midwest, Pumpkin seed appearance
Calcified coin lesion granuloma
Blastomyces dermatitides
Endemic to Ohio and Mississippi river valleys
Broad-Based-Budding
Self limiting granuloma
Coccidiodes immitis
Endemic to SW US
Eosinophilic granulomatous response
Immunocompromised Pneumonia Infections
Bacteria with Descriptions (2)
Pneumocystis jiroveci
AIDS defining illness with non-specific radiography
Mycobacterium avium complex
slender rod shaped bacteria on acid fast stain
Lung Death
Transplant vs Infection
Rejection shows perivascular mononuclear infiltrates
Infection often caused by candida, pneumocystis, aspergillus
