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Pathology II Chamberlin Fall 2014 > Pulmonary Pathology Part III: Pulmonary Infections > Flashcards

Pulmonary Pathology Part III: Pulmonary Infections Flashcards

1
Q

What is the difference between pneumonia and pneumonitis?

A 
Pneumonitis = inflammation of interstitial tissue
Pneumonia = infection or inflammation of only the alveolar spaces
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2
Q

What are the predisposing factors for pneumonia?

A
  • Loss of cough reflex
  • Diminished mucin or cilia function
  • Alveolar macrophage interference
  • Vascular flow impairments
  • Bronchial flow impairments
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3
Q

T or F? Pneumonia
A. Cough, wheezing, chest tightness, bronchospasm
B. Tachycardia, tachypnea, Sns of lung consolidation
C. Severe pneumonia always includes fever and cough
D. Infx when small droplets are inhaled into alveoli

A

A. False. Cough, fever, fatigue, myalgia, incr. sputum (rust color), pleuritic chest pain
B. True
C. False. Can occur with little to no cough or fever
D. True

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4
Q

Pneumonia: Lobar, Viral, or Broncho?
A. Patchy
B. Entire lobe affected
C. Interstitium infiltrated, some giant cells often present
D. Presents more commonly with wheezing than others
E. Acute inflammation of the walls of the bronchioles

A 
A. Broncho
B. Lobar
C. Viral
D. Viral
E. Broncho
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5
Q

Hepatization: Red or Gray?
A. RBC disintegration, shift to increased fibrinization
B. RBC exudate, neuts, and fibrin fill alveolar spaces
C. Persistent neuts, fibrin & suppurative exudate; Alveoli still consolidated
D. Gross appearance is red, firm, airless, consolidated

A

A. Gray
B. Red
C. Gray
D. Red

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6
Q

Congestion or Consolidation?
A. Dilated capillaries leak protein rich exudate or transudate into interstitium
B. Intra-alveolar fluid w few neuts & numerous bacteria
C. Alveolar spaces completely filled
D. Cellular debris, intact bacteria & exudate => jello

A

A. Congestion
B. Congestion
C. Consolidation
D. Consolidation

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7
Q

Pneumonia: Name that Organism
A. Most common community acquired pneumonia
B. Most prevalent in kids

A

A. Streptococcus
B. Haemophilus Pneumonia
C. Klebsiella Pneumoniae
D. Pseudomonas Aeruginosa

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8
Q

Pneumonia : Name that Organism
A. Often in outbreaks, immunocomp. patients, often lobar
B. Most common pneumonia from COPD in adults
C. 2nd most common COPD pneumonia
D. Most common pneumonia following viral pneumonias

A

A. Legionella(Pneumophila)
B. Haemophilus Pneumonia
C. Moraxella Catarrhalis
D. Staph Aureus

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9
Q

Pneumonia : Name that Organism
A. Common in older children and young adults.
B. Most common viral pneumonia overall
C. Most common viral pneumonia of infants/young kids
D. Types of organisms that can cause pneumonia

A

A. Mycoplasma pneumonia
B. Haemophilus Influenza
C. RSV
D. ANY

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10
Q 
Pneumonia : Gram negative or positive?
A. Moraxella Catarrhalis 
B. Streptococcus 
C. Haemophilus Pneumonia  
D. Klebsiella Pneumoniae
E. Pseudomonas Aeruginosa
A 
A. Gram negative 
B. Gram positive
C. Gram-negative 
D. Gram-negative 
E. Gram negative
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11
Q

Pneumonia : Name that Organism
A. Treated w Penicillin
B. Responsible for SARS
C. Treated w Bactrim (Trimethoprim-Sulfa)
D. Causes bullous myringitis. Otitis media & TM blisters

A

A. Streptococcus
B. Corona virus
C. Haemophilus Pneumonia
D. Mycoplasma pneumoniae

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12
Q

How is Legionella transmitted and what is unusual about the organism’s morphology?

A

Transmission: inhalation of aerosolized organisms or aspiration of contaminated drinking water.
Flagellum

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13
Q

What are the atypical pneumonias and what is walking pneumonia. Are cultures helpful?

A

Less typical pathogens or cell wall deficient bacteria. Walking pneumonia = mild case of pneumonia.
Also be called atypical pneumonia b/c the dz is different from more serious (typical) cases.
Cultures not helpful

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14
Q

Pneumonia: Interstitial or Alveolar
A. Original location of viral pneumonias
B. Original location of bacterial pneumonias
C. On percussion, sound quality is 1/2 dullness
D. Organisms that do not need host machinery to replicate can be in the ______ space

A

A. Interstitial
B. Alveolar
C. Interstitial
D. Alveolar

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15
Q

How is the presence of the corona virus confirmed?

A

Like most other non-bacterial pneumonias, by PCR

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16
Q

What are the most common causes of nosocomial pneumonia?

A

Acquired in hospitals from dehabilitation, catheters, ventilators, Enterobacter, Pseudomonas, Staph (Methicillin resistant staph aureus)

17
Q

T or F? Aspiration Pneumonias
A. Caused by Klebseilla, Pseudomonas, and E coli
B. Posterior lobes most commonly involved
C. Oral flora (bacteroides & fusobacterium) also seen
D. Does not lead to abscesses

A

A. False. Strep, Staph, H flu, Pseudomonas
B. True
C. True
D. False. Often leads to abscesses

18
Q

What is the difference between Pleural Effusion and Empyema?

A

Pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs.

Pleural empyema, also known as pyothorax or purulent pleuritis, is empyema (an accumulation of pus) in the pleural cavity that can develop when bacteria invade the pleural space, usually in the context of a pneumonia.

19
Q

Pulmonary Abscess

A

A

20
Q

Pulmonary Abscess

A

A

21
Q

What is a bronchopleural fistula?

A

A bronchopleural fistula (BPF) is a fistula between the pleural space and the lung. It sometimes develops following pneumonectomy or an infection (pneumonia). It may also develop when large airways are in communication with the pleural space following a large pneumothorax or other loss of pleural negative pressure, especially during positive pressure mechanical ventilation.

22
Q

What 4 organisms are we talking about when we refer to “Chronic Pneumonias?”

A

TB, histoplasmosis, blastomycosis,, coccididomycosis

23
Q

Ghon focus or Ghon complex?
A. Inhalation of mycobacterium, engulfed by alveolar macrophages, undergoes necrosis
B. Original site plus hilar lymph node involvement
C. May calcify and be seen on CXR
D. 90% of mycobacterium found here

A

A. Gohn focus
B. Gohn complex = Gohn focus plus hilar lymph nodes
C. Gohn complex
D. Gohn focus

24
Q

What percentage of pulmonary TB is latent? What percentage reactivates and what percentage immediately becomes active after the initial infection?

A

1-5% active after initial infection.
90-95% is latent.
5-10% reactivates

25
Q

Describe the cellular makeup of a TB granuloma.

A

Macrophages, T cells, B cells, and fibroblasts aggregate to form a granuloma

26
Q

What is miliary TB?

A

Disseminated TB
Infx invades the circulatory system.
Millet-like seeding of TB bacilli in the lungs and other organs

27
Q

TB, Histo-, Blasto- or Coccidio-, or Aspergilloma?
A. ASx or fever/night sweats, cough, pleuritic chest pain, dyspnea, hemoptysis, wt loss, cachexia, fatigue
B. Productive cough, chest pain, wt. loss, fever, & night sweats
C. Sx of dry cough and high fevers, pleural effusion
D. Delayed type hypersensitivity

A

A. TB
B. Blastomycosis
C. Coccidioidomycosis
D. Coccidioidomycosis

28
Q

TB, Histo-, Blasto- or Coccidio-, or Aspergilloma?
A. Lamellar (“onion skin”) noncaseating granulomas
B. Caseating granulomas
C. Large, suppurative, calcified granulomas, in spherules
D. Large, calcified granulomas, in smaller spherules
E. Granulomas in upper lobes

A 
A. Histoplasmosis
B. TB
C. Blastomycosis
D. Coccidioidomycosis
E. TB, Histoplasmosis
29
Q

TB, Histo-, Blasto- or Coccidio-, or Aspergilloma?
A. Forms thick-walled, non-budding spherules 20 -60 μmin diameter within macrophages or giant cells
B. Found in soil in central or SE US, etc.
C. Fungus found in bird or bat droppings
D. Spores in soil in SW US, etc.

A

A. Coccidioidomycosis
B. Blastomycosis
C. Histoplasmosis
D. Coccidioidomycosis

30
Q

What are the 4 inflammatory stages described in lobar pneumonia?

A
  • Congestion
  • Red hepatization
  • Grey hepatization
  • Resolution
31
Q

What is an oxygen tent?

A

An oxygen tent consists of a canopy placed over the head and shoulders, or over the entire body of a patient to provide oxygen at a higher level than normal. Usually used for children/infants instead of ventilator.

Pathology II Chamberlin Fall 2014 (5 decks)

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