Respiratory

Question 1

Bronchitis, bronchiolitis, bronchiectasis - definition only

chronic bronchitis

Answer 1

1) BRONCHITIS = Infection of MAIN AIRWAYS of Lungs (Bronchi), causing them to become –> IRRITATED + INFLAMED

2) BRONCHIOLITIS = COMMON Lung Infection in YOUNG CHILDREN / INFANTS, causing –> INFLAMMATION + CONGESTION of BRONCHIOLES

CHRONIC BRONCHITIS
0 Micro
- INCREASED Goblet Cells in BRONCHIAL Epithelium
- HYPERPLASIA of Bronchial GLANDS
- SQUAMOUS Metaplasia + Dysplasia
- Chronic Inflammatory Cell INFILTRATE

0 Gross
- EARLY Stage = Mucosa + Bronchi Wall are THICKENED, causing –> HYPERTROPHY

• LATE Stage = Mucosa + Bronchi Wall become THIN, becoming–> ATROPHIC

Question 2

Types of pneumonias and morph

Answer 2

DEFINITION = ACUTE Inflammation of Lung PARENCHYMA, distal to TERMINAL Bronchioles

MAIN TYPES
1) Lobar Pneumonia
2) Bronchopneumonia
3) Interstitial Pneumonia

ETIOLOGICALLY - Bacterial, Viral, Fungal + Parasitic

EXUDATE TYPES - Serous, Fibrinous, Purulent || Haemorrhagic, Putrefactions, Mixed

Question 3

What is the cause of the lobar pneumonia ? Describe the third stage?

Answer 3

STAGES
1) Congestion
- Vascular Engorgement
- Small N.O of Neutrophils
- Numerous Bacteria
- Lung is Heavy + Hyperaemic

2) Red Hepatisation
- Vascular Congestion w/ Extravasation of RBCs into Alveolar Spaces BY Exudate

3) GREY HEPATISATION
- RBC Disintegrate w/ PERSISTENCE of Neutrophils + Fibrin
- Alveoli are Consolidates
- Pale Colour
- Cut Surface is DRY

4) Resolution
- Exudate is digested by Enzymatic Activity
- Exudate is cleared by MFs via COUGH Mechanism, via Sputum or drained via Lymph

Question 4

What are the most common causes of interstitial pneumonia? Describe the typical
microscopic finding of this disease

Answer 4

CAUSES:
- Respiratory Syncytial Virus, RSV
- Mycoplasma Pneumoniae
- Influenzae & Parainfluenza
- Adenoviruses
- Rhinoviruses
- Coxsackie Viruses
——————–
MACROSCOPY :
- Heavy Lungs
- Congested
- Patchy
- Consolidated
- Subcrepitant
————————-
MICROSCOPIC = INTERSTITIAL Inflammation
- THICKENED Alveolar Walls

• MONONUCLEAR Infiltration w/ Lymph, MFs, Plasma Cells OR LEUCOCYTE Infiltration IF bacterial
• MULTINUCLEATED Giant Cells + Syncytia in bronchiole AND alveoli walls
• RESEMBLE Squamous Epithelium
• VIRAL Inclusions that are INTRANUCLEAR + CYTOPLASMIC

Question 5

Gross and histology for silicosis
- Silicosis & its types

Answer 5

DEFINITION = Prolonged INHALATION of Silicon Dioxide / Silica

0 GROSS
- Nodular Lesions look like Egg-Shell Shadows in X-Ray

• Lungs have FIBROTIC Nodules, 1 - 5mm Diameter

0 MICROSCOPIC
1) Nodular Form
a. Silicotic = Central Hyalinised Material w/ Dust, surrounded by Concentric Laminations of Collagen

b. Collagenous = Cleft Spaces BTW Collagen w/ Silica Particles

2) Diffuse - Sclerotic Form = Inhalation w/ LOWER Conc + FEWER Nodules w/ CT Growth around Bronchi, BVs

3) Mixed Form = COMBO of Other Forms

Question 6

Gross and histo of laryngeal carcinoma (essay 22)
-give a definition and point out the morphological changes in p

Answer 6

MORPHOLOGY
1) Extrinsic = Arises / Extends outside Larynx
2) Intrinsic = Arises within Larynx

GROSS
- Glottis Carcinoma = Small, Pearly, White, Plaque-like Thickening

MICRO
1) Keratinizing / Non-Keratinizing Squamous Carcinoma

2) Well-Differentiated Squamous Carcinoma

3) Elongated Tumour Cells Resembling Sarcoma = Pseudosarcoma

OUTCOME = Cervical LN Metastasis

Question 7

Specify the main five histological types of lung cancer (E30)

Answer 7

1. squamous cell carcinoma
2. adenocarcinoma
3. adenosquamous carcinoma
4. small cell carcinoma
5. non small cell carcinoma

Question 8

Pulmonary carcinomas types and morp

Answer 8

TYPES
1) BENIGN
a. Papilloma
b. Adenoma

2) MALIGNANT
a. Bronchogenic Carcinoma
b. Bronchial Carcinoid Tumour
c. Pulmonary Blastoma

MORPHOLOGY
Metastasis = Kidneys, Colon, Uterus, Prostate, Liver, Pancreas, Breast

a. Hilar Type = Cancer arises in Hilar Part of Lung

b. Peripheral Type = Tumour of Single / Multiple Nodules in Lung Periphery

c. Pneumonia-like Consolidation = Cut-Surface is Grey + Mucoid

Question 9

Types of spread in lung carcinoma

Answer 9

1) DIRECT Spread
- Tumour EXTENDS DIRECTLY via invading through Bronchial WALL, destroying + REPLACING the PERIBRONCHIAL Lung Tissue

2) LYMPHATIC Spread
- Hilar LN
- Mediastinal, Cervical, Supraclavicular + Para-Aortic LN

3) HEMATOGENOUS Spread
- Liver
- Adrenals
- Bone
- Brain
- Kidneys