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Y3 Respiratory Pathology > Respiratory inflammatory conditions > Flashcards

Respiratory inflammatory conditions Flashcards

1
Q

Where is the primary site of injury for interstitial pneumonia?

A

Alveolar epithelium and capillary endothelium

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2
Q

What are the causes of interstitial pneumonia?

A

viruses, bacteria, protozoa, helminths, irritants, allergy and toxins

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3
Q

What are the two route of entry for interstitial pneumonia?

A
  • inhalation

- haematogenous

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4
Q

How is interstitial pneumonia usually distributed in the lungs?

A

Diffuse

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5
Q

How would a lung with interstitial pneumonia appear grossly?

A
  • heavy, rubbery, elastic texture
  • red, grey mottled surface
  • lack of visible exudate
  • lungs fail to collapse on opening thorax
  • Costal impression on pleural surface – where the ribs would have been when the lungs over expanded
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6
Q

What are the 3 phases of the acute response for interstitial pneumonia?

A
  1. Injury to type 1 pneumocytes or capillary endothelium
  2. Exudative response
  3. Proliferative phase
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7
Q

What occurs in the exudative response?

A
  • Expansion of the interstitial tissue: oedema and inflammatory exudate
  • Leakage of fluid and plasma proteins into the alveolar space
  • May see hyaline membrane formation
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8
Q

What is the hyaline membrane?

A

A high protein density fluid made up of plasma proteins and surfactant which coats the alveolar spaces

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9
Q

What cells would be found in interstitial tissue?

A

Macrophages
Fibroblasts
Blood vessels

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10
Q

What occurs in the proliferative phase of interstitial pneumonia?

A
  • Macrophage population expands, these phagocytose and remove the exudate
  • Type II pneumocytes proliferate to replace lost type I cells
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11
Q

What are the functional consequences of acute interstitial pneumonia?

A

Disruption of alveolar walls
Oedema and exudate
= Hypoxia

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12
Q

How does acute interstitial pneumonia resolve?

A
  • alveolar macrophages remove alveolar fluid and cells

- type II pneumocytes differentiate into type I

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13
Q

Give examples of causes of acute interstitial pneumonia

A
  • Viruses e.g. distemper
  • Migrating parasites
  • Type III hypersensitivity reaction
  • Toxins e.g. tryptophan
  • Inhaled smoke
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14
Q

Give examples of causes of chronic interstitial pneumonia

A
  • Infections e.g. Ovine lentivirus
  • Hypersensitivity reaction
  • Toxins
  • Irritants
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15
Q

If interstitial pneumonia injury persists which 4 chronic changes occur?

A
  • interstitial fibrosis
  • chronic inflammatory cells
  • persistence of type II pneumocytes
  • smooth muscle hyperplasia around bronchioles
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16
Q

Which cells are present in chronic interstitial pneumonia?

A

Fibroblasts
Lymphocytes
Plasma cells
Macrophages

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17
Q

Which cells are present in acute interstitial pneumonia?

A

Proliferative type II cells
Macrophages
Exudate

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18
Q

What are the functional consequences of chronic interstitial pneumonia?

A
  • thickened alveolar walls, which decreases lung compliance

- Increased respiratory effort

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19
Q

Which agents produce lesions that have features of both bronchopneumonia + interstitial pneumonia? (bronchointerstitial pneumonia)

A

Pneumotropic viruses

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20
Q

What are the consequences of thickened alveolar walls in chronic interstitial pneumonia?

A
  • Reduced airspaces
  • Impaired diffusion
  • Reduced gas exchange
    = hypoxia
    = pulmonary hypertension
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21
Q

What is the route of entry and distribution of embolic pneumonia?

A 
ROE = Haematogenous 
Distribution = random disseminated foci
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22
Q

What are the 3 common causes of embolic pneumonia?

A
  • Hepatic abscesses
  • Right heart valve endocarditis
  • Joint/naval infections
23
Q

What follows on sequalae to embolic pneumonia?

A
  • Formation of abscesses
  • Fibrosis and resolution
  • Chronic pneumonia
  • Rupture => pyothorax
24
Q

Granulomatous inflammation is dominated by which 2 cells?

A

Macrophages and multinucleated giant cells

25
Q

Which types of agents cause Granulomatous inflammation ?

A
  • Ones that persist in tissues

- Induce chronic inflammation

26
Q

What are the routes of entry and distribution of Granulomatous inflammation?

A 
ROE = inhalation and haematogenous 
Distribution = variable, nodular foci
27
Q

How do multinucleated giant cells form?

A

Fusion of macrophages in an attempt to phagocytose an agent more effectively

28
Q

Give some examples of causes of Granulomatous inflammation

A
  • Bacteria: Mycobacteria e.g. TB
  • Parasites: migrating lungworm or heartworm
  • Viruses: Feline infectious peritonitis
  • Fungi
  • Foreign bodies
29
Q

What kind of exudate will be seen grossly in Granulomatous inflammation?

A

Caseous = cheese like

30
Q

Bacteria causing Granulomatous inflammation will stain what colour with Ziehl-Neelson?

A

Purple

Gram +ve

31
Q

Give examples of primary lung tumours (these are rare)

A
  • Bronchioalveolar squamous cell carcinoma

- Papillary adenocarcinoma

32
Q

How does neoplasia spread in/around the lung?

A

By not only metastasis but also locally within the lung through spread along the airways
- spread by friable tumour fragments in the airflow along bronchi and bronchioles

33
Q

What is the favourable environment for pulmonary adenomatosis?

A

Housing sheep intensively overwinter - ovine pulmonary carcinoma

34
Q

How is pulmonary adenomatosis induced?

A

Retroviral induced neoplasia - aerosol infection

35
Q

How do the cells of pulmonary adenomatosis appear?

A

Predominantly cuboidal or columnar cells resembling type II pneumocytes.

36
Q

How do the lungs of a sheep with pulmonary adenomatosis appear grossly?

A
  • Lungs are heavy, with small grey to white nodules

- Copious amount of mucoid fluid

37
Q

Why is metastatic spread to the lungs causing secondary neoplasia very common?

A

The lungs have a good blood supply and a fine capillary network

38
Q

Give 3 examples of tumours that can be deposited in the lung

A
  • Mammary tumours
  • Osteosarcoma
  • Haemangiosarcoma
39
Q

Describe the pleural cavity and its role in the body

A
  • Surround the lungs which are under partial pressure

- When the ribs expand outwards, the pressure is reduced and the lungs are drawn outwards

40
Q

What is a pneumothorax?

A

The partial pressure in the pleural cavity has been dispersed, so the pleural pressure is the same as outside and the lungs collapse

41
Q

How would a radiograph of a pneumothorax appear?

A

A lateral chest radiograph shows the lung size to be greatly reduced

42
Q

What are some causes of a pneumothorax?

A
  • Spontaneous rupture of abscess, emphysematous bulla
  • Traumatic rupture or perforation of lung or trachea
  • Penetrating injury of the thoracic wall
43
Q

Pleural effusions all inhibit?

A

Lung expansion

44
Q

What is a hydrothorax?

A

Oedema/transudate (low protein density fluid) in the pleural space

45
Q

What are the causes of a hydrothorax?

A
  • heart failure
  • hypoproteinaemia
  • intrathoracic tumours
46
Q

What is a haemothorax?

A

Blood in the pleural space

47
Q

What are the causes of a haemothorax?

A
  • trauma and rupture of blood vessels
  • erosion of blood vessels by tumours
  • clotting disorders
48
Q

What is a chylothorax?

A

Lymph in the pleural space

49
Q

What are the causes of a chylothorax?

A
  • traumatic rupture or neoplastic erosion of the thoracic duct wall
  • heart disease
  • congenital abnormality to the thoracic duct
50
Q

What is a pyothorax?

A

Pus in the pleural space

51
Q

What are the causes of a pyothorax?

A

Penetrating injury

Lung abscess rupture

52
Q

What is the name given to inflammation of the pleural cavity/

A

Pleuritis

53
Q

What are the causes of pleuritis?

A
  • pneumonia
  • bacteria
  • pyothorax
  • FIP virus

Y3 Respiratory Pathology (5 decks)

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