Respiratory Pathology Flashcards
the “common cold”, usually viral with bacterial infection developing thereafter; may involve pharynx, tonsils, bronchi?
rhinitis
allergic from of rhinitis?
hay fever
catarrhal discharge; mucopurulent discharge secondary to bacterial infection; recurrences may lead to polyp formation?
rhinitis
common infection secondary to breakdown in the normal secretion elimination system; predisposing factors: typically upper viral respiratory infection?
sinusitis
bacteria associated with sinusitis?
s. pneumoniae and h. influenzae
headache, fever, facial pain, malaise; nasal discharge; maxillary sinusitis may mimic a toothache?
sinusitis
treatment for acute sinusitis?
amoxicillin or appropriate antibiotic
treatment for chronic sinusitis?
sinus surgery
necrotizing granulomatous process of unknown etiology, classically affects upper airway, lungs, kidneys; epitaxis, pain, nasal obstruction; later signs include ulceration and destruction of adjacent tissue or structures; any organ may be involved?
Wegener’s granulomatosis
oral lesions: large, chronic ulcers, “strawberry gums”?
Wegener’s granulomatosis
subepithelial hemorrhage; poorly formed granulomas; scattered giant cells; vasculitis?
Wegener’s granulomatosis
in diagnosis of Wegener’s, look for …?
c-ANCA
treatment of Wegener’s?
prednisone and cyclophosphamide
aggressive, destructive process of T lymphocytes; adults; nasal stuffiness, epitaxis; deep necrotic ulcerations; may progress to palatal perforations?
extranodal NK/T-cell lymphoma, nasal type
necrosis and angiocentric arrangement of atypical inflammatory cells?
extranodal NK/T-cell lymphoma, nasal type
benign but aggressive vascular neoplasm of the nasopharynx; almost exclusively of male adolescents; resemblance to nasal turbinates?
nasopharyngeal angiofibroma
nasal obstruction, epitaxis; anterior bowing of the posterior wall of the maxillary sinus?
nasopharyngeal angiofibroma
dense fibrous connective tissue with myofibroblasts; numerous, variably-sized, thin-walled vessels?
nasopharyngeal angiofibroma
benign, papillary overgrowth of epithelium primarily on nasal septum?
papilloma
benign but aggressive neoplasm of the sinuses; high rate of recurrence and destruction with possible invasion of the orbit and cranial vault; inward growth of squamous epithelium?
inverted papilloma
malignancy of the nasopharyngeal mucosa that is more common in parts of Asia; associated with Epstein-Barr virus, vit. C deficiency; diets high in salted fish (nitrosamines)?
nasopharyngeal carcinoma
enlarged cervical nodes usually the first sign; unilateral serous otitis media and hearing loss?
nasopharyngeal carcinoma
common; secondary to viruses, diphtheria, cig smoking; may result in obstruction
laryngitis
“croup”; under age of 3; upper respiratory viral infection; loud breathing and cough with difficulty in breathing?
acute laryngotracheobronchitis
tumors; overgrowths of edematous inflammatory tissue, “Singer’s nodes”
polyps
tumors; HPV related, single or multiple (children)
papillomas
associated with smoking, asbestos; ulcerated, fungated; hemoptysis, increasing hoarseness
squamous cell carcinoma of the larynx
heavy and wet lungs; development of pneumonia; left sided heart disease, allergies, CNS disorders
pulmonary congestion and edema
most common preventable cause of hospital death; deep vein thrombosis; dyspnea w/ or w/o shock or sudden death, pain, hemoptysis, acute or chronic cor pulmonale?
pulmonary embolism
large embolus at bifurcation of the pulmonary artery?
saddle embolus
appears as wedge shaped area of necrosis?
small or multiple emboli
arteriosclerosis or increased pulmonary vascular blood flow associated with pulmonary hypertension; pulmonary hypertension secondary to mitral stenosis, fibrosis, COPD; death secondary to right-sided heart failure
pulmonary vascular sclerosis
airless lung, appearing shrunken, red-blue, rubbery and non-crepitate?
atelectasis
infant (neonatal) respiratory distress syndrome (hyaline membrane disease); secondary to over-sedation of the mother, aspiration of blood or amniotic fluid, birth injuries, prematurity
primary atelectasis
the fundamental defect of hyaline membrane disease (RDS) is …?
deficiency of pulmonary surfactant
hyaline membranes and necrosis of alveolar walls?
hyaline membrane disease of the newborn
main treatment of hyaline membrane disease of newborn is …?
prevention
complete airway obstruction; resorption of air distal to the obstruction?
secondary atelectasis (collapse), obstructive (resorption) type
mechanical collapse due to external pressure; entire lung or portion?
secondary atelectasis (collapse), compression type
adult version of hyaline membrane disease; secondary to alveolar epithelium and endothelial damage; increase in permeability leading to fluid in the septa and alveolar sacs; hyaline membrane formation
acute respiratory distress syndrome (ARDS)
resistance to expiration
COPD
examples of COPD
emphysema; chronic bronchitis; bronchiectasis; asthma
progressive dyspnea; reduced recoil; cyanosis; weight loss; hypoxic brain damage; bronchopneumonia; cor pulmonale
COPD
enlargement and destruction of air spaces distal to the terminal bronchioles?
emphysema
affecting respiratory bronchioles of the upper lobes (strongly associated with smoking)
centrilobular (centriacinar) emphysema
affects respiratory bronchioles and distal alveoli (alpha-1-antitrypsin deficiency)
panacinar emyphsema
persistent cough with copious sputum for at least 3 months for 2 consecutive years; common in smokers and smog-ridden cities; inflammation, fibrosis and narrowing of bronchioles?
chronic bronchitis
hypertrophy of mucous glands, metaplastic formation of mucin-secreting goblet cells in the surface epithelium of bronchi; chronic inflammation; late fibrosis?
chronic bronchitis
some chronic bronchitis patients develop significant … with outflow obstruction?
COPD
many patients will have both chronic bronchitis and …
emphysema
abnormal, permanent and irregular dilation of bronchi associated with superimposed, necrotizing infection; typically secondary to other pulmonary diseases
bronchiectasis
especially before age 20; cyanosis, coughing, copious purulent and/or bloody sputum, fever, digital clubbing?
bronchiectasis
chronic inflammatory disorder that causes sudden episodes of wheezing, breathlessness, chest tightening and cough; increased responsiveness to stimuli-bronchoconstriction, inflammation, mucous secretion
bronchial asthma
IgE mediated, type 1 hypersensitivity broncial asthma
atopic
bronchial asthma triggered by respiratory viral infections, which probably lower the threshold of the vagal receptors of the irritants?
non-atopic
bronchial asthma with leukotriene production?
drug-induced
curshmanns spirals-accumulation of epithelial cells and mucous and charcot-leyden crystals-granules of eosinophils seen in sputum
bronchial asthma
prolonged bronchial asthmatic attack that can last days or weeks, sometimes resulting in death?
status asthmaticus
entire lobe; severe fibropurulent reaction with massive edema; bacterial pneumonia
lobar pneumonia
four discrete stages of lobar pneumonia
congestion; red hepatization; gray hepatization; resolution
patchy distribution within lobes; multilobar and bilateral; neutrophil rich exudate; bacterial pneumonia
bronchopneumonia
which pneumonia carries a better prognosis: community or hospital acquired
community
mycobacterium tuberculosis?
tuberculosis
ghon complex; low grade fever, night sweats, fatigue (secondary tuberculosis); weight loss (consumption); chronic bloody cough?
tuberculosis
diffuse dissemination seen in the immune compromised patient?
miliary tuberculosis
necrotizing granulomatous inflammation; multinucleated giant cells; demonstrated by acid fast method?
tuberculosis
histoplasma capsulatum; endemic to mississippi and ohio river valleys; spores in soil contaminated with bird or bat droppings?
histoplasmosis
calcified hilar nodes; acute-flu like; granulomatous inflammation; 1-2 micron yeasts in macrophages; silver stain or PAS
histoplasmosis
T or F: for acute histoplasmosis, no treatment is usually necessary
T
treatment of choice for mild cases or as maintenance therapy of histoplasmosis
itraconazole
1 cause of lung abscess?
aspiration
secondary to aspiration or complication of pneumonia, obstruction, septic emboli, trauma; cough with foul smelling mucus, fever, pain
lung abscess
idiopathic multisystem granulomatous process; improper degradation of antigenic material; effects lungs, lymph nodes, skin, eyes, and salivary glands
sarcoidosis
variable onset; dyspnea; dry cough; fever, malaise; fatigue, athralgia; lymphadenopathy?
sarcoidosis
granulomatous inflammation; langhans or foreign body giant cell; schaumann bodies; asteroid bodies
sarcoidosis
elevated angiotensin converting enzyme; kveim test
sarcoidosis
1 fatal cancer in US (associated with smoking, asbestos, radioactive ores)
bronchogenic carcinoma
histologic subtypes of bronchogenic carcinoma
squamous cell; adenocarcinoma, undifferentiated
most common subtype of bronchogenic carcinoma
adenocarcinoma
spread to hilar and scalene nodes, then to adrenals, liver, brain, bone and kidney; weight loss, chest pain, dyspnea, hemoptysis; paraneoplastic syndromes; many secondary diseases associated
bronchogenic carcinoma
