Respiratory Pathology Flashcards
Rhinitis is inflammation of the nasal mucosa; the most common cause is ___________; presents with sneezing, congestion, and runny nose (common cold)
Adenovirus
Allergic rhinitis is due to a type ______ HSR (e.g., due to pollen), characterized by inflammatory infiltrate with _________; it is associated with asthma and eczema
Type I HSR; eosinophils
_____ _____ = protrusion of edematous, inflamed nasal mucosa, usually secondary to repeated bouts of rhinitis bu also occur in _____ _____ and ASA-intolerant asthma (asthma, aspirin-induced bronchospasm, and nasal polyps — seen in 10% of asthmatic adults)
Nasal polyps; cystic fibrosis
Benign tumor of nasal mucosa composed of large blood vessels and fibrous tissue classically seen in adolescent males; presents with profuse epistaxis
Angiofibroma
Nasopharyngeal carcinoma is a malignant tumor of nasopharyngeal epithelium. It is associated with _______ (virus); classically seen in African children and Chinese adults who present with cervical LAD.
Biopsy shows pleomorphic _______-positive epithelial cells in a background of lymphocytes
EBV
Keratin
Acute epiglottitis = inflammation of the epiglottis, most commonly casued by __________, especially in non-immunized children.
Patients present with high fever, sore throat, drooling, dysphagia, muffled voice, and inspiratory ______. There is a risk of acute airway obstruction.
H influenza type b
Stridor
____________ = inflammation of the upper airway that presents with hoarse “barking” cough and inspiratory stridor; most common cause is ________ virus
Laryngotracheobronchitis (croup); Parainfluenza
Vocal cord nodules arise due to excessive use and are usually bilateral. They present with hoarseness and resolve with rest. What are these nodules composed of?
Degenerative (myxoid) connective tissue
Laryngeal papilloma = benign papillary tumor of vocal cord due to __________. Tend to present as single lesions in adults, and multiple in children. Presents with hoarseness
HPV 6 and 11
What type of cancer is laryngeal carcinoma?
Squamous cell
Laryngeal carcinoma is a squamous cell carcinoma arising from the epithelial lining of the vocal cord; Primary risk factors are _____ and ______. Presents with hoarseness, cough, and/or stridor
Alcohol; tobacco
Pneumonia is an infection of lung parenchyma arising when normal defenses are impaired (i.e., cough reflex, damage to mucociliary escalator, mucus plugs). Clinically patients present with fever and chills, cough with yellow-green or rusty sputum, tachypnea with pleuritic chest pain, decreased breath sounds with dullness to percussion, and elevated WBC count. Diagnosis is made by CXR, sputum gram stain and culture, and blood cultures. What are the 3 patterns classically seen on CXR and are they usually bacterial or viral?
Lobar pneumonia — bacterial
Bronchopneumonia — bacterial
Interstitial pneumonia — viral
Lobar PNA is a consolidation of an entire lobe and is usually bacterial. What are the 2 most common causes of lobar PNA?
S pneumoniae (95% of cases)
Klebsiella pneumoniae
_______ ______ affects malnourished and debilitated individuals, especially elderly in nursing homes, alcoholics, and diabetics (enteric flora that is aspirated). Thick mucoid capsule results in a gelatinous sputum (currant jelly); often complicated by abscess
Klebsiella pneumoniae
4 classic phases of lobar PNA
Congestion — congested vessels and edema
Red hepatization — exudate with neutrophils and blood
Grey hepatization — breakdown of exudate and blood
Resolution — mediated by type II pneumocyte
Bronchopneumonia is characterized by scattered patchy consolidation centered around bronchioles; often multifocal and bilateral, and is caused by a variety of bacteria. What are the 5 most common causes of bronchopneumonia?
S aureus
H influenzae
Pseudomonas aeruginosa
Morazella catarrhalis
Legionella pneumophila
Most common cause of secondary pneumonia (bacterial PNA superimposed on viral URI); often complicated by abscess or emphysema
Staphylococcus aureus
Common cause of secondary PNA and PNA superimposed on COPD (leads to COPD exacerbation)
Haemophilus influenzae
Cause of bronchopneumonia that should be associated with cystic fibrosis pts
Pseudomonas aeruginosa
Community-acquired PNA and PNA superimposed on COPD (leads to exacerbation of COPD)
Moraxella catarrhalis
Community-acquired PNA, PNA superimposed on COPD, or PNA in immunocompromised states; transmitted from water source. Intracellular organism best visualized by silver stain
Legionella pneumophila
Interstitial (atypical) PNA is characterized by diffuse interstitial infiltrates, presenting with relatively mild URI symptoms (minimal sputum, cough, and low fever). What are some of the organisms that can cause atypical PNA?
Mycoplasma pneumoniae
Chlamydia pneumoniae
Respiratory syncytial virus (RSV)
Cytomegalovirus (CMV)
Influenza virus
Coxiella burnetii
Most common cause of atypical PNA, usually affects young adults (classically military recruits or college students in dorms). Complications include autoimmune hemolytic anemia (IgM against I antigen on RBCs causes cold hemolytic anemia) and erythema multiforme. Not visible on gram stain due to lack of cell wall
Mycoplasma pneumoniae
Second most common cause of atypical PNA in young adults
Chlamydia pneumoniae