Respiratory System Flashcards
What are the most common causes of health care associated pneumonia?
- MRSA
- Pseudomonas aeruginosa
What are the most common causes of hospital acquired pneumonia?
- Gram-negative rods
- Enterobacteriacae
- Pseudomonas sp.
- Staph. aureus
What is the most likely cause of a single lung abcess in the right lung?
Aspiration
Genetic mutations in what structures lead to idiopathic pulmonary fibrosis?
- Telomerase
- Surfactant
- Mucous
What cytokine is responsible for lung injury in idiopathic pulmonary fibrosis?
TGF beta
What is the histology associated with Non-specific interstitial pneumonia? What population is most affected? What is the prognosis?
- Histology
- Diffuse fibrosis
- No fibroblastic foci (UIP), honeycombing, hyaline membranes, or granulomas
- Population
- Nonsmoking females
- Most in 50’s
- Prognosis
- Cellular pattern is best
- Both patterns better than UIP
What is the characteristic finding of Cryptogenic Organizing Pneumonia?
Polypoid plugs (Masson bodies) of organizing loose connective tissue in the lumen of alveolar ducts, alveoli, bronchioles
What mediators are released by macrophages in silicosis?
- IL-1
- IL-18
Which drugs cause pneumonitis and fibrosis of the lung?
- Bleomycin
- Amiodarone
Which drugs cause Hypersensitivity Pneumonitis?
- Methotrexate
- Nitrofurantoin
Which drugs cause Bronchospasm?
- Aspirin
- Beta antagonists
What are the effects of radiation on the lung?
- Acute radiation pneumonitis
- Pleural effusions
- Infiltrates
- Chronic “
- DAD
- atypical and hyperplastic Type II pneumocytes
- Foam cells in vesel walls
- Epithelial cell atypia
What HLA genes are associated with sarcoidosis?
HLA-A1 and HLA-B8
What is the immune reaction to sarcoidosis?
- Driven by CD4+ cells
- Increased in Th1 cytokines
- IL-2
- INF-gamma
What causes Desquamative Interstitial Pneumonia?
100% smoking
Mutation in which gene predisposes to pulmonary Langerhans Cell HIstiocytosis?
Activation mutations to serine/threonine kinase BRAF
Mutations to which gene cause hereditary PAP and immediate onset neonatal respiratory distress?
GM-CSF
Immature macrophages do not clear surfactant from alveoli, leading to accumulation
Mutations in which genes lead to surfactant dysfunction disorders? What is the pattern of inheritance for each?
- ATP-binding casette protein member 3 (AR)
- Most common
- Surfactant protein C (AD)
- Surfactant protein B (AR)
What is a common complication of Paraseptal Emphysema?
- Bullous emphysema
- Formation of cyst-like structures close to the pleura
- Rupture can cause Pneumothorax
What is the mechanism leading to drug induced asthma?
- Decreased PGE2 production
- Loss of inhibition of production of proinflammatory LTs
What is the infecting organism in Bronchiectasis? COPD?
- Bronchiectasis:
- Haemophilus influenzae
- Pseudomonas aeruginosa
- COPD:
- Haemophilus influenzae
- Streptococcus pneumoniae
What are the most common indications for lung transplantation?
- End stage emphysema
- Idiopathic pulmonary fibrosis
- Cystic fibrosis
- Idiopathic / Familial pulmonary arterial HTN
- Bronchiectasis
What types of genes are mutated in Squamous cell carcinoma of the lung?
Tumor suppressor genes
What types of genes are mutated in Adenocarcinoma of the lung?
Growth factors or receptors
Gain of function mutations
(EGFR, ALK, KRAS)
What genes are mutated in Small Cell Carcinoma of the lung?
- TP53
- RB1
- Myc-N and Myc-L amplification
- Chromosome 3p deletions
What is the most common mutation in Small Cell Carcinoma of the lung?
Bcl-2
What are the markers of mesothelioma?
- Keratin proteins
- calretinin
- WT-1
- Cytokeratin 5/6
- D2-40
*
What cell markers are present in solitary fibrous tumor?
CD34+
(keratin negative, which differentiates them from malignant mesothelioma)
Which HLA subtypes are found in Goodpasture Syndrome?
HLA-DRB1
Germline mutation in which gene is associated with destructive pneumococcal pneumonia?
MyD88
(adaptor for TLRs important in NFkB activation
Which bugs cause Healthcare-Associated Pneumonia?
- Staph aureus
- MRSA
- Strep pneumoniae
- Pseudomonas aeruginosa
Which bugs cause Hospital Acquired Pneumonia?
- Staph aureus (MRSA)
- Enterobacteriaceae
- Klebsiella
- Serratia marcescens
- E. coli
- Pseudomonas
Which bugs cause Aspiration Pneumonia?
Anaerobic oral flora
- Bacteroides
- Prevotella
- Fusobacterium
- Peptostreptococcus
Aerobes more common
Which bugs cause Chronic Pneumonia?
- Nocardia
- Acinomyces
- Granulomatous:
- TB
- Histoplasma capsulatum
- Coccidioides immitis
- Blastomyces dermatitidis
What causes Pneumonia in the immunocompromised?
- CMV
- Pneumocystis jiroveci
- Mycobacterium avium-intracellulare
- Invasive aspergillosis
- Invasive candidiasis
What is the most common cause of Community acquired pneumonia?
Strep pneumoniae
What is the most common bacterial infection causing acute COPD exacerbations?
Haemophilus influenza
Which bug causes pneumonia following viral respiratory infections? Which viruses are most common?
- Bug:
- S aureus
- Viruses:
- Children: measles, influenza
- Adults: Influenza
What is the most frequent cause of gram negative bacterial pneumonia?
Klebsiella pneumoniae
- Current jelly sputum
- Common in malnourished or debilitated (aspiration)
What is the most common cause of hospital acquired infections?
Pseudomonas aeruginosa
Who is most commonly affected by the Human Metapneumovirus?
- Young children
- Elderly
- Imunocompromised
How is Human Metapneumovirus diagnosed?
Reverse transcriptase PCR
What are the most common causes of Health Care Associated Pneumonia?
- MRSA
- Pseudomonas aeruginosa
Which bugs are most commonly associated with lung abscess?
Anaerobes of oral cavity
- Bacteroides
- Fusobacterium
- Peptococcus
