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Pathoma > Respiratory Tract Pathology > Flashcards

Respiratory Tract Pathology Flashcards

1
Q

Nasal Polyp

A

Occurs in CF and asprin-intolerant asthma

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2
Q

Nasopharyngeal Carcinoma

A

Malignant tumor of nasopharyngeal epithelium; Associated with EBV; Classically seen in African children and Chinese adults; Biopsy reveals pleomorphic keratin-positive epithelial cells in a background of lymphocytes; Often involves cervical lymph nodes

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3
Q

Acute Epiglottitis

A

Inflammation of epiglottis; HiB is most common cause, esp. in non-immunized children; Presents with high fever, sore throat, drooling with dysphagia, muffled voice and inspiratory stridor; Risk of airway obstruction

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4
Q

Croup

A

Inflammation of upper airway; Parainfluenza virus is most common cause; Presents with hoarse, barking cough and inspiratory stridor

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5
Q

Laryngeal Papilloma

A

Benign papillary tumor of vocal cord; Due to HPV 6 and 11; Usu single in adults and multiple in children; Present with hoarseness

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6
Q

Laryngeal Carcinoma

A

Squamous cell carcinoma usu. arising from epithelial lining of vocal cords; Alcohol and tobacco are risk factors; Presents with hoarseness, stridor, cough

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7
Q

Lobar Pneumonia

A

Characterized by consolidation of an entire lobe of lung; Most common causes are Strep. pneumo and Klebsiella pneumoniae
Gross phases:
1) Congestion - due to congested vessels and edema
2) Red hepatization - due to exudate, neutrophils and hemorrhage filling the alveolar air spaces given the spongy lung a solid consistency
3) Gray hepatization - due to degradation of red cells within the exudate
4) Resolution - type II pneumocytes regenerate air sacs

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8
Q

Strep. Pneumo Pneumonia

A

Most common cause of community acquired pneumonia in middle aged and elderly and secondary pneumonia following a viral infection.

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9
Q

Klebsiella Pneumo Pneumonia

A

Enteric flora that is aspirated; Affects malnourished and debilitated individuals esp. elderly in nursing homes, alcoholics and diabetics; Thick mucoid capsule results in gelatinous sputum (currant jelly); often complicated by abscess

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10
Q

Staph Aureus Pneumonia

A

Second most common cause of secondary pneumonia after viral infection; Often complicated by abscess or empyema (pus in pleural space)

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11
Q

Haemophilus Influenzae Pneumonia

A

Common cause of secondary pneumonia and pneumonia superimposed on COPD –> exacerbation

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12
Q

Pseudomonas Aeruginosa Pneumonia

A

Pneumonia in CF patients

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13
Q

Moraxella Catarrhalis Pneumonia

A

Community-acquired pneumonia and pneumonia superimposed on COPD

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14
Q

Legionella Pneumophila Pneumonia

A

Community-acquired pneumonia, pneumonia superimposed on COPD, or pneumonia in immunocompromised states; Transmitted from water source; Intracellular organism best visualized by silver stain

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15
Q

Mycoplasma Pneumonia Pneumonia

A

Most common cause of atypical pneumonia; Usu affects young adults (military, college); Complications include autoimmune hemolytic anemia (IgM against I antigen on RBCs – cold hemolytic anemia) and erythema multiforme; Not visible on gram stain due to lack of cell wall

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16
Q

Chlamydia Pneumoniae Pneumonia

A

Second most common cause of atypical pneumonia

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17
Q

RSV Pneumonia

A

Most common cause of atypical pneumonia in infants

18
Q

CMV Pneumonia

A

Atypical pneumonia with post-transplant immunosuppresive therapy

19
Q

Influenza Virus Pneumonia

A

Atypical pneumonia in elderly, immunocompromised and those with preexisting lung disease; Also increases the risk for superimposed S. Aureus or H. Influenzae bacterial pneumonia (secondary pneumonia)

20
Q

Coxiella Burnetti Pneumonia

A

Atypical pneumonia with high fever (Q fever); seen in farmers and veterinarians (spores are deposited on cattle by ticks or are present in cattle placenta);
Is a rickettsial organism, but distinct from most because it causes pneumonia, does not require arthropod vector for transmission and does not produce a skin rash

21
Q

Bronchopneumonia

A

Characterized by scattered patchy consolidation centered around bronchioles, often multifocal and bilateral; Caused by Staph. aureus, H. influenzae, Pseudomonas, Moraxella, Legionella

22
Q

Interstitial (Atypical) Pneumonia

A

Characterized by diffuse interstitial infiltrates; Presents with relatively mild URTI (minimal sputum and low fever)
Caused by Mycoplasma, Chlamydia, RSV, CMV, Influenza, Coxiella

23
Q

Aspiration Pneumonia

A

Seen in patients at risk for aspiration (alcoholics and comatose patients); Most often due to anaerobic bacteria in the oropharynx (eg. Bacteriodes, Fusobacterium, Peptococcus); Classically results in R lower lobe abscess

24
Q

Primary TB

A

Results in focal caseating necrosis in LOWER LOBE of lung with hilar lymphadenopathy that undergo fibrosis and calcification forming a Ghon complex (subpleural)
Asymptomatic, but +PPD

25
Q

Secondary TB

A

Reactivation commonly due to AIDS or steroids or meds that lead to immunocompromise; Occurs at APEX of lung (high oxygen tension); Forms cavitary foci of caseous necrosis; Can also lead to miliary TB or tuberculous bronchopneumonia
Clinical features: fevers, night sweats, cough with hemoptysis, weight loss
Biopsy reveals caseating granulomas and acid-fast bacilli

26
Q

Pott Disease

A

Lumbar TB

27
Q

Chronic Bronchitis

A

Productive cough lasting at least 3 months over a minimum of 2 years; Highly associated with smoking
Characterized by hypertrophy of bronchial mucinous glands (Reid Index >50%)
Clinical Features: productive cough, cyanosis (mucus plugs trap carbon dioxide), increased PaCO2 and decreased PaO2; increased risk of infection and cor pulmonale

28
Q

Phosphatidylcholine (Lecithin)

A

Major component of surfactant;
Lecithin to sphingomyelin ratio is use to screen for lung maturity - a ratio of >2 indicates adequate surfactant production; Insulin decreases surfactant production (eg. Maternal diabetes)

29
Q

Small Cell Carcinoma

A

Arises from neuroendocrine (Kulchitsky) cells; Common in Male smokers; Central location; May produce ADH or ACTH or cause Lambert-Eaton syndrome

30
Q

Squamous Cell Carcinoma

A

Keratin pearls or intracellular bridges; Most common tumor in male smokers; Central location; May produce PTHrP

31
Q

Adenocarcinoma

A

Glands of mucin; Most common tumor in nonsmokers and female smokers; Peripheral location; Can involve pleura

32
Q

Large Cell Carcinoma

A

Poorly differentiated large cells; Associated with smoking; Central or peripheral

33
Q

Bronchioalveolar Carcinoma

A

Columnar cells that grow along preexisting bronchioles and alveoli; Arise from Clara cells; Not related to smoking; Peripheral location; May present with pneumonia-like consolidation on imaging

34
Q

Carcinoid Tumor

A

Well-differentiated neuroendocrine tumor; Chromogranin +, Not related to smoking; Classically forms a poly-like mass in bronchus; Low grade; Can cause carcinoid syndrome

35
Q

Charcot-Leyden Crystals

A

Eosinophil-derived crystals found in asthma

36
Q

Curschmann Spirals

A

Spiral-shaped mucus plugs found in asthma

37
Q

Sarcoidosis

A

Restrictive lung disease; Elevated ACE; Hypercalcemia due to increased active vitamin D (1-alpha hydroxylase activity of epithelioid histiocytes converts Vit. D to its active form)

38
Q

Coal Workers’ Pneumoconiosis

A

Diffuse fibrosis (black lung); associated with rheumatoid arthritis (Caplan syndrome); Affect upper lobes

39
Q

Silicosis

A

Seen in sandblasters and silica miners; Fibrotic nodules in upper lobes of lung; Increased risk for TB - silica impairs macrophages and phagolysosome formation

40
Q

Berylliosis

A

Seen in beryllium miners and aerospace industry workers; Noncaseating granulomas in the lung and hilar lymph nodes (resembles sarcoid); Increased risk for lung cancer

41
Q

Asbestosis

A

Construction workers and plumbers and shipyard workers; Fibrosis of lung pleura with increased risk for lung carcinoma>mesothelioma; Lesions may contain long brown fibers with associated iron/ferruganous bodies

Pathoma (8 decks)

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