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Unit 4: Pathoma > Rubins Chap 12 (Second Half) > Flashcards

Rubins Chap 12 (Second Half) Flashcards

1
Q

What is more important…the severity of emphysema or the type?

A

The severity

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2
Q

What are the histologic findings in emphysema?

A

enlargement of airspaces distal to the terminal bronchioles with destruction of their walls w/o fibrosis

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3
Q

What are the three types of emphysema?

A

1- centrilobular
2- Panacinar
2- Localized

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4
Q

Centrilobular emphysema is seen in…

A

smokers, upper lobes of the lungs

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5
Q

“cotton candy lung” describes what type of emphysema?

A

Panacinar

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6
Q

Who is panacinar emphysema seen in?

A

smokers and alpha AT deficiency

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7
Q

“Acini are uniformly involved and septal damage thoughout acini in lower lungs” describes what type of emphysema?

A

Panacinar

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8
Q

“destruction of alveoli and emphysema at only one or a few locations” describes which type of emphysema?

A

Localized

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9
Q

“Destruction of the cluster or terminal bronchioles near the end of the bronchiolar tree in the centrla part of the bronchioles near the end of the bronchiolar tree” describes which type of emphysema?

A

Centrilobular

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10
Q

Where in the lung is each type of emphysema usually found?

A

Localized: apex of upper lobe
Centrilobular: upper lobes
Panacinar: lower lobes

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11
Q

Are people with emphysema “pink puffers” or “blue bloaters”?

A

Pink puffers

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12
Q

What is asthma?

A

reversible airway bronchoconstriction

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13
Q

Exercised induced asthma is related to…

A

magnitude of heat or water loss from the airway epithelium

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14
Q

Drugs related to drug induced asthma?

A

Aspirin

Beta blockers

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15
Q

What is status asthmaticus?

A

severe, acute asthma that is unresponsibe to therapy

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16
Q

Histologic indings of status asthmaticus?

A

Hyperplasia of smooth muscle, submucosal mucous glands, goblet cells, basal cells

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17
Q

What are pneumoconiosis?

A

Pulmonary diseases caused by mineral dust inhalation

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18
Q

Primary defense against inhaled particles?

A

Alveolar macrophages!

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19
Q

Findings in simple nodular silicosis?

A

20-40 post exposure

small whorled nodules (reflractile under polarized light)

Calcified hilar lymph nodes

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20
Q

Findings in progresive massive fibrosis form of silicosis?

A

Nodular mass with central cavitation in background of sciliosis–> smaller nodules coalesce

Usually in upper lobes!

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21
Q

Findings in simple coal worders pneumo?

A

Coal dust macules and nodules (scattered black foci of carbon

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22
Q

Findings of complicated CWP?

A

Simple CWP + lesions >2cm

Can progressive to massive fibrosis

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23
Q

What is caplan syndrome?

A

Many large nodules that are bilateral and associated with periphery

Like RA nodules

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24
Q

Does asbestos produce little or a lot of fibrosis?

A

Massive fibrosis! Even with a little dust

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25
Q

What is asbestosis?

A

diffuse, interstitial fibrosis resulting from inhalation of asbestos fibers

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26
Q

What type of lung finding is associated with asbestiosis?

A

“honeycomb lung”

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27
Q

What are asbestos bodies?

A

Thin colorless asbestos fibers coated with Fe- protein–> appear golden/ brown and beaded on micoscopy

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28
Q

What do asbestos pleural plaques look like?

A

Smooth, pearly white and nodular

Have a “basket-weave” pattern

Prefer parietal pleura

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29
Q

Is asbestos exposure more likely to cause mesothelioma or carcinoma of the lung?

A

Carcinoma of the lung

30
Q

Histologic findings with beryliosis?

A

Scattered nocaseating granulomas (like sarcoidosis), no lymphocyte proliferation

31
Q

Histologic findings with Talcosis?

A

foreign body granulomas associated with BIREFINGENT platelike talk particles scattered in the parenchyma

32
Q

Name some examples of hypersensitivity pneymonitis?

A

Farmer’s lung, Bagossosis, Maple-Sugar-stripper’s lung, Bird fancier’s lung suberpsis, ushroom workers disease

33
Q

Pathology seen with hypersensitivity pneumonitis?

A

bronchiolocentric intersitital pneumonia, noncaseating granumonas, pulm fibrosis

34
Q

What is the exaggerated response in sarcoidosis?

A

exaggerated helper T cell response–> granulomas in multiple organs

35
Q

Symptoms of sarcoidosis?

A

bilateral hilar LAD, erythema nodosum, uveitis, skin disease, lacrimal gland involvement, cough, dyspnea

36
Q

Special cell findings associated with sarcoidosis?

A

Ateroid bodies (crystals) and Schaumann bodies (calcifications)

37
Q

Serum markers for sarcoidosis?

A

Increased CD4

Increased serum ACE

Increased urine Ca

38
Q

Another name for usualy interstitial pneumonia (UIP)?

A

idiopathic pulmonary fibrosis

39
Q

Pathologic findings in UIP/ IPF?

A

patchy interstitia fibrosis

fibrosis of “temporal heterogeneity” (different ages)

40
Q

Etiology of honeycomb lung?

A

interstitial and alveolar inflammation destroys the distal acinus and the proximal parts dilate and become lined by bronchiolar epithelium

41
Q

Gross lung changes seen in nonsprecific interstitial pneumonia (NIP)?

A

“ground glass” appearance

42
Q

Changes seen in desquamative interstitial pneumonia (DIP)?

A

1- accumulation of intra-alveolar macrophages

2- hyperplasia of type II pneumpcytes

3- “ground glass” appearance in lower lobes

43
Q

What is desquamative interstitial pneumonia (DIP) associated with?

A

ONLY seen in SMOKERS

44
Q

RB-ILD is found in what part of the lungs mainly?

A

Upper lobes!

Patchy accumulation of pigmented macrophages in the airspaces, centered on bronchioles

45
Q

Another name for Organizing pneumonia pattern?

A

BOOP: bronchiolitis oblterans organizing pneumonia

46
Q

Histologic features of BOOP/ OPP?

A

patchy areas of loos organizing fibrosis and chronic inflammatory cells int eh distal aireays

Plugs of organizing fibroelastic tissue occlude bronhioles, alveolar ducts and surround alveoli

47
Q

Where in the lungs is BOOP. OPP seen?

A

distal airways, it is patchy

48
Q

Where in the lungs is RB–ILD seen?

A

Upper lobes and it is patchy

49
Q

Defining features of LIP (lymphoid interstitial pneumona?

A

lumphoid aggregates noncaseating granulomas, increased risk of lymphoma

50
Q

Describe the interstitial nodules seen in langerhans histiocytosis?

A

stellate border extending into the interstitim

51
Q

Markers of LAM cells seen in lymphangioleiomyomatosis?

A

HMB-45 +
Estrogen -
Progesterone receptor +

52
Q

Wegeners commonly affects which organs?

A

KIdney and lungs

53
Q

Wegener is a disease of what sized vessels?

A

Small and medium–> aseptic, necrotizing, granumlomatous infalmmation

54
Q

What cell marker is indicative for Wegener?

A

+ c-ANCA

55
Q

Symptoms of Churg-strauss syndrome?

A

Asthma, eosinophelia, vasculitis, renal problems

56
Q

CXR patterns of a pulmonary hamartoma?

A

“coin lesions” and “popcorn” calcifications

57
Q

2 main cardinogens in cigarettes?

A

Polycyclic aromatic hydrocarbons

Arsenic

58
Q

Which type of lung cancer is more prevalent…small cell or non-small cell?

A

Non-small cell (>85%)

59
Q

Name the lung cancer:

“Keratin pearls”, male smoker, CENTRAL tumor, Increased PTH (increased Calcium in blood and urine)

A

Squamous cell carcinoma

60
Q

Name the lung cancer:

glands or mucin, NONSMOKER, female, peripheral location

A

Adenocarcinoma

61
Q

Name the lung cancer:

columnar cells that grow along breexisting bronchioles and alceoli, clara cell link, NONSMOKERS, peripheral

A

Bronchiolalveolar carcinoma

62
Q

Name the lung cancer:

poorly differentiated large cells, SMOKING, in central location OR the periphery, poor prognosis

A

Large cell lung cancer

63
Q

Name the lung cancer:

Well differentiated neuroendocrine cells, CHROMOGRANAN +, nonsmoker, Central or peripheral, CHILDHOOD

A

Carcinoid tumor

64
Q

Name the lung cancer:

Poorly differentiated small cells, neuroendocrine cells, MALE SMOKERS, CHROMOGRANIN +, central, paraneoplastic syndrome

A

Small cell Lung cancer

65
Q

Most common pulmonary lymphoma?

A

MALT lymphoma (martinal B cell)

66
Q

Which class of lung cancers respond to chemo?

A

small cell lung cancer

67
Q

Name the Lung cancer:

“cannonball lesions”

A

Mets

68
Q

Name some paraneoplastic syndrome:

A

acanthosis nigrans, polymyocytic, clubbing, Eaton-lambert syndrome, cushing

69
Q

Paraneoplasic syndrome specific for small cell lung cancer:

A

SIADH, encephalomyoitis, anit-Hu

70
Q

Paraneoplasic syndrome specific for squamous cell lung cancer:

A

hypercalcemia

Unit 4: Pathoma (3 decks)

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