Saroj 2 Flashcards
how do you diagnose sarcoidosis
diagnosis of exclusion
Sarcoidosis occurs more commonly in who
women
african american
southeast US
what are immunologic and genetic abnormalitlies of sarcoidosis
-CD4 IL2 IL8 TNF macrophage inflammatory protein increased
histo for sarcoidosis? types of cells seen?
noncaseating granulomas
- epithelioid cells
- langhans
- Schaumann bodies
- asteroid bodies
The granulomas in sarcoidosis may be replaced by
firbrous scars
how are the lungs impacted in Sarcoidosis?
-bilateral hilar lymphadenopathy or lung involvment
granulomas are in close proximity to what in lungs in sarcoidosis
lymphatics, bronchi, and blood vessels
lesions in lung in Sarcoidosis tend to produce what
interstitial fibrosis
what yields to a high diagnostic yield for sarcoidosis
bronchoscopic biopsies
what lymph nodes are involved with sarcoidosis? what happens to them
hilar and mediastinal lymph nodes
- calcified
how is the liver impacted in sarcoidosis
granulomas in portal tarcts
which part of the bodies bone marrow is impacted by sarcoidosis
hands and feet
how is eye impacted by sarcoidosis
Mikulicz syndrome
Iritis and Dacroadenitis
Dacroadenitis
lacrimal gland inflammation
Mikulicz syndrome
lacrimal gland involvement + bilateral parotid, submaxillary and sublingual glands
what is chest x-ray sarcoidosis
bilateral hilar lymphadenopathy
clinical symptoms for sarcoidosis
dyspnea
cough
chest pain
maybe hemotpysis
what is prognosis for sarcoidosis
2/3 recover
who has the best prognosis for sarcoidosis
patients with hilar lymphadenopathy only
who has fewer remission
patients with pulmonary disease only
what is hypersensitivity pneumonitis
immunologically-mediated disorders
etiology for hypersensitivity pneumonitis
prolonged exposure to inhaled organic dusts and occupational antigens
What type of hypersensitivity reactions are seen in hypersensitivity pneumonitis
Type III - immune complex
Type IV - delayed type
hypersensitivity pneumonitis: farmers lung
inhaled spores of thermophilic actinomycetes
hypersensitivity pneumonitis: pigeon breeder’s lung
inhaled proteins from feathers or excretion
hypersensitivity pneumonitis: humidifier lung
inhaled thermophilic bacteria from heated water reservoirs
hypersensitivity pneumonitis what is on histo slide
- chronic interstitial pneumonitis with lymphocytes, plasma cells, macrophages
- noncaseating granulomas
- interstitial fibrosis and HONEYCOMBING
when do acute attacks occur for hypersensitivity pneumonitis? what is a clinical symptoms
in previously sensitized patient
-fever
when do symptoms begin after re-exposure
4-6 hours
clinical symptoms for chronic hypersensitivity pneumonitis? how does this impact lung
dyspnea CYANOSIS
decrease lung compliance and lung capacity
Pulmonary Eosinophilia: acute: most likely etiology
hypersensitivity response to inhaled antigen ( not drugs or food)
clinical features for Pulmonary Eosinophilia: acute:
rapid fever
hypoxemia
respiratory failure
Another name for Pulmonary Eosinophilia: simple pulmonary eosinophilia
Loeffler’s syndrome
what is the most likely etiology for Loeffler’s syndrome
hypersensitivity to food or drugs (sulfa drugs)
X- ray for Pulmonary Eosinophilia: simple pulmonary eosinophilia
prominent irregular lung densitites
what is in the blood for leoffler’s syndrome
blood eosinophilia
Pulmonary Eosinophilia: secondary pulmonary eosinophilia: seen in what type of infections
parasitic
bacterial
fungal
Pulmonary Eosinophilia: secondary pulmonary eosinophilia is associated with what
asthma
allergic bronchopulomary aspergillosis
Pulmonary Eosinophilia: chronic eosinophilic pneumonia: associated with?
autoimmune disease: rheumatoid arthritis
what is the histo for Pulmonary Eosinophilia: chronic pulmonary eosinophilia
lymphocytic and eosinophilic
clinical feature for Pulmonary Eosinophilia: chronic pulmonary eosinophilia
high fever
Desquamative interstitial pneumonitis is related to
smoking interstitial disease
What is morphology for Desquamative interstitial pneumonitis
alveoli filled with numerous pigment-laden macrophages ( “smokers” macrophage)
when do Desquamative interstitial pneumonitis symptoms begin
4 or 5 decade
gender Desquamative interstitial pneumonitis
male
treatment Desquamative interstitial pneumonitis
steroid
what is histo for respiratory bronchiolitis - associated interstitial lung disease
respiratory bronchioles
alveoli with ‘smokers’ macrophages
onset and gender respiratory bronchiolitis - associated interstitial lung disease
men
4 and 5 decade
Pulmonary alveolar proteinosis: acquired PAP due to
granulocyte macrophage colony stimulating factor (GM-CSF) antibodies
- causes impaired surfactant clearance
Pulmonary alveolar proteinosis: secondary PAP etiologies include
silicosis
immunodeficiency syndromes
morphology of pulmonary alveolar proteinosis
- marked increase in lung size and weight
- PAS +
- cholesterol clefts
- minimal inflammation
X-ray for Pulmonary alveolar proteinosis
- consolidation
insidious onset Pulmonary alveolar proteinosis
dyspnea
productive cough with gelatinous material
what is mortality in congenital PAP
fatal
what is used to remove alveolar precipitate
bronchoalveolar lavage
are schuamann and asteroid bodies pathogenic for sarcoidosis
no
