Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y2 - Path - Exam 4 > 9: Pulm 2 > Flashcards

9: Pulm 2 Flashcards

1
Q

define: diffuse interstitial lung disease

A
  • Heterogeneous group of disorders
  • Interstitial inflammation (alveolar septae)
  • _**Fibrosis_ – stiff or restricted lung morphology
  • Reduced compliance with more effort needed to expand the “stiff” lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

diffuse interstitial lung disease:

pathogenesis

A
  1. Inhaled or blood-born toxins –> Epithelial/endothelial injury
  2. Recruitment/activation of inflammatory cells including macrophages, neutrophils and
  3. Fibroblasts (alveolar walls/spaces)
  4. Release of injurious (oxidants/ cytokines) and fibrogenic (FGF,IL-1, TGF-β1) mediators
  5. Interstitial fibrosis and chronic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the FIBROSING DISEASES w/in the Diffuse Interstitial Lung Disease

A
  • Idiopathic pulmonary fibrosis, older males.
  • Collagen vascular diseases (SLE, RA, systemic sclerosis)
  • Pneumoconioses: non-neoplastic lung reactions to inhaled mineral dusts (coal dust, silica, asbestos), organic particulates, chemical fumes/vapors.
  • Therapeutic drugs, therapeutic radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the GRANULOMATOUS DISEASES w/in the Diffuse Interstitial Lung Disease

A
  • sarcoidosis
  • hypersensitivity pneumonitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 categories of Diffuse Interstitial Lung Disease

A
  • FIBROSING disease
  • GRANULOMATOUS disease
  • PULMONARY EOSINOPHILIA
  • PULMONARY ALVEOLAR PROTEINOSIS (more rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which histologic pattern is associated with Idiopathic pulmonary fibrosis?

A

Usual interstitial pneumonitis (UIP): is a chronic fibrosing interstitial lung disease

  • Pathologic correlate of clinical syndrome of idiopathic pulmonary fibrosis.
  • UIP can be pathologic diagnosis, whereas IPF is clinical term (idiopathic pulmonary fibrosis)
  • End result is FIBROSIS OF THE LUNG (irreversible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

define: idiopathic pulmonary fibrosis (IPF)

A

Progressive interstitial fibrosis with hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IDIOPATHIC PULMONARY FIBROSIS:

etiology and epidemiology

A
  • Etiology: UNKNOWN
    • theory is that it’s caused by repeated cycles of epithelial injury and activation by unknown antigen –>
    • chronic inflammation and fibroblastic/myofibroblastic proliferation
  • Epi:
    • OLDER adults of either gender (mostly >50 years)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

USUAL INTERSTITIAL PNEUMONIA (UIP)

histopathology

A
  • histopath:
    • interstitial fibrosis in PATCHWORK PATTERN
    • FIBROBLASTIC FOCI
    • parenchymal scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

USUAL INTERSTITIAL PNEUMONIA (UIP):

end stage

A

end stage: honeycomb lung

(characteristic appearance of variably sized cysts in a background of densely scarred lung tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which histo pattern is associated w/ the following images?

A

Usual intersitial pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Since Idiopathic Pulmonary Fibrosis is a diagnosis of exclusion (50% of interstitial fibrosis), what are the other disease in which Usual Interstitial Pneumonia (UIP) pattern is seen?

A

Similar pattern can be seen in later/end stage of diseases :

  • Pneumoconioses
  • Hypersensitivity pneumonitis
  • Collagen vascular diseases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-specific interstitial pneumonia (NSIP):

how are subtypes classified?

A

on basis of histology – divided into:

  • cellular pattern
  • fibrosing pattern
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

define: Non-specific interstitial pneumonia (NSIP)

A

Uniform and diffuse alveolar septal expansion by lymphocytes or collagen or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which condition was previously known as BOOP?

(bronchiolitis obliterans-organizing pneumonia)

A

organizing pneumona (OP): common pathologic finding in lung

  • characterized by the presence of polyp-like collections of fibroblasts within airspaces,
  • referred to as fibroblastic plugs or Masson bodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the major causes of ORGANIZING PNEUMONIA

A
  • Infections (localized finding at the edge of another histologically obvious process such as fungal granuloma)
  • Minor part of the pathologic findings of another process
  • Connective tissue disease
  • Drug-related
  • Bronchial obstruction
  • Idiopathic (Cryptogenic organizing pneumonia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the causes of PNEUMOCONIOSES?

A
  • Mineral dusts (e.g: coal, silica, asbestos, Beryllium)
  • Organic dusts (e.g: mold [aspergillus], bird droppings, cotton)
  • Fumes and Vapors (e.g: nitrous oxide, sulfur dioxide, ammonia, benzene)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what factors affect toxicity and fibrogenic activity in PNEUMOCONIOSES?

A
  • Physical properties of the particles (size/shape)
  • Physiochemical reactivity, solubility
  • Concentration
  • Duration of exposure
  • Effectiveness of clearance mechanisms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do the physical properties of particles affect toxicity and fibrogenic activity in Pneumoconiosis?

A
  • Particles 1-5 µm are greatest danger as get lodged at bifurcation points in distal airways
  • Elicit macrophage (MO) phagocytosis → release of mediators/cytokines → inflammation and fibrosis
    • RECALL: MO should be in lung for protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

define, and epidemiology:

anthracosis

A
  • DEF: Accumulation of coal-dust in lungs, pleura, and lymph nodes
    • No significant reaction
    • Asymptomatic
  • Epi: Smokers & urban dwellers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

define: Simple Coal Workers’ Pneumoconiosis (CWP)

and symptoms

A
  • Coal macules (coal-dust laden macrophages 1-2 mm, peribronchial) and coal nodules (> 2 mm) in a background of collagen deposition
  • Sxs:
    • Cough
    • Black sputum
    • No dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

define: COMPLICATED Coal Workers’ Pneumoconiosis (CWP)

and effect on respiration

A
  • Complicated CWP (progressive massive fibrosis - PMF)
    • Progressive severe fibrosis in a background of simple CWP
  • RESPIRATORY INSUFFICIENCY results
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

COMPLICATED Coal Workers’ Pneumoconiosis (CWP):

histo features

A

Multiple nodules and black scars > 2cm (dense collagen and black pigment) with central necrosis

24
Q

define: Caplan’s Syndrome

A
  • a combination of rheumatoid arthritis (RA) and pneumoconiosis
25
**CAPLAN'S SYNDROME:** diagnosis, course, associated w/ which minerals/conditions?
* dx: Nodular lesions with central necrosis and peripheral fibrohistiocytic inflammation * nodules are seen on xray * course: Faster progression/more severe * assoc: carbon, silicosis and asbestosis
26
sources of exposure of Silicosis: what is the most damaging/fibrogenic of these causes?
* \*\*Most damaging/fibrogenic to the lung: **crystalline forms such as QUARTZ** * Other causes (occupational): * Mining (gold, tin, copper, coal) * Quarrying * Sandblasting, stone cutting * Metal grinding * Manufacture of ceramics
27
what specific disease does SILICOSIS increase the susceptiblity of?
silicosis --\> increased susceptibility to TUBERCULOSIS (bc it interferes w/ immune function --\> macrophage clearance is decreased)
28
**SILICOSIS:** histopathology
* Nodular fibrosis * Hyalinized whorls of collagen * Scant inflammation * Birefringent silica particles * Coalescence of nodules/large areas of dense scars (progression even after cessation of exposure) * Concomitant anthracosis
29
**SILICOSIS:** radiology
* Eggshell calcification on chest x-ray
30
ASBESTOSIS: histology
* Mineral fibers containing crystalline hydrated silicates * curled flexible serpentines * **straight stiff amphiboles** (more pathogenic) * ferruginous bodies **(iron coating)\*\* important clue on histology** * Diffuse interstitial fibrosis * Pleural effusions/fibrous adhesions * Hyalinized fibrocalcific ***pleural-plaques***
31
what is the KEY histological finding to confirm ASBESTOSIS?
FERRUGINOUS BODIES (iron coating)
32
ASBESTOSIS: pathogenesis
* Fibers ingested by macrophages leads to: * activation of macrophages and neutrophils * release of enzymes and fibrogenic cytokines * deposition in interstitium and lymphatics * direct stimulation of fibroblast collagen * Progressive fibrosis even after cessation of exposure
33
what are occupational exposure causes of asbestosis?
* Mining * Pipefitters and plumbers * Textile industry * Shipbuilding * Constructions * Insulations
34
asbestosis acts synergistically with what to increase risk of carcinoma (but not mesothelioma)
cigarette smoking (act synergistically to inc risk of carcinoma)
35
asbestosis has strong association with which tumors?
* Strong association with **malignant mesothelioma** and **bronchogenic carcinoma** * (Generates free radicals and adsorbs toxic chemicals, affecting nearby mesothelium or bronchial epithelium)
36
what condition is this gross anatomical image of?
PLEURAL PLAQUES; common manifestation of asbestos exposure
37
key word associations of: * anthracosis * silicosis * asbestosis
* **Anthracosis**: complicated coal workers pneumoconiosis * **Silicosis**: occupations exposed to silica; large collagenized nodules in lungs; seen under microscope * **Asbestos**: can cause pleural plaques, fibrosis (asbestosis), mesothelioma, lung cancer
38
SARCOIDOSIS: define
* **Non-caseating granulomas** (many tissues and organs) * **Disordered immune regulation** in genetically predisposed individuals when exposed to certain environmental agents * **CD4+ TH1** cells play a big role in formation of granulomas
39
SARCOIDOSIS: epidemiology
* Common disease, with **unknown etiology** * **Young adults (females)** * **Geographic/ethnic variations** (African-americans)
40
SARCOIDOSIS: clinical presentation
* bilateral, symmetrical, enlargement of lymph nodes (aka **"potato lymph nodes")** * *Peripheral lymphadenopathy/hepatosplenomegaly* * may be **asymptomatic** (incidental on chest xray) * *Usually lung involvement with hilar adenopathy (characteristic chest x-ray)* * **Insidious onset** with respiratory and constitutional symptoms **(fever, night sweats, weight loss)** * **Acute** onset with fever, **erythema nodosum, polyarthritis** * *isolated cutaneous or ocular lesions* * Usually lung involvement with hilar adenopathy (characteristic chest x-ray)
41
SARCOIDOSIS: key histopathological findings
* **non-caseating granulomas** * Pulmonary granulomas increase and eventually replaced by diffuse interstitial fibrosis of the lung
42
Sarcoidosis is a DIAGNOSIS OF EXCLUSION; how do you get a definitive diagnosis?
you need a **transbronchial biopsy** for a definitive diagnosis (granuloma is circled)
43
SARCOIDOSIS: clinical course
* 70% - recover w/ minimal or no residual disease * 20% - permanent lung or ocular dysfunction * 10% progress w/ severe interstitial pulmonary fibrosis and cor-pulmonale and death
44
HYPERSENSITIVITY PNEUMONITIS: define
* Intense, prolonged exposure to inhaled organic antigen * **Type III/IV** hypersensitivity reactions * Inflammation w/ **gradual fibrosis**
45
HYPERSENSITIVITY PNEUMONITIS: causes
* **Farmer’s lung**: thermophnilic actinomycetes in hay * **Pigeon breeder’s lung:** proteins from bird feathers and excreta * mold at home, or bird droppings * **Humidifier/air-conditioner lung:** thermo-philic bacteria * hot tub lung
46
HYPERSENSITIVITY PNEUMONITIS: histopathology; what is key feature?
* **Non-caseating _poorly formed_ interstitial granulomas - (**key feature) * Interstitial pneumonitis * Fibrosis * Organizing pneumonia reaction * May progress to severe interstitial fibrosis
47
PULMONARY ALVEOLAR PROTEINOSIS (PAP): very rare disease; what is the clinical manifestation?
* **Sputum (chunks of gelatinous material)** * Cough * Progressive respiratory difficulty
48
PULMONARY ALVEOLAR PROTEINOSIS (PAP): histopathology
* Alveolar spaces filled with **_dense, amorphous, PAS-positive, lipid containing, surfactant-_**like material * **autoimmune disease** (whole lung undergoes lavalge in the patient)
49
**pulmonary alveolar proteinosis:** two common forms of the disease?
1. autoimmune 2. secondary (associated with hematopoietic disorders, malignancies and immunodeficiency states)
50
lung disease can result from several causes: what are the **drug-induced lung diseases?**
* Bronchospasm (Aspirin, Beta-antagonists) * Pulmonary edema * Chronic pneumonitis/fibrosis (amiodarone/bleomycin) * Hypersensitivity pneumonitis (methotrexate)
51
lung disease can result from several causes: what are the **radiation-induced lung diseases?** (acute and chronic)
* Acute radiation pneumonitis (1-6 months.) * fever, dyspnea, radiologic infiltrates * Lymphocytic alveolitis, hypersensitivity pneumonitis * Respond to steroids * Chronic radiation pneumonitis * DAD and atypical type II pneumocytes * Progression to interstitial fibrosis
52
what does **CHRONIC radiation-induced lung diseases** look like on histology?
can look like fibrotic lung disease
53
lung disease can result from several causes: what are complications of therapy following **LUNG TRANSPLANT?**
* Infections (immunocompromised host) * Acute rejection - *we want to recognize and tx this as early as possible* * Chronic rejection * Lymphoproliferative diseases
54
ACUTE rejection of lung transplant: timing, sxs, tx
* Timing: **early weeks to months** post transplant * Sxs: **fever, dyspnea, cough, infiltrates on CXR** * perivascular and peribronchiolar mononuclear cell infiltrates * Tx: **increased immunosuppression**
55
CHRONIC rejection of lung transplant: timing, sxs, tx
* Timing: 6 - 12 months post transplant * Sxs: dyspnea, cough, --\> **_bronchiolitis obliterans_** (BO, aka popcorn lung) * Chronic rejection --\> total occlusion of bronchiole by fibrous tissue (BO) * BO is key histological finding * Tx: of BO disappointing

Y2 - Path - Exam 4 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions