A patient dies and the surface of his airway is fiery red. What is the likely infectious agent?
A patient is infected with a microorganism, begins to recover and dies. On autopsy, the bronchioles show signs of obliterative bronchiolitis. What is the Dx?
A child acquires a respiratory infection from a nursery. What is the likely infectious agent?
Respiratory Syncytial virus
A patient is admitted to the hospital with bouts of coughing followed by a whooping inspiration. What is your Dx? What portions of the respiratory tract would be inflamed?
Bordetella Pertussis (Whooping Cough); Bronchi and bronchioles
A patient working at a welding factory and grain silo goes home for the weekend and begins to experience dyspnea and cough late Saturday evening. The cough and dyspnea resolve. What is your Dx? What is a more serious complication of this disease?
Silo-filler disease caused by NO2 inhalation; Bronchiolitis obliterans and death due to respiratory failure
From what source is SO2 produced?
Burning fossil fuels
A biopsy of a patients bronchiole is shown below with necrosis, ulceration, and granulomatous inflammation. What is the Dx?
What two groups of patients does bronchocentric granulomatosis predominate? What complicates the condition in each patient subtype?
Asthmatic - allergic bronchopulmonary aspergillosis
Non-asthmatic - Infection, especially with tuberculosis or fungi (such as Histoplasma capsulatum)
A patient presents with dyspnea and wheezing. The patient recently had a bone marrow transplant. The biopsy of the patients bhronchiole is shown below. What is the Dx? What other conditions is this disease associated with? What is the pathologic progression of this condition?
- Lung transplantation
- Collgen vascular diseases
- Postinfectious disorders
- Inhalation of toxins
- Ingestion of certain drugs
Infalmmation, bronchiolar scarring, fibrosis, progressive narrowing, obliterative bronchiolitis
What does bronchial obstruction often lead to?
Describe the pathophysiology leading to atelectasis
- If air supply is obstructed, air in the alveoli will transfer to the blood causing collapse of the lung. The mediastinum will move toward the affected side.
- IF compression occurs and is severe enough the lung may compress and the mediastinum will shift away from the affected side
What is Right middle lobe syndrome?
Atelectasis due to obstruction of the bronchus to the right middle lobe. This particular lobe is susceptible to external compression because it is long and slender and surrounded by lymph nodes
What is bronchiectasis? What is it caused by?
Irreversible dilation of bronchi caused by destruction of bronchial wall muscle and elastic elements
What are the subtypes of bronchiectasis?
- Localized Nonobstructive
- Generalized Nonobstructive
What is obstructive bronchiectasis?
Localized bronchiectasis that occurs to a mechanical obstruction (tumors, inhaled objects, etc)
What is Localized Nonobstructive bronchiectasis?
Bronchiectasis usually following childhood bronchopulmonary infections with measles (uncommon in industrialized countries)
What is generalized nonobstructive bronchiectasis?
Bronchiectasis that is secondary to inherited impairment in host defense mechanisms or acquired conditions that permit introduction of infectious organisms into the airways
What are the main inherited conditions that predispose a person to generalized nonobstructive bronchiectasis?
CF, Dyskinetic ciliary syndromes, Hypogammaglobulinemias, and deficiencies of IgG subclasses
A patient presents with dextrocardia, bronchiectasis and sinusitis. What is your Dx?
A patient is found to have an absence of cilia throughout the body. The patient is sterile. The patient experiences recurrent upper and lower respiratory tract infections. What is the Dx?
Radial Spoke Deficiency (Sturgess Syndrome)
What are the three classifications of bronchiectasis on gross examination of the lung?
A patient with a Hx of chronic lung problems expires. The patient had chronic productive cough with several mL of mucopurulent sputum a day. The patient often had hemoptysis. The patient's lung is shown below. What is the Dx? How would this condition be Dx in a living patient?
Bronchiectasis; CT Scan