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Flashcards in Images Deck (125):
1

What bug is causing this pneumonia?

strep pneumo = gram positive diplococci

2

What bug is causing this pneumonia?

staph aureus

3

What bug is causing this pneumonia that can occur in pts with COPD?

H influenza

4

WHat bug is causing this pneumonia that is often seen in alcoholics

klebsiella pneumoniae

5

What is causing this pnuemonia that is seen in hospitalized patients?

pseudomonas

6

What does this chest xray show?

bronchopneumonia

7

What does this chest xray show?

Lobar pneumonia

8

What type of pneumonia is this?

interstitial pneumoniae

9

What is the difference between these two images?

left = non-necrotizing granuloma

right = necrotizing granuloma

10

What does this xray show?

miliary TB

11

What is the difference between these two pictures?

left = bronchial pneumonia

right = lobar pneumonia

12

What disease of the lungs is this?

bacterial pneumonia because you can see lots of neutrophils filling the air space

13

What is this?

lung abscess

14

What type of pneumonia is this?

atypical pneumonia since lack of neutrophils and inflammation just in interstitium not airways

15

What does this show?

Cytomegalovirus = owl eyes

16

What is this?

CMV

17

What is this?

CMV

18

What is this?

herpes infection

 

pomegranite apperance 

multi-nucleated cell with intranuclear inclusions

19

What is this?

adenovirus 

 

arrow = smudge cell

20

What is this?

ghon complex = primary TB

21

What is this?

cavitary lesion of seoncdary TB

22

What are these structures in the lung?

multiple granulomas

 

at this point are not necrotizing

23

What does this arrow point to?

necrotic center of a granuloma

24

What does this lesion in lung show?

periphery of necrotizing granuloma

 

shows histiocytes, ginat cells,and lots of lymphocytes

25

What kind of stain is this? What bug is the red structure?

acid fast bacilli = TB or atypical mycobacteria

26

What type of stain? What bug?

acid fast bacili 

 

TB or atypical mycobacteria

27

What caused this lesion to form in lungs

granulomas from histoplasmosis

 

well circumscribed, concentric, fibrotic rim + central necrosis

28

What bug does this arrow point to?

this is histoplasma

narrow based budding = looks like bowling pins

29

What bug is this on silver stain?

large spherules = coccidoides

30

What bug is this on PAS stain? how can you tell?

coccidoides

 

lots of spherules many of which have visible endospores inside

spherules are much much biger than lymphocytes

31

What makes this granuloma specific for blastomycosis?

central necrosis which contains lots of neutrophils

32

What bug does this arrow point to

blastomycosis = broad based budding

33

What fungus does this show?

34

What fungus does this lesion represent?

this is aspergillus = aspergilloma in previous body cavity

 

you can see difference between central aspergilloma and the fibrotic cavity surrounding it

35

What does this lesion represent

This is invasive aspergillus

 

typical "target lesion" = central necrosis surrounded by hemorrhage and inflammation

36

What is morphology of aspergillus?

- acute angle < 90 branching

septate hyphae

37

What type of fungus does this show?

aspergillus = acute angle branched hyphae

38

What fungus does this show?

aspergillus = acute angle branched hyphae

39

What does this arrow point to?

cryptococcus

 

have fibroinflammatory mass with histiocytes

 

can see organism at arrow

40

What organism is this stained on GMS?

cryptococcus = narrow based budding

different sizes of organisms

41

What is this organism? what does the arrow point to?

white that arrow is pointing to = halo

this is cryptococcus

42

What organism is this pointing to on mucicarmine stain?

this is cryptococcus

narrow based budding

mucicarmine = stains the capsule

43

What organism creates this type of lesion

pneumocystis jiroveci

 

classic intra-alveolar exudate with frothy appearance

 

KNOW THIS

44

What bug is shown here on GMS stain?

 

hint only in immune compromised

pneumocystis jiroveci

45

What fungus is this on silver stain?

PCP in frothy exudate

46

What type of pathology does this show in this bronchial wall?

 

Diagnosis?

This is mucous gland hypertrophy

 

means this patient has chronic bronchitis

47

What pathology/diagnosis in the pt on the left?

emphysema

48

What disease in the lung on the right?

This is emphysema

you can see destruction of lung parenchma

49

What is this disease of the bronchiole?

Asthma!

 

thickened basement membrane = pink line

mucus plug

50

What is each of these types of emphysema

Left = centriacinar emphysema; see central areas surrounded by spared alveolar spaces

Right = panacinar emphysema; involves entire pulmonary architecture

51

What is this disease of the airways?

chronic bronchitis = enlarged mucus glands; very high Reid index

52

What is this disease of the airways?

bronchiectasis

53

What is this disease of the airway?

bronchiectasis!

54

The picture on the left is normal. What is the picture on the right?

ARDS

 

exudative phase

55

What pathophys findings in ARDS do these pictures represent?

left = proliferative phase

right = fibrotic phase

56

What does this chest xray in a neonate show?

Neonatal respiratory distress syndrome

 

due to lack of surfactant

57

What does this show?

hyaline membranes in exudative phase of DAD

58

What does this show?

hyaline membranes in diffuse alveolar damage

59

What does this image show?

hyaline membranes in diffuse alveolar damage

60

What stage of DAD is this?

 

What findings?

This is early organizing/proliferative phase

 

still have residual hyaline membranes

see fibroblastic proliferation in interstitium, type 2 pneumocyte hyperplasia

61

What type of pneumonia is this?

eosinohpilic pneumonia

 

looks like acute bacterial but eosinophils instead of neutrophils

chronic b/c have intra-alveolar fibrin and macrophages

62

What type of pneumonia is this?

Acute eosinophilic pneumonia

 

hyaline membranes with eosinophils

63

What kind of pneumonia is this?

acute eosinophilic pneumonia

= hyaline membranes with eosinophils

64

What pattern is this?

65

What does this show?

organizing pneumonia pattern

66

What does this show?

Organizing pneumonia pattern

67

What does this show?

organizing pneumonia pattern

 

with fibroblastic tissue partially within lumen of bronhole

68

What does this show?

traction bronchiectasis= look like dilated airways

69

What does this show?

arrows point to reticular abnormality = excessive linear densities

sign of ILD

70

What do these arrows point to?

honeycombing + cysts

sign of ILD

71

What do you see in this radiology that is typical of diagnosis?

typical IPF

- bases of lungs more involved than apex

- periphery more involved than center

looksl ike subpleural changes

72

What is this pattern?

this is usual interstitial pneumonia --> suggest idiopathic pulmonary fibrosis diagnosis

 

see fibrosis just underneath pleura, honeycomb changes

73

What does this show? 

this is fibroblast focus = whirly of colalgen/fibroblasts/thick tissue

tells you that diagnosis is interstitial pulmonary fibrosis

74

What stage of sarcoidosis is this?

stage 1 = enlarged hilar lymph nodes but not yet lines/densities in lung fields

75

What is this?

well formed tightly packed non-caseating granulomas = sarcoidosis

76

What is this?

This is a ferruginous body = sign of asbestos exposure

77

What is this?

Asbestos pleural plaque = sign of exposure not disease

78

What is this finding that can be associated wtih many different interstitial lung diseases?

honeycomb lung

79

What is this finding assocaited wtih interstitial lung disease?

80

What type of ILD pathology is this?

usual interstitial fibrosis = patchy fibrosis w/ subpleural predominance

81

What type of ILD pathology is this?

usual interstitial pnuemonia = patchy fibrosis

 

right = start to see honeycomb changes

82

What does this arrow point to?

fibroblast focus = shows usual interstitial pneumonia

83

What type of NSIP?

cellular nonspecific interstitial pneumonia

84

What type of NSIP?

fibrosing NSIP

85

What type of interstitial lung disease?

lymphocytic infiltrative pneumonia

86

What type of interstitial lung disease?

lymphocytic interstitial pneumonia

87

What does this show?

sarcoidosis = noncaseating granulomas in lung w/ many giant cells

88

What finding of a type of interstitial lung disease does this show?

bronchiolocentric pattern of inflammation in hypersensitivity pneumonitis

89

What type of interstitial lung disease associated wtih smoking?

DIP = diffuse inflammation not just around ariway

90

What diagnostic marker are the arrows pointing to in this interstitial lung disease?

these are langerhans cells = polygonal cells w/ groove in nucleus

 

this is langerhans cell histiocytosis

91

What does this arrow point to?

This is birbeck granule = tennis raquet shaped intracellular structure

 

characteristic of langerhans cell

92

What is this?

pleural plaques due to asbestos exposure?

93

What disease is this?

asbestosis = you can see the asbestos bodies

94

What disease is this?

asbestosis = shows asbestos bodies

95

What is this?

advanced silicosis

96

What is this? What causes it?

silicotic nodule = due to silicosis

97

What is this?

simple coal workers pneumoconiosis

98

What is this?

simple coal workers pneumoconiosis

99

What is this?

complicated coal workers pneumoconiosis

100

What does this pathologic finding suggest? What is it called?

This is a plexiform lesion. This suggest pulmonary arterial hypertension

101

What significant finding does the arrow point to on this xray? what does it signify?

This is hampton's hump

 

represents pulmonary infarction

102

What is this? Effect?

pulmonary saddle embolus

 

results in sudden death

103

What is characteristic of this clot in pulm vasculature?

has lines of zahn

 

tells you this is a thrombus rather than a postmortem clot

104

What does the characteristic pattern here represent?

these are lines of zahn = show that its a true thrombus not a post-mortem clot

105

What is this? Where is the location of the initial lesion?

This is a pulmonary infarct due to a small thromboembolism

 

typically the occluded vessel is at the point of the triangle

106

What is this finding in a pulmonary vessel?

pulmonary thromboembolus

107

What does this finding in a pulmonary vessel suggest?

This is an organized embolus you can see some recanalization occuring with webs across

 

sign of chronic small pulmonary embolus

108

What is this finding in lungs characteristic of?

this is plexiform lesion

characteristic of pulm arterial htn

109

What is this finding in lung on elastic stain?

plexiform lesion = suggests pulm arterial htn

110

What does this finding suggest in a patient with pulm htn?

suggests chronic thromboembolic disease = thrombus that is organized w/in arterial wall

111

What disease does this suggest?

Wegeners = have not-well formed granulomas; very blue areas of necrosis = lots of neutrophils

112

What vascular disease does this suggest?

113

What vascular disease does this suggest?

Churg-strauss

 

have granulomas w/ pallisaded histiocytes/giant cells

around central zone of necrosis w/ eosinophils

114

What is this finding? What is major cause?

this is diffuse alveolar hemorrhage w/ capillaritis

 

major cause is microscopic polyangiitis

115

What is this finding?

hemosiderin; sign of chronic hemorrhage

116

What is happening in this lung?

this is squamous metaplasia

 

sign of progression toward squamous cell carcinoma

117

What is happening in this lung?

This is dysplasia and carcinoma in situ

 

sign of progression to squamous cell carcinoma

118

What is this highly suggestive finding in lung cancer?

keratin pearl = sign of squamous cell carcinoma

119

What is this finding in setting of lung cancer?

atypical adenomatous hyperplasia

suggests adenocarcinoma

120

What is this finding in cancer?

minimally invasive adenocarcinoma in situ

121

What type of cancer?

adenocarcinoma! b/c you can see gland formation

122

What type of cancer?

large cell carcinoma

 

large cells; no keratin; no mucin; no glands

123

What type of cancer?

small cell lung cancer

124

What type of cancer?

this is a carcinoid tumor = small round uniform cells

125

What type of tumor?

carcinoid tumor