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Flashcards in Lung Deck (452)
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210

Grading scheme for pulmonary hypertension: Histology of Grade III (3).

Grade I plus subendothelial fibrosis.

Small arteries and arterioles: Concentric masses of fibrous tissue, reduplication of elastic lamina, occlusion of vascular lumens.

Large arteries: Atherosclerosis.

211

Grading scheme for pulmonary hypertension: Histology of Grade IV (3).

Medial hypertrophy is less apparent.

Progressive dilatation of small arteries.

Plexiform lesions.

212

Grading scheme for pulmonary hypertension: Histology of Grade V (2).

Plexiform and angiomatoid lesions.

Intraalveolar hemosiderin-laden macrophages.

213

Grading scheme for pulmonary hypertension: Histology of Grade VI (2).

Necrotizing arteritis with thrombosis.

Transmural infiltrates of neutrophils and eosinophils.

214

Grading scheme for pulmonary hypertension: Which grades are reversible?

Grades I, II, and III.

215

Grading scheme for pulmonary hypertension: Which grades are associated with secondary pulmonary hypertension?

Grades I, II, and III.

216

Pulmonary hypertension due to chronic thrombotic or embolic disease: Histology (3).

Little or no medial hypertrophy.

Eccentric intimal fibrosis with focal obliteration.

Organizing thrombi with recanalization.

217

Pulmonary hypertension: Mutation.

Familial pulmonary arterial hypertension: BMPR4 on 2q33-q34.

218

Pulmonary veno-occlusive disease: Age group.

Mostly in children and young adults.

219

Pulmonary veno-occlusive disease: Distribution of lesions.

Pulmonary venules and small veins in the lobular septa.

220

Pulmonary veno-occlusive disease: Histology of veins.

Occlusion of affected veins by intimal fibrosis.

Medial hypertrophy ("arterialization") and increase in elastic fibers.

Usually no plexiform lesions or vascular inflammation.

221

Pulmonary veno-occlusive disease: Additional histology.

Capillaries may be dilated and tortuous, mimicking pulmonary capillary hemangiomatosis.

Hemosiderin may be abundant, mimicking idiopathic pulmonary hemosiderosis.

222

Pulmonary capillary hemangiomatosis.

Proliferation of capillaries causes thickening of alveolar septa.

223

CMV pneumonia: Infected cells (4).

Fibroblasts.

Endothelial cells.

Respiratory epithelial cells.

Macrophages.

224

CMV pneumonia: Effect of ganciclovir on histology.

Makes the intranuclear inclusions redder and rounder.

225

Herpes simplex virus: Respiratory infections.

Necrotizing tracheobronchitis.

Necrotizing bronchiolocentric pneumonia.

Interstitial pneumonitis resembling DAD.

226

Measles virus: Respiratory infections.

Necrotizing bronchiolitis.

Giant-cell pneumonia.

227

Parainfluenza virus:

A. Cytopathic effects.
B. Respiratory infection.

A. None or multinucleate giant cells.

B. Giant-cell pneumonia (genotypes 2 and 3).

228

Hantavirus:

A. Cytopathic effect.
B. Histology of respiratory infection (2).

A. None; virus is identified by IHC or PCR.

B. Marked alveolar edema; immature leukocytes in alveolar capillaries.

229

Legionella pneumonia: Type of inflammation (3).

Neutrophilic.

Monocytes and macrophages.

All of the above.

230

Legionella pneumonia: Other histologic features (3).

Intraalveolar fibrin and hemorrhage.

Abundant nuclear debris.

Vasculitis occasionally.

231

Legionella pneumonia:

A. Special stain.
B. Other method of detection.

A. Silver stain.

B. Urinary antigen test detects serogroup 1 only.

232

Nocardia pneumonia: Main route of infection.

Inhalation of bacteria in soil and decaying organic matter.

233

Nocardia pneumonia: Sites of concurrent infection (4).

Skin.

Bone.

Kidney.

Brain.

234

Nocardia pneumonia: Histology (3).

Necrosis.

Microabscesses.

Immunocompromised: Poorly formed granulomas rather than abscesses.

235

Nocardia pneumonia: Special stains (3).

Gram stain.

Fite's stain.

Silver stain.

236

Ghon lesion of pulmonary tuberculosis:

A. Size.
B. Consistency.
C. Location.

A. 1-2 cm.

B. Necrotic center.

C. Lower upper lobe or upper lower lobe, near the pleura.

237

Pulmonary tuberculosis: Ghon complex.

Consists of a Ghon lesion and enlarged hilar lymph nodes.

238

Pulmonary tuberculosis: Ranke complex.

Fibrosis and calcification of the Ghon complex due to cell-mediated immunity.

239

Pulmonary tuberculosis: Characteristic cell.

The Langhans cell: A giant cell with peripherally arranged nuclei, formed by the fusion of the histiocytes that surround the granuloma.