Lung Pathology IV

Question 1

desquamative interstitial pneumonia

Answer 1

lots of smokers macrophages in alveoli

NOT desquamative

> 50yo
Male

Tx - steroids and cessation of smoking

Question 2

respiratory bronchiolitis associated interstitial lung disease

Answer 2

pigmented macrophages in bronchioles
-peribronchiolar fibrosis

30+ pack year history

Tx - stop smoking

**not as bad as macros in alveoli

Question 3

pulmonary langerhans cell histiocytosis

Answer 3

eosinophilic granuloma

proliferating dendritic cells
-response to smoking

Tx - stop smoking

express CD1a, S-100, CD207

Question 4

CD1a

Answer 4

seen in pulmonary langerhans cell histiocytosis

Question 5

pulmonary alveolar proteinosis

Answer 5

cough and gelatinous chunky sputum

bilateral, patchy CXR

accumulation of acellular surfactatnt in intra-alveolar and bronchiolar spaces

autoimmune
secondary
congenital - fatal

Tx - pulmonary lavage and GM-CSF therapy or transplant

Question 6

accumulation of acellular surfactant in intraalveolar bronchiolar spaces

Answer 6

pulmonary alveolar proteinosis

Question 7

ABC3 gene mutation

Answer 7

pulmonary alveolar proteinosis

Question 8

pulmonary embolism

Answer 8

SOB, chest pain, swollen leg

Question 9

saddle embolus

Answer 9

massive PE - death

• massive stress on right heart
• right side HF

PEA

Question 10

fever, chest pain, SOB, electromechanical dissociation, sudden death

Answer 10

pulmonary embolism

Question 11

mismatch of V/Q

Answer 11

pulmonary embolus

Question 12

gold standard for PE

Answer 12

angiography

Question 13

other emboli

Answer 13

fat - has vacuoles
amniotic fluid - blue lines
air - iatrogenic
nitrogen - divers

Question 14

amniotic fluid emboli

Answer 14

during delivery

• can lead to DIC
• many patients die

Question 15

Fen/Phen

Answer 15

interstitial fibrosis of lung

led to pulmonary HTN

Question 16

bush tea

Answer 16

backyard tea

can lead to pulmonary HTN

Question 17

primary pulmonary arterial HTN

Answer 17

80% genetic

idiopathic

mostly females 20-40yo

autosomal dominant

Question 18

BMPR2 mutation

Answer 18

idiopathic primary pulmonary arterial HTN

BMPR2 - inhibits proliferation of vascular smooth m

Question 19

secondary pulmonary HTN

Answer 19

normal rxn of arteries to increased pressure

medial hypertrophy

narrows arteries
-further increase P

lead to cor pulmonale

Question 20

atheromas

Answer 20

form with pulmonary HTN

Question 21

plexiform

Answer 21

severe long standing pulmonary HTN leads to oblitered lumen and revascularization**

Question 22

diffuse alveolar hemorrhage syndrome

Answer 22

causes

• goodpastures
• idiopathic pulmonary hemosiderosis
• vasculitis

hemosiderin laden macrophages

Question 23

alpha3 chain of collagen IV

Answer 23

anti-BM membrane antibodies

-goodpasture syndrome

Question 24

proliferative rapidly progressive GN and necrotizing hemorrhagic interstitial pneumonitis

Answer 24

goodpasture

Question 25

goodpasture

Answer 25

M young smokers teens-20yo pulmonary and renal symptoms Tx - immunosuppression and plasmapharesis

Question 26

SOB, proteinuria, hematuria, elevated Cr, couging up blood, hemoptysis

Answer 26

goodpasture

Question 27

linear anti-BM deposits

Answer 27

lung and kidney goodpasture

Question 28

idiopathic pulmonary hemosiderosis

Answer 28

rare, children diffuse hemorrhage hemosiderin deposition in macrophages and alveolar walls Tx immunosuppression bloody cough, weight loss, anemic

Question 29

cANCA

Answer 29

PR3 wegeners

Question 30

wegener granulomatosis

Answer 30

necrotizing granulomatous arteritis of lungs wegeners

Question 31

upper resp lesions, vasculitis with granulomas, kidney problems

Answer 31

triad for wegeners

Question 32

pulmonary infectious disease

Answer 32

often viral

Question 33

splenectomy pts

Answer 33

lose ability to mount response to encapsulated pneumococcus**

Question 34

COPD pneumonia

Answer 34

haem influenza | gram - pleomorphic

Question 35

gram - pleomorphic

Answer 35

haem influenza COPD pneumonia

Question 36

splenectomy/sickle cell pneumonia

Answer 36

streptococcus pneumonia | gram + diplococci

Question 37

post viral pneumonia

Answer 37

staph aureus | gram + cocci

Question 38

cystic fibrosis pneumonia

Answer 38

pseudomonas aeruginosa | gram - coccobacilli

Question 39

gram + diplococci

Answer 39

streptococcus pneumonia | splenectomy/sickle cell

Question 40

gram + cocci

Answer 40

staph aureus | post viral pneumonia

Question 41

legionella

Answer 41

macrophage response - not neutrophils

Question 42

debilitaed/malnourished pneumonia

Answer 42

klebsiella pneumoniae | gram - rod

Question 43

cold agglutinins

Answer 43

mycoplasma pneumoniae

Question 44

atypical pneumonias

Answer 44

chlamydia viruses mycoplasma coxiella