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Pathology II > Path 2, Exam 1 > Flashcards

Path 2, Exam 1 Flashcards

1
Q

What can cause pulmonary hypoplasia? (2)

A
  1. Space-occupying lesions in uterus

2. Congenital diaphragmatic hernia

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2
Q

What is a TE fistula?

A

abnormal connection between esophagus and trachea

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3
Q

What is the most common TE fistula?

A

TYPE C

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4
Q

What is atelectasis?

A

Incomplete expansion of lung due to collapse, compression or obstruction

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5
Q

Is atelectasis a disease?

A

NO

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6
Q

What causes atelectasis? (3)

A
  1. Bronchial Obstruction-tumor
  2. Compression- pneumothorax/pleural effusion
  3. Contraction-fibrotic lung
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7
Q

A lesion on RUL is what until proven otherwise?

A

TB

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8
Q

What is NRDS?

A

Neonatal Respiratory Distress Syndrome, lack of surfactant

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9
Q

What are other names for NRDS? (2)

A

Hyaline membrane disease (neonate)

Surfactant deficiency disorder (adult)

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10
Q

What is pulmonary edema?

A

accumulation of fluid in the lungs—>impaired gas exchange, possible respiratory failure

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11
Q

What causes pulmonary edema? (2)

A
  1. Failure of the heart to remove fluid from lung circulation (cardiogenic)
  2. Direct injury to the lung
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12
Q

Pathophysiology of PE? (3)

A
  1. Capacity of the lymphatics to absorb and drain interstitial fluid is exceeded
  2. Architecture of the alveolar epithelial cells breaks down
  3. Fluid entering the alveolar spaces reduces or halts gas exchange
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13
Q

What is the pathophysiology of ARDS? (6)

A
  1. Neutrophils produce pro-inflammatory products
  2. Immune is compromised and unable to balance the pro-inflammatory products.
  3. Increased permeability of capillary
  4. Flooding transudate fluid into alveolus.
  5. Loss of gas exchange fxn
  6. Decrease surfactant production
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14
Q

What is the pathophysiology of COPD?

A

Inflammation throughout airways, activated inflammatory cytokines????

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15
Q

What is chronic bronchitis?

A

Persistent cough with sputum production for at least 3 months in 2 consecutive years without identifiable cause

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16
Q

What is unusual about the chronic bronchitis diagnosis

A

No clinical findings

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17
Q

What does atopic mean?

A

Atopic is allergic (IgE mediated) whereas non-atopic is infxn

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18
Q

What is Samter’s Triad (3)

A
  1. Asthma
  2. Rhinitis and nasal polyps
  3. Hives
    Things aspirin causes
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19
Q

What is exercise induced asthma?

A

People who experience asthma in exercise, but not other circumstances. Could be due to sensitivity to changes in temperature and humidity of air entering lungs—air is not warmed and humidified with rapid breathing rate

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20
Q

How can exercise induced asthma be prevented?

A

warm up and cool down

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21
Q

What is airway remodeling? (2)

A
  1. Hypertrophy and hyperplasia of muscle layer

2. Deposition of sub epithelial collagen

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22
Q

Is bronchiectasis a disease?

A

NO, condition in which large bronchi are damaged and dilated

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23
Q

What is the most lethal genetic disease to Caucasians?

A

Cystic Fibrosis

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24
Q

What is Cystic Fibrosis?

A

Disorder of ion transport of epithelial cells–

resulting from genetic mutations in the CTFR (cystic fibrosis transmembrane conductance regulator gene)

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25
Q

What are characteristics of Cystic Fibrosis?

A
  1. Atelectasis
  2. Obstruction v restriction
  3. COPD
  4. Restrictive Pulmonary Diseases
  5. Reduced compliance
  6. Diffuse- increase
    fluid secretion in exocrine glands–defective ion transport
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26
Q

Particle sizes for pneumonconiosis–most dangerous

A

1-5 micrometers

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27
Q

What is silicosis?

A

Most common chronic occupational disease due to inhalation of TETRAHEDRAL (shape increases chemical activity) silica crystals that damage epithelial cells and macrophages causing inflammatory response—fibroblasts proliferate

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28
Q

What would you see on CXR for silicosis?

A

Eggshell calcification of hilar lymph notes 1-2 cm in diameter with walls 2 mm thick (typically upper lung)

29
Q

What is Asbestosis?

A

A diffuse parachymal disease; asbestos fibres are engulfed by macrophages and cause infllatory reaction in airways

30
Q

What 2 cancers are associated with asbestosis?

A

Bronchiogenic carcinoma and mesothlioma

31
Q

What is Sarcoidosis?

A

systemic granulomatous disease of unknown cause that may involve many different tissues and organs—presents with bilateral hilar LA, no known cause-disease of exclusion

32
Q

Why is pulmonary HTN a vicious cycle?

A

Alveoli become wider and arterioles become narrower, increases pulmonary blood pressure and enlargement of right ventricle which causes right sided heart failure

Narrowing causes HTN and HTN causes narrowing

33
Q

Pneumonia v Pneumonitis?

A

Pneumonia is bacterial infxn and pneumonitis is caused by inhalation of particulates

34
Q

Risk factors for pneumonia? (5)

A
  1. Any condition leading to diminished gag reflex
  2. Mucociliary elevator dysfunction/damage causing to decreased clearance of defective agents
  3. Accumulation of secretions
  4. Decrease in phagocytic or bactericidal action of alveolar macrophages
  5. Pulmonary congestion and edema
35
Q

What organism is responsible for most cases of community acquired pneumonia worldwide?

A

Streptococcus pneumoniae

36
Q

Gram staining for streptococcus pneumoniae?

A

Gram +

37
Q

What are ssx of pneumonia

A
  1. cough
  2. fatigue
  3. myalgia
  4. incerased sputum production
  5. Pleuritic chest pain
38
Q

How are signs and sx different depending on lobar, viral or bronchopneumonia?

A

lobar
viral
broncho

39
Q

Difference between congestion and consolidation?

A

Congestion: leaky dilated capillaries- protein rich exudate into interstitium/intra-alveolar fluid with few neutrophils, exudative rxn—not solidification
Consolidation: Exudative rxn and subsequent solidification

40
Q

4 stages of lobar pneumonia

A
  1. congestion
  2. Red hepatization
  3. grey hepatization
  4. Resolution
41
Q

Characteristics of red hepatization (3)

A
  1. Red cell exudate, neutrophils, and fibrin in alveolar spaces
  2. Red, firm, airless
  3. consistency: liver tissue
42
Q

Gray Hepatization characteristics (4)

A
  1. Red cell disintegration, shift to increased fibrinization
  2. Persistent neutrophils, fibrin and supperative exudate
  3. Alveoli still consolidated
  4. appears grayer and browner and drier
43
Q

In which populations is Haemophilus Pneumonia most prevalent? (2)

A
  1. Children under 2 with otitis media, URI, meningitis, cellulitis or osteomylitis
  2. Adults with COPD
44
Q

How does Haemophilus Pneumonia gram stain?

A

Gram -

45
Q

Antibiotic for haemophilus pneumoniae

A

Bactrim

46
Q

2nd most Common cause of pneumonia in people with COPD?

A

Moraxells Catarrhalis

47
Q

Gram staining of Moraxells Catarrhalis?

A

negative

48
Q

Which population most often get Klebsiella Pneumoniae? (2)

A
  1. Debilitated/malnourished

2. Alcoholics

49
Q

Klebsiella gram staining properties?

A

negative

50
Q

Cystic Fibrosis patients with pneumonia presumably have which bacteria?

A

Pseudomonas Aeruginosa

51
Q

Gram staining properties of Pseudomonas Aeruginosa?

A

negative

52
Q

How is legionella transmitted?

A

inhalation of aerosolized organisms or aspiration of contaminated water

53
Q

What is unusual about Legionella?

A

?

54
Q

What are the atypical pneumonias

A

viral (influenza)
mycoplasmal (mycoplasma pneumoniae (obligate intracellular)
not bacterial

55
Q

What is walking pneumonia?

A 
cell wall deficient bacteria cause walking pneumonia
legionella
coxiella burnetti
mycoplasma pneumoniae
chlamydia pneumoniae
56
Q

Are cultures helpful for atypical/walking pneumonia

A

NO

57
Q

What findings in tympanic membrane of a person with pneumonia might indicate the causative organism

A

Bullous myringitus

blisters on tympanic membrane

58
Q

What is unusual about the original location of viral versus bacterial pneumonia?

A

Viral- interstitial

bacterial- alveolar

59
Q

What is the most common viral overall

A

Influenza A/varicella zoster

60
Q

Most common viral in children

A

RSV/ respiratory synctal virus

61
Q

What is an oxygen tent

A

enclosure/high oxygen. helps them breath better

62
Q

What is virus responsible for SARS

A

Corona virus

63
Q

How is SARS identified

A

by PCR, giant cells present

64
Q

What most common causes of nosocomial pneumonia?

A

hospital acquired, bugs resistentant to antibiotics

MRSA or psuedomonias

65
Q

What are the characteristics of aspiration pneumonia?

A

Aspiration of gastric contents
prolonged bed rest
posterior lobes
leads to abscesses

66
Q

Common organisms of aspiration pneumonia

A

aerobic–Strep, Staph, H FLu. Pseudomonas—normal oral flora
anaerobic bacteroides and fusobacteriam

67
Q

What is the difference between pleural effusion and empyema?

A

Pleural effusion- fluid in between visceral and parietal lung layers
empyema- pus not fluid—will be cloudy on CXR

68
Q

What is bronchoplueral fistula?

A

pus filled empyema/fistula/sinus tract from bronchus to pleural space

69
Q

What 4 organisms associated with chronic pneumonia?

A

tb, histoplasmosis, blastomycosis, coccidiomycosis

Pathology II (5 decks)

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