Pathology Flashcards
(188 cards)
1
Q
What is Emphysema?
A
Emphysema is characterized by permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls without significant fibrosis
2
Q
What are the types of Emphysema?
A
Centriacinar
Irregular
Panacinar
Distal acinar
“Not COPD but CIPD”
3
Q
In Centriacinar emphysema which parts of the acini is damaged?
A
Central and Proximal Acini
4
Q
True or False? Centriacinar emphysema are normally found in the Lower lobes of the lungs while Panacinar (Panalobular) are found in the Upper lobes of the lungs.
A
FALSE!! Centriacinar is found in Upper lobes while Panacinar is found in theLower lobes.
5
Q
What type of Emyphesema is associated with a α1-anti-trypsin deficiency?
A
Panacinar Emphysema
6
Q
Fill in the blank. “ In Distal (paraseptal)Acinar emphysema , the ______ part of acini is damaged.
A
Distal
- it’s literally in the name…
7
Q
Which inflammatory mediators are released in Emphysema?
A
Leukotriene B4, IL-8, TNF
8
Q
Which inflammatory cells are released in Emphysema?
A
Neutrophils, macrophages, and CD4+ and CD8+ T cells
9
Q
What is the function of α1-anti-trypsin in the body?
A
α1-anti-trypsin is a major inhibitor of proteases (particularly elastase) secreted by neutrophils during inflammation.
10
Q
Where is α1-anti-trypsin produced in the body?
A
In the liver
11
Q
Where is α1-anti-trypsin found in the body?
A
Serum
Tissue fluids
Macrophages
12
Q
The term ‘blue bloater’ is associated with which disease?
A
Chronic bronchitis
13
Q
The term ‘pink puffer’ is associated with which disease?
A
Emphysema
14
Q
Why are these patients called pink puffers?
A
Because of prominent dyspnea and adequate oxygenation of haemoglobin.
15
Q
What is Compensatory emphysema ?
A
The dilation of residual alveoli in response to loss of lung substance else- where, such as occurs after surgical removal of a diseased lung or lobe.
16
Q
Fill in the blanks. “__________ refers to any form of emphysema that produces large subpleural blebs or bullae.
A
Bullous emphysema
17
Q
What type of emphysema can be developed in children with Whooping cough?
A
Mediastinal (interstitial) emphysema
18
Q
What is Mediastinal (interstitial) emphysema?
A
This is caused by entry of air into the interstitium of the lung, from where it may track to the mediastinum and sometimes the subcutaneous tissue
19
Q
What is a common cause of Obstructive overinflation ?
A
Subtotal obstruction of an airway by a tumor or foreign object.
20
Q
What are factors for the development of emphysema (Pathogenesis)
A
Inflammatory cells and mediators
Protease–anti-protease imbalance
Oxidative stress
Airway infection
21
Q
What are the macroscopic features of Panacinar emphysema
A
Pale, voluminous lungs
Hypercrepitant
Diffused dilated spaces
22
Q
Which type of Emphysema is associated with Anthrocosis ( Black pigment- black discoloration of bronchial mucosa)
A
Centriacinar
23
Q
True or False? In patients with Emphysema , there is an increased lung compliance and decreased lung elastance?
A
TRUE!!!
24
Q
How is a deficiency of α1-anti-trypsin connected to emphysema?
A
α1-anti-trypsin is a INHIBITOR of elastase, During Emphysema a lot of elastase is released from the Neutrophils. This elastase released destroys & degrades elastin fibers in the lung tissue, leading to the destruction of alveolar walls, enlarges airways and reduces surface area.
In lungs, ( decreased 1-antitrypsin ->
uninhibited elastase in alveoli -> decreased elastic tissue ->panacinar emphysema
25
How are α1-anti-trypsin alleles represented?
PiMM = normal α-1 antitrypsin levels
PiMZ = intermediate α -1 antitrypsin levels
PiZZ = very low α-1 antitrypsin levels
M - normal, S -intermediate, Z- marked decrease
26
True or false? Eosinophils are present in Chronic bronchitis?
FALSE!! They are NOT present.
27
What are histologic features of Chronic Bronchitis?
-Mucous gland hypertrophy and hyperplasia
Reid index
– Goblet cell hyperplasia
– Squamous metaplasia
– Oedema and increased vascularity
– Chronic inflammatory cell infiltration
– Mucopurulent exudate (infection)
28
What is the normal thickness of mucous glands to thickness of bronchial wall using the Reid Index?
0.36-0.41
29
What value using the Reid scale indicates Chronic Bronchitis?
0.44 -0.79
30
What is the time period used to diagnose Chronic Bronchitis?
3 months per year for 2 consecutive years
31
What is Asthma?
Asthma is a chronic inflammatory disorder of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough, particularly at night and/or early in the morning.
32
What are the hallmarks of Asthma?
Reversible airway obstruction
Chronic bronchial inflammation with eosinophils
Bronchial smooth muscle cell hypertrophy and Hyperreactivity; and increased mucus secretion.
33
What are the cells that play an active role in Asthma?
Eosinophils
Mast cells
Macrophages
Lymphocytes
Neutrophils and epithelial cells
34
What are the major factors contributing to Asthma?
Genetic predisposition to type I hypersensitivity (atopy)
Acute and chronic airway inflammation
Bronchial hyperresponsiveness to a variety of stimuli.
35
What are the subdivisions of Asthma?
Atopic and Non-Atopic
36
In which subdivision of Asthma is associated with type 2 helper T (TH2) cell activation?
Atopic
37
Which cytokines produced by T helper cells is involved with IgE production?
IL-4 and IL-13
38
True or False? In Atopic Asthma, the activated T helpers cells produces cytokine IL-5 which causes mucus production.
FALSE!!
IL-5 produces Eosinophils
39
Fill in the blank ." Cytokine _____ is involved with mucus production "
IL-13.
40
How can one diagnose Atopic Asthma?
Serum radioallergosorbent tests (RASTs) that identify the presence of IgEs that recognize specific allergens.
41
What is the most common drug associated with Drug induced Asthma?
Aspirin
42
What is Occupational Asthma?
Occupational asthma may be triggered by fumes (epoxy resins, plastics), organic and chemical dusts (wood, cotton, platinum), gases (toluene), and other chemicals.
43
What are the different mediators in Asthma and what are their roles?
-HISTAMINE & LEUKOTRIENES:
Bronchoconstriction
↑ vascular permeability → submucosal oedema → narrowing of bronchial lumen
↑ Mucus secretion from goblet cells → mucus plugs in the airways
-PROSTAGLANDINS:
Bronchoconstriction
Vasodilation → submucosal oedema
- PLATELET ACTIVATING FACTOR:
Aggregation of platelets → Release of histamine
44
What are the different chemotactic factors involved with Asthma?
- Neutrophil chemotactic factor→
Accumulation & activation of neutrophils →
Release of O2 free radicals → Tissue Damage
- Eosinophil chemotactic factor →Accumulation of eosinophils → Discharge of granules → cationic protein & major basic protein → Impairment of ciliary function & damage to bronchial epithelial cells
45
What are the histologic features present in Asthma?
1)Thickening of basement membrane
2)↑ Inflammatory cells in lamina propria (Eosinophils & Mast cells)
3)Hypertrophy of bronchial smooth muscle
4)↑ # of submucosal glands
46
What distinct features can be found in the sputum of Asthmatic patients?
Curshmann’s spirals
Charcot- Leyden crystals
47
What is Curshmann’s spirals?
Mucus & shed bronchial epithelium in spirals
48
What is Charcot- Leyden crystals?
Bipyramidal structures derived from membrane of degenerate eosinophils as well as eosinophil proteins (galectin -10)
49
What is Bronchiectasis?
Bronchiectasis is the permanent dilation of bronchi and bronchioles caused by destruction of smooth muscle and the supporting elastic tissue; it typically results from or is associated with chronic necrotizing infections.
50
What are the causes of Obstructive bronchiectasis?
Bronchial tumours
Aspirated foreign bodies
Mucus plugs in airways
Enlarged hilar lymph nodes – Tb, Metastatic tumours
51
What are the causes of Congenital Non-Obstructive bronchiectasis?
Defective cilia: Kartagener’s Syndrome
( Bronchiectasis + Situs Inversus + Sinusitis)
Defective mucus secretion: Cystic Fibrosis
52
What are the causes of Acquired Non-Obstructive bronchiectasis?
- Infections: Necrotizing pneumonia
(Staphylococcus, Pseudomonas, Measles &
Whooping cough)
53
True or False? In Congenital non-obstructive bronchiectasis, the issue is confined to one lobe while in acquired non-obstructive bronchiectasis the issue is confined to all lobes of bronchi.
TRUE!!
54
What percentage of of non-smokers worldwide develop lung cancer?
25%
55
What percentage of heavy smokers develop lung cancer?
11%
56
What is the most common benign lung tumor?
Hamartoma
57
What are the four major histologic types of carcinomas of the lung?
Adenocarcinoma
Squamous cell carcinoma
Small cell carcinoma
Large cell carcinoma
58
What is the most common type of lung carcinoma in people?
Adenocarcinoma
59
What are other carcinogenic nfluences associated with occupational exposures to develop lung carcinoma?
Asbestos
High-dose ionizing radiation
Nickel
Arsenic chromium
Uranium
Vinyl-chloride
60
What is the increased risks of exposure to asbestos to smokers?
55 times
61
Which type of lung carcinoma is normally peripherally located but may be close to the Hilum?
Adenocarcinoma
62
What are the growth patterns of Lung adenocarcinomas?
Acinar (gland- forming)
Papillary
Solid sheets of cells with mucin
63
What is the putative precursor of adenocarcinoma?
Atypical adenomatous hyperplasia (AAH)
64
What is another name for Adenocarcinoma in situ?
Bronchioloalveolar carcinoma
65
Where do Adenocarcinomas in situ grow?
Along alveolar septa
66
Which lung carcinomas are strongly associated with smoking?
Squamous cell carcinoma and Small cell carcinoma
S& S associated with S-moking
67
Which lung carcinoma is mostly located centrally in major bronchi and eventually spread to local hilar nodes?
Squamous Cell carcinoma
68
Fill in the blanks." Squamous cell carcinomas often are preceded by the development, over years, of _______ or _______ in the ________epithelium, which then transforms to________ a phase that may last for several years
Squamous metaplasia
Dysplasia
Bronchial epithelium
Carcinoma in situ
69
What histological findings are associated with Squamous cell carcinoma?
Keratin pearls and Intercellular bridges to poorly differentiated neoplasms exhibiting only minimal squamous cell features.
70
What is the main location for Small cell carcinomas?
Centrally located masses that extend into the lung parenchyma.
71
Which lung carcinoma is associated with a salt and pepper like appearance?
Small cell carcinoma
72
What neuroendocrine cells do small carcinoma originate from?
Kulchitsky cells ( Enterochromaffin cells)
73
What neuroendocrine markers are expressed on small cell carcinoma cells?
Synaptophysin, chromogranin A, and CD56
74
What other disease can be associated with smAll cell carcinoma?
-Acth(Adrenocorticotropic hormone) production causing Cushing's syndrome
-siAdh (Syndrome of inappropriate antidiuretic hormone )
- Antibodies against presynaptic Ca2+ channels (Lambert- Eaton myasthenic syndrome
75
Which lung carcinoma is poorly differentiated ?
Large Cell carcinoma
76
Which lung carcinoma is associated with PTHrP(Parathyroid hormone-related peptide) overproduction, which can cause hypercalcemia ?
Squamous cell carcinoma
77
What is Pancoast syndrome?
Pancoast tumour aka superior sulcus tumour (tumour in apex of the upper lobe) can grow to involve cervical and thoracic nerves leading to shoulder pain that radiated down the arm
78
Pancoast tumour that paralyses cervical sympathetic nerves leading to: ptosis of upper eyelid; miosis (constriction of pupil); anhidrosis (lack of sweating) can cause?
Horner's syndrome
79
Where does Hematogenous metastasis from Primary lung cancer involve?
- Intraparenchymal spread (within the lungs)
– Pleura
– Brain, bone, liver
– Adrenal glands
80
Where does Lymphatic metastasis to regional lymph nodes from Primary lung cancer involve?
Hilar
Mediastinal
Carina
Neck (scalene nodes)
Clavicular regions
81
What is the staging method used for Lung carcinomas?
TNM ( tumor node metastasis)
82
What are the most common sites for secondary lung cancer?
Breast
Colons
Stomach
Pancreas
83
What are types of Granulomatomas?
Necrotizing (has a necrotic centre) and Non-Necrotizing ( solid with no necrotic centre)
84
What is Tuberculosis(TB)?
Tuberculosis is a communicable chronic granulomatous disease caused by Mycobacterium tuberculosis. It usually involves the lungs but may affect any organ or tissue in the body.
85
How can one be tested for TB?
Tuberculin (Mantoux) test -(Skin test)
86
Which type of TB may present may present with flu-like symptoms, fever and pleural effusions?
Primary TB
87
What specific bacteria is responsible for most cases of Tuberculosis?
M. tuberculosis hominis
88
Which type of TB bacteria can be contracted by drinking unpasteurised milk?
Mycobacterium bovis (T.Bovis)
89
What type of bacterium is Mycobacterium Tuberculosis?
Gram -Positive Acid- Fast - because they resist decolorization by acid after staining with carbolfuchsin. This is due to the high lipid content of their cell walls
90
What is the function of IFN-γ in the role of cell mediated immunity against Tuberculosis?
IFN-γ ACTIVATES macrophages, making them bactericidal.
91
What substances do these now activated macrophages , in cell mediated immunity against TB, produce and what are their functions?
*TNF - TNF helps to form monocytes which then differentiate into epithelial histiocytes. These epithelial histiocytes can fuse together forming GIANT CELLS or aggregate to form granulomas.
* iNOS ( inducible nitric oxide synthase) - this produces NO which helps with killing mycobacterium
*Anti-microbial peptides (defensins) which are toxic towards mycobacterial organisms.
92
True or False? Ghon complex is at the lower part of upper lobe or upper part of lower lobe.
FALSE!!! Ghon focus is!!!
" Focus on the upper parts"
93
What is Ghon complex?
This is the combination of parenchymal and nodal lesions ( focus + hilar lymphadenopathy)
94
Fill in the blanks. "If normal immunity and infection is not overwhelming then there is fibrosis and then calcification of the _______"
Ghon complex - this overall can be detectable as a Ranke complex on radiograph.
95
What is miliary pulmonary disease?
This occurs when organisms reach the blood- stream through lymphatic vessels and then recirculate to the lung via the pulmonary arteries.
96
When there is Tuberculosis manifested in the vertebrae it is known as?
Pott disease
97
Where does secondary tuberculosis normally develop?
In the apical areas of the lungs near the clavicles because oxygen tension is highest and these are obligate aerobes.
98
What is the most common extra pulmonary tuberculosis?
Lymphadenitis (usually in the cervical region ) aka Scrofula
99
In what areas are systemic millary tuberculosis most prominent?
Liver, bone marrow, spleen, adrenal glands, meninges, kidneys, fallopian tubes, and epididymis
100
What is Sarcoidosis?
Sarcoidosis is a multisystem disease of unknown etiology characterized by NON-CASEATING granulomatous inflammation in many tissues and organs
101
What is the cardinal histopathologic feature of sarcoidosis, irrespective of the organ involved?
Non-necrotizing epithelioid granuloma
102
What are two histologic features present in Sarcoidosis?
Schaumann bodies and Asteroid bodies
103
What is the hallmark for acute sarcoidosis?
Erythema nodosum (swollen fat under the skin causing bumps and patches that look red or darker than surrounding skin)
104
What are other implications associated with Sarcoidosis
Bell's palsy
Uveitis (choroiditis,retinitis)
Granulomas
Lupus Pernio
Interstitial Fibrosis & Iritis
Erythema Nodosum
Rheumatoid arthritis -like arthropathy
than
Sally - Sicca syndrome( can't cry)
Mason - Mikulicz syndrome (abnormal enlargement of glands in the head and neck, including those near the ears (parotids) and those around the eyes (lacrimal) and mouth (salivary)
Betty's sarcoidosis is UGLIER than Sally Mason's
105
What are the clinical features of Sarcoidosis?
shortness of breath, dry cough, vague sub- sternal discomfort, fever, fatigue, weight loss, anorexia, night sweats, peripheral lymphadenopathy, cutaneous lesions, eye involvement, splenomegaly, or hepatomegaly
106
What are implications of Sarcoidosis?
Elevated ACE ( angiotensin converting enzyme) levels
Elevated CD4/8 ratio in bronchoalveolar lavagea fluid
Hypercalcemia( due to hypervitaminosis D caused by increased synthesis of 1-α-hydroxylase within the granulomas)
107
What is the treatment for Sarcoidosis?
Steroids
108
Where are granulomas normally present in Sarcoidosis?
Hilar lymph nodes and parenchyma of lungs
109
What are the types of Rhinitis?
Infectious
Allergic
110
What is the etiology of Infectious rhinitis?
Adenovirus
Rhinovirus
Echovirus
111
What is the etiology of Allergic (Hay fever) rhinitis?
Plant pollen, dust mites, animal allergens
112
Fill in the blanks. " Empyema, orbital osteomyelitis, bacterial meningitis, dural venous sinus thrombophlebitis are all complications of __________"
Sinusitis
113
What cells are found in the stroma of a sinonasal polyp?
Eosinophils, lymphocytes, plasma cells
114
What are Sinonasal (Schneiderian) Papillomas?
Benign Tumours
115
Which types of type of Schneiderian papilloma is at risk to developing into a papilloma?
Inverted and Oncocytic
116
What are the types of Sinonasal papillomas?
Inverted
Oncocytic
Exophytic
117
What is the localisation of Exophytic sinonasal papillomas ?
Unilateral, Nasal septum
118
What is the localisation of Inverted and Oncocytic sinonasal papillomas ?
Unilateral, Lateral nasal wall; paranasal sinuses
119
Which type of Sinonasal papilloma presents with Nasal obstruction; rhinorrhoea,; epistaxis; anosmia; frontal headaches; proptosis; diplopia?
Inverted sinonasal papilloma
120
Which sinonasal papilloma has a histologic feature of tall columnar cells with pink granular cytoplasm ?
Oncocytic Sinonasal papilloma
121
Fill in the blanks. " Inverted and Exophytic Sinonasal papillomas has _________ epithelium."
Straified Squamous Epithelium
122
Fill in the blank "________ has epithelium that can be described as fingerlike projections."
Exophytic
123
What are the types of Sinonasal adenocarcinoma?
Intestinal and Non-Intestinal Type
124
True or False? Intestinal sinonasal adenocarcinoma is of unknown etiology.
FALSE!! It is caused by wood dust &leather dust
125
True or False? Intestinal sinonasal adenocarcinoma is of unknown etiology.
FALSE!! It is caused by wood dust &leather dust
126
What type of Nasopharyngel carcinoma is associated with EBV , high salt food intake with nitrosamine & genetic suscebility?
Non-Keratinizing nasopharyngeal carcinoma
127
True or False? Keratinizing nasopharyngeal carcinoma is associated with Tobacco smoking & alcohol consumption.
TRUE!!
128
Where are laryngeal nodules(singers nodes) normally located?
On the true vocal folds.
129
True or False? Recurrent respiratory papillomatosis (RRP) are caused by HPV types 6 & 18
FALSE!!! Are caused by types 6 &11
130
True or False? Mucillary blankets are found in the small airways?
FALSE!! They are found in the large airways
131
Fill in the blanks." In the Respiratory Tract Defense mechanisms , _______ traps large particles while ______ traps small particles(less than 5 microns)
Mucus(large) & Alveolar macrophages (small)
132
What are the causes of impairment to the lung defence mechanisms?
1.Loss /suppression of cough reflex
2.Injury of to the mucociliary apparatus
3.Accumulation of secretions
4. Interference with Phagocytic action
5.Pulmonary congestion & oedema
133
What gram positive bacteria is the most common cause of Community- Acquired Pneumonia?
Streptococcus pneumoniae
134
What gram negative bacteria is the most common cause of Community- Acquired Pneumonia?
Klebsiella pneumoniae
135
What viruses are responsible for causing Community-Acquired pneumonia?
Respiratory syncytial virus (RSV)
Influenza virus types A and B
Adenovirus
Human Coronavirus
* SARS CoV-2
136
What are the most common organisms associated with Health Care acquired pneumonia?
Staphylococcus aureus
Pseudomonas aeroginosa
137
What etiologic agents is strongly associated with nasopharyngeal carcinoma?
Epstein-Barr Virus (EBV)
138
What is the major immunoglobulin in airway secretions?
IgA
A- for Airway
139
What is Hoarseness?
Hoarseness is characterized by a change in the quality of voice.
140
What is the time period marked as for persistent Hoarsness?
2 weeks
141
What are the causes of hoarseness?
*Intrinsic lesion of the true vocal cords
*Neural lesion: vagus or recurrent laryngeal
*Neuromuscular Junction lesion
*Lesion of the laryngeal muscles or arthritis of the cricoarytenoid joint
142
What are examples of Nuclear Lesions of the Vagus nerve?
*Bulbar poliomyelitis
*Motor neuron disease
*Lateral medullary syndrome (PICA)
143
Acoustic neuroma & Meningioma are what type of lesions for the vagus nerve?
Posterior Fossa Lesions of the Vagus nerve
144
Glomus jugulare & Metastatic carcinoma of the nasopharynx are examples of what type of lesions of the Vagus nerve?
Jugular Foramen lesions of the Vagus nerve
145
Give an example of a Supranuclear lesion of the Vagus nerve?
Cerebrovascular accident
146
What are examples of Thoracic lesions?
Aortic aneurysm or aneurysmal surgery
Carcinoma of oesophagus
Tuberculous or metastatic nodes
'ACT'
147
What is stridor?
A high pitch auditory manifestation of laryngeal or tracheal obstruction with an inspiratory component.
148
Fill in the blank. " The _______ and _______ is a site of obstruction for Inspiratory and Expiratory stridor."
Subglottis and Trachea
149
A glottic obstruction is an example of what type of stridor ?
Inspiratory stridor
150
A persistent hoarseness can be associated with what disease?
Cancer of the voicebo
151
Cancer of the voice box normally arises at what location?
Anterior 1/3 of vocal chords
152
Which disease accounts for 90% of congenital stridor?
Laryngomalacia
153
Give examples of Intrinsic lesions of the true vocal cords?
*Acute and chronic laryngitis
*Vocal cord nodules
*Laryngeal papillomatosis
*Carcinoma of the larynx
154
Where are vocal cords nodules(singer nodules) normally located and what type of persons normally have them?
Anterior 1/3 and posterior 2/3 of vocal cords
155
True or False? In recurrent laryngeal nerve palsy, the left side is more common than the right side.
TRUE!!
156
What is Laryngomalacia?
A defect in the development of the cartilage in the Larynx, the airway collapses whenever the child breathes.
157
What shape can be used to describe the epiglottis in patients with Laryngomalacia?
Omega type shape
158
What is the aetiology of laryngeal papillatamosis?
HPV virus types 6, 11
159
At what location is a tracheostomy done?
Between tracheal rings 2&3 ( where the tracheal isthmus is located)
160
What is the most common cause of Epxitaxis?
Nose picking
161
Fill in the blank. " ________ is the cause of an Anterior epistaxis and ________ is the cause of Posterior epistaxis."
Kiesselbach's Plexus( Little Area) - Anterior bleed
Plexus of Woodruff - Posterior bleed
162
Unilateral bleeding from the nose can be an indication of what?
A neoplastic mass
163
What are the general causes of Maxillary carcinoma?
*Hypertension
*Pregnancy
*Warfarin, Heparin, NSAID
*Hereditary Haemorrhagic Telangiectasia
*Congenital coagulopathy
164
How can one indicate CSF Rhinorrhoea?
One sided drainage from the nose that is crystal clear.
165
Fill in the blanks. '________ are present in large airways while _______ are present in small airways"
Mucocillary Blanket- Large airways
Phagocytes- Small ariways
166
True or False? Mucus traps small particles.
FALSE!!! Mucus traps LARGE particles
167
Which structure phagotysose particles
smaller than 5 microns?
Alveolar macrophages
168
What are factors that can interfere with phagocytic action?
* Alcohol
* Tobacco smoke
* Anoxia
* Oxygen intoxification
169
What are factors that can cause injury to the mucociliary apparatus?
* Cigarette smoke
* Inhalation of hot or corrosive gases
* Viral diseases
* Genetic defects of cilia function, eg immotile cilia syndrome
170
Which gram positive bacteria is the most common cause of Community Acquired pneumonia?
Streptococcus pneumoniae
171
Which gram negative bacteria is the most common cause of Community- Acquired pneumonia?
Klebsiella pneumoniae
172
What are examples of viruses that can cause Community-Acquired pneumonia?
Human coronavirus
Adenovirus
Influenza virus type A &B
Respiratory syncytial virus (RSV)
173
What are associated risk factors with Health-care Associated pneumonia?
* Hospitalization of at least 2 days within the recent past
* Presentation from a nursing home or long-term care facility
* Attending a hospital or hemodialysis clinic
* Recent IV antibiotic therapy, chemotherapy or wound care
174
Fill in the blanks." ______ and ________ are the most common organisms associated with Health-Care associated pneumonia."
* Staphylococcus aureus
* Pseudomonas aeroginosa
175
Which gram positive bacteria is the most common cause of Hospital Acquired Pneumonia?
Staphylococcus aureus (usually methicillin-resistant)
176
Anaerobic oral flora - 'Bacteroides, Prevotella, Fusobacterium' are associated with what type of pneumonia?
Aspiration pneumonia
177
Which fungi can be associated with Chronic pneumonia?
* Histoplasma capsulatum
* Blastomycosis dermatitidis
178
Nocardia & actinomyces - are associated with which type of pneumonia?
Chronic pneumonia with non-granulomatous inflammation
179
Fill in the blank. "Bacterial invasion of the lung parenchyma causes exudative solidification called
__________"
Consolidation
180
In which stage of Lobar pneumonia has Intra-alveolar exudate of RBC with polymorphs?
Red- Hepatization
181
What are some symptoms of Lobar pneumonia?
* Sudden onset malaise, fever, chills, rigors
* Pleuritic chest pain, pleural rub
* Rusty sputum
* Purulent sputum
182
Fill in the blanks. " Bacterial pneumonia present with ______ & _______ involvement while viral pneumonia present with _______."
Broncho & Lobar - bacterial
Interstitial - Viral
183
What are causes of Interstitial pneumonia?
* Mycoplasma pneumonia
* Pneumocystis jiroveci
184
What is the main histological feature associated with Acute Respiratory syndrome?
Diffuse alveolar damage (DAD)
185
What is Acute Respiratory Distress syndrome?
ARDS is a clinical syndrome of progressive respiratory insufficiency caused by diffuse alveolar damage in the setting of sepsis, severe trauma, or diffuse pulmonary infection.
186
What is Atypical pneumonia?
Atypical pneumonia is characterized by protracted course of constitutional symptoms and signs with gradual resolution,lack of typical consolidation on CXR,failure to isolate a pathogen on routine bacteriological investigation and lack of response to penicillin therapy
187
What are the classical atypical bacteria associated with Atypical pneumonia?
1.) Mycoplasma pneumonia
2.) Chlamydia pneumonia
3.) Legionella pneumonia
188
