Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RESPIRATORY EXAM 2 > PATHOLOGY EXAM 2 > Flashcards

PATHOLOGY EXAM 2 Flashcards

1
Q

What happens to type I/II pneumocytes in idiopathic pulmonary fibrosis?

A

Type I’s damaged and Type II undergo hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

In what occupation is silicosis a problem? What is the causative agent?

A

Foundry, sandblasting, and stone cutting; Crystalline silicon dioxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are the 2 main forms of asbestos and which are removed from the lungs by mucociliary motion?

A

Chrysotile (serpentine) removed; Amphiboles (straight and stiff) not removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Which lung disease is most likely to have Schaumann and Asteroid bodies?

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is the Tx of the disease that leads to accumulation of surfactant and is associated with anti GM-CSF antibody?

A

Lung transplant; if not the kid is dead by 3-6 months of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 stages of the inflammatory response of lobar pneumonia?

A

Congestion, red hepatization, grey hepatization, and resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the current concept of pathogenesis in Idiopathic pulmonary fibrosis?

A

Repeated cycles of epithelial activation and injury by unidentified agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which pneumoconiosis has birefringent spicules with pointed ends in plane-polarized light?

A

Silcosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the gram stain of S. pneumo? Why might a person have a false-positive for this as a cause of pneumonia?

A

Gram positive diplococci (lancet shaped); It is normal flora in 20% of adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most important pertinent negative for nonspecific interstitial pneumonia? What is the Tx?

A

There is NO TEMPORAL HETEROGENEITY also no honeycombing; steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 2 possible outcomes of inhalation of the bacteria that lives in amoebae in AC units and hot tubs?

A

This is L. pneumophila–can be either Legionnaire’s disease or Pontiac fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What kind of “aspiration pneumonia” is a newborn at risk for?

A

Aspiration of amniotic fluid and epithelial cells (will look similar to amniotic fluid embolus b/c of the fetal squames)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which 2 restrictive diseases are granulomatous?

A

Sarcoidosis and Hypersensitivity pneumonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the gram stain of the most common cause of CAP as an acute exacerbation of COPD?

A

Gram negative coccobacilli (pleomorphic)–this is Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the risks of cancer in silicosis, asbestosis, and coal worker’s pneumoconiosis?

A

In CWP there is NO increased risk, in asbestosis there is definite risk, in silicosis the risk is unclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who is most likely to get desquamative interstitial pneumonia? What will you see? Tx?

A

Middle aged male smokers; intraalveolar macrophages w/ dusky pigment; smoking cessation and steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the histologic hallmark of pulmonary alveolar proteinosis?

A

Accumulation of surfactant in the alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are 2 ways to make a diagnosis of L. pneumophila?

A

Antigen detection in urine or grow on buffered charcoal yeast extract agar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which bug looks like crushed ping pong balls or dented helmets? Below what CD4 count is an AIDS patient predisposed?

A

Pneumocystis jiroveci; below 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an AIDS patient at risk for when his/her CD4 dips below 200 cells/mm3?

A

Pneumocystis jiroveci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is cryptogenic organizing pneumonia often secondary to?

A

Viral and bacterial pneumonia and also generalized inflammatory insults to the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A stroke patient is particularly at risk for what type of pneumonia?

A

Aspiration pneumonia if they have dysphagia. Also, they may lose the cough reflex which predisposes them to normal CAP and HAP pneumonia as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which pediatric emergency of unvaccinated children may descend to cause CAP?

A

Epiglottitis; most likely with Haemophilus influenza B in unvaccinated kids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Loeffler Syndrome?

A

Simple Pulmonary eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which disease causes ARDS-like Sx in a full-term infant? What is the best IMMEDIATE Tx, definitive?

A

Pulmonary Alveolar Proteinosis. WHOLE LUNG LAVAGE to get rid of the gelatinous stuff, lung transplant is definitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which type of pneumonia may look like it has cholesterol clefts like in atherosclerosis on biopsy?

A

Aspiration pneumonia, from the food that was aspirated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which restrictive disease tends to have bilateral hilar lymphadenopathy?

A

Sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the second most common cause of acute exacerbation of COPD? Gram stain?

A

Moraxella catarrhalis (w/ H. flu being most common)–gram negative diplococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 4 fibrosing restrictive diseases?

A

Idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, and the pneumoconioses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which type of asbestos is most likely to wind up in a pleural effusion and why?

A

Chrysotile (serpentine) because they are more SOLUBLE than amphiboles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are 3 complications of pulmonary abscesses?

A

SEPTIC EMBOLI (brain abscess), hemorrhage, and pleuritis/effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the effect of coal workers P on PFT’s and cancer risk?

A

Most are not affected by this unless it progresses, and there is no increased CA risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Micro tie-in: If a pulmonary abscess heals and leads to a cavity, what might colonize it?

A

Aspergillus fumigatus, FUNGAL BALL!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where are disseminated infections from the dimorphic fungus endemic to the desert SW most likely to go?

A

To the skin (erythema nodosum and multiforme) and to the meninges, particularly in IC patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does a lobular pneumonia look like on CXR?

A

Patchy and frequently BILATERAL (lower lung fields), lobar pneumonias are more localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the most likely causes of pulmonary abscess? What is a good way to differentiate this from a neoplasm on CXR?

A

Aspirated anaerobes and Staph aureus; A neoplasm (mass) will never have AIR FLUID LEVELS but an abscess will

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why does smoking worsen pneumoconioses?

A

It knocks out the cilia and thus worsens the clearing ability of the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which mediator seems to be driving aberrant epithelial repair in idiopathic pulmonary fibrosis?

A

TGF-B1

29
Q

What does a Ziehl-Neelsen stain, stain for?

A

Acid fast Bacilli

30
Q

In what way is hypersensitivity pneumonitis different from asthma?

A

HP affects alveoli vs. bronchioles and it is a granulmatous inflammation mediated by IgG rather than IgE (also, asthma is NOT granulomatous)

31
Q

T/F: under normal conditions inhaled dust particulates remain in the alveoli, pneumoconiosis occurs when you inhale too much

A

False, normally the dust is phagocytosed by alveolar macrophages and pneumoconiosis occurs when the phagocytic ability of the macros is overpowered by the amount of dust inhaled

31
Q

Why are smaller inhaled particles more likely to cause acute lung injury while large ones are more likely to induce fibrosis over time?

A

Because smaller ones are often inhaled in larger quantities and reach toxic levels quickly, whereas large ones tend to persist in the lung and evoke fibrosis

33
Q

What is the best way to differentiate sarcoid from hypersensitivity pneumonitis?

A

Since both have non-caseating granulomas, the Hx of sarcoid DOESN?T MATTER whereas HP is usually from an occupation

34
Q

What is the major complication of aspiration pneumonia? Why?

A

Lung abscess, really the cause is because they are caused by anaerobic bacteria. ASPIRATION PNEUMONIAS ARE VERY SERIOUS

34
Q

How does Blastomyces dermatiditis replicate? Compare the size of the yeast cells to histoplasma:

A

Via broad-based budding; Blasto is much bigger than histo

36
Q

An AIDS patient with a CD4 count below 50 cells/mm3 is most likely to have what as the cause of a pneumonia?

A

CMV or MAC

37
Q

How long must someone have been hospitalized before you call it HAP? Most common types of organisms to cause HAP?

A

48 hours; Gram negative rods

38
Q

What is the culprit of Coal Worker’s Pneumoconiosis? What are the 3 stages?

A

Carbon dust? Anthracosis, Simple Coal Worker’s pneumoconiosis, and Progressive Massive Coal Worker’s pneumoconiosis

39
Q

Which pulmonary disease is associated with anti-granulocyte-monocyte colony stimulating factor (anti GM-CSF) antibody?

A

Pulmonary Alveolar Proteinosis

40
Q

What do the pleural surfaces of a person with idiopathic pulmonary fibrosis look like? The parenchyma?

A

COBBLESTONED; Honey-combed

42
Q

What happens when you cut the lung of a specimen with pulmonary alveolar proteinosis?

A

Exudation of turbid fluids

43
Q

Where do CWP and silicosis affect the lungs? With which infectious agent are silicosis patients at risk for and why?

A

Both affect upper lungs; TB b/c the silica may inhibit the MO ability to phagocytose the TB

44
Q

Which infection has a concentric (dystrophic) calcification that gives it an annular tree bark appearance?

A

Histoplasma capsulatum, this is a chronic infection and it can lead to granuloma formation

46
Q

Who is at risk for Pseudomonas aeruginosa CAP?

A

Cystic fibrosis patients, particularly. Also neutropenic patients

48
Q

Discuss the fibrosis seen in early and late lesions in IPF (i.e. the temporal heterogeneity) where do most lesions occur in IPF?

A

Early = myxoid lesions Late = dark pink (more mature collagen); mostly in the bases (bibasilar rales often heard)

49
Q

Name the 2 smoking associated interstitial lung diseases

A

Desquamative Interstitial Pneumonia; Respiratory Bronchiolitis associated interstitial lung disease

50
Q

Which infectious agent forms “Coin lesions” on CXR? What is a major concern in immunocompromised patients?

A

Histoplasma capsulatum; it may disseminate

52
Q

What is the major difference between Idiopathic Pulmonary Fibrosis and Nonspecific Interstitial Pneumonia?

A

IPF has temporal heterogeneity and NIP does not, also NIP lacks honeycombing and foci of fibroblasts

53
Q

When alveoli are destroyed in IPF, what are the cystic spaces lined by?

A

Type II pneumocytes and/or bronchiolar epithelium

54
Q

What form of silicon is most commonly implicated in silicosis? Why is that important?

A

Quartz, in the workplace it is rarely pure and the purer forms of silicon are the most fibrogenic

56
Q

What is a hallmark finding on biopsy of an interstitial pneumonitis, pathologically?

A

Widened and edematous alveolar septa–b/c the infection is in the INTERSTICES not the alveoli

57
Q

Why might a Hx of stroke predispose to a pneumonia? Just for the hell of it would the stroke most likely be in the vertebrobasilar circulation or the anterior circulation?

A

They may have lost the cough reflex; vertebrobasilar since coughing controlled by brainstem

58
Q

Which bacteria is most likely to cause CAP in a debilitated alcoholic?

A

Klebsiella pneumoniae- gram negative bacillus produces a VISCID CAPSULAR POLYSACCHARIDE

59
Q

What is the required histologic pattern for Idiopathic pulmonary fibrosis?

A

usual interstitial pneumonia

60
Q

Why is it easier to identify the cause of a restrictive lung disease early as opposed to later?

A

Because they all end in the HONEYCOMB LUNG

61
Q

Which is more acute, typical or atypical pneumonia?

A

Typical

63
Q

What is the causal agent of tropical eosinophilia? Where does it reside?

A

Wucheria bancrofti, in pulmonary capillaries

64
Q

What is the difference in Cancer association for silicosis, CWP, and asbestosis?

A

Definite increase in asbestosis, controversial in silicosis, and none in CWP

65
Q

Why is desquamative interstitial pneumonia a misnomer?

A

They used to think it was sloughed off type II alveolar cells but really it is macrophages

66
Q

What is Caplan Syndrome?

A

A person with an occupational pneumonconiosis and rheumatoid arthritis

67
Q

Which fungus infects macrophages intracellularly? What is the likely Hx?

A

Histoplasma capsulatum; contaminated bird/bat droppings in Ohio/Mississippi river valley

69
Q

What effect will quitting one’s job have on silicosis vs. hypersensitivity pneumonitis?

A

HP will get better b/c no longer exposed to the allergen; Silicosis will continue to progress but it would still be best to leave

70
Q

What do you use a Gomori methenamine silver stain for?

A

Fungi. They show up black, the counterstain is green

72
Q

Why is it more likely to have a pulmonary abscess on the right side?

A

Because most pulmonary abscesses are caused by anaerobic bacteria; anaerobic bacteria are often introduced by aspiration; when something is aspirated it is more likely to go into the right mainstem bronchus than left b/c the right is more steeply angled

73
Q

What is the major complication of CAP caused by S. aureus? Sputum looks like what?

A

Empyema, looks salmon pink

75
Q

What are 4 possible complications of pneumonia?

A

Abscess formation, Empyema, Sepsis, and Pleural scars & Pleural adhesions

76
Q

What is an important pertinent negative in cryptogenic organizing pneumonia? What are causing the problems?

A

There is no interstitial fibrosis or honeycombing but there are MASSON BODIES plugging up the alveoli etc

77
Q

What is the most common cause of of community acquired pneumonia? Removal of which organ predisposes to this?

A

Streptococcus pneumoniae; Splenectomized patients are at risk

78
Q

How would you differentiate coccidiodes from paracoccidiodes on microscopy?

A

Coccidiodes forms a spherule while paracoccidiodes would have pilot-wheel budding yeast

79
Q

What is the definitive Tx for IPF?

A

Lung transplant

81
Q

What type of virus is SARS? What are the 2 most common bacterial causes of interstitial pneumonitis w/o consolidation?

A

Coronavirus; Mycoplasma pneumoniae and Chlamydophila pneumoniae

82
Q

How to Dx pulmonary eosinophilia on bronchoalveolar lavage? Tx?

A

> than 25% eosinophils; respond well to cortiosteroids

83
Q

What is a coal macule and nodule? In what stage of CWP are these first seen?

A

Coal macules are 1-2 mm collections of carbon-laden MO and Coal nodules are small areas of collagen fibers? Seen in simple coal workers pneumoconiosis first (NOT anthracosis)

84
Q

Which fibrosing disease doesn?t result in honeycombing?

A

Cryptogenic organizing pneumonia (BOOP)

85
Q

What does the pleura of IPF look like compared to asbestos?

A

IPF is cobblestoned and asbestos has plaques

86
Q

Which general type of pneumonia often follows a viral URT infection?

A

Community Acquired pneumonia

87
Q

What is another name for Cryptogenic Organizing Pneumonia?

A

Bronchiolitis obliterans organizing pneumonia

88
Q

What is the name of the disease in which there is rheumatoid arthritis concurrent with occupational pneumoniosis?

A

Caplan Syndrome (positive Rheumatoid factor)

89
Q

What are the 4 fibrosing diseases?

A

Idiopathic pulmonary fibrosis, Nonspecific interstitial pneumonia, Cryptogenic organizing pneumonia, and pneumoconioses

90
Q

Which fibrosing disease has plugs of loose connective tissue in the alveoli and bronchioles? What is the name of the plugs?

A

Cryptogenic organizing pneumonia; Masson Bodies

91
Q

What does the CXR of asbestosis look like?

A

Irregular linear densities–especially in the LOWER LOBES

92
Q

An AIDS patient with a CD4 count above 200 is most likely to have what as the cause of pneumonia?

A

TB (or probably anything, really, but pick TB

93
Q

What is the PATHOLOGICAL significance of the pores of Kohn?

A

They allow for the spread of infection among alveoli

94
Q

Reye syndrome is a result of what?

A

Taking aspirin while having a viral illness (particularly in children) which leads to HEPATIC FAILURE and then encephalopathy

RESPIRATORY EXAM 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions