Pathology of inflammatory disease Flashcards Preview

Year 2 Respiratory > Pathology of inflammatory disease > Flashcards

Flashcards in Pathology of inflammatory disease Deck (27)
1

acute pneumonia

usually pyogenic bacteria with neutrophils in alveoli

2

pneumonitis

usually not pyogenic - atypical (viral or mycoplasmic)

3

chronic pneumonias - causes

often TB, fungi, parasites, odd bacteria

4

what are factors predisposing to pneumonia?

1. loss of cough reflex
2. injury to mucociliary apparatus
3. interference with phagocytic or bactericidal action of alveolar macrophages
4. pulmonary edema, congestion
5. accumulated secretions

5

what are the two overlapping patterns of bacterial pneumonia? what does the pattern depend upon?

bronchopneumonia
lobar pneumonia

bacterial virulence and host resistance

6

90-95% of lobar pneumonia cases are due to what organism?

strep pneumo

7

what are the classic morphologies of lobar pneumonia?

congestion
red hepatization
gray hepatization
resolution

8

what are the presenting features of primary atypical pneumonia?

lack of alveolar exudate
elevated WBCs
very little sputum
confined to alveolar septa and interstitium

9

"walking pneumonia" is typically due to what organism? what are the most serious symptoms?

mycoplasma

bad persistent cough
V/Q mismatch

10

what is the common pathogenic mechanism of atypical pneumonia?

attachment of organisms to respiratory epithelium - necrosis of cells and inflammatory response

if it extends to alveoli - interstitial inflammation

11

what is possible if sputum changes from green to yellow?

superimposed bacterial infection

12

what is the typical histopathology in atypical pneumonia?

interstitial pneumonia with mononuclear infiltrate, diffuse alveolar damage

13

definition: sarcoidosis

systemic disease of unknown cause, noncaseating granulomas in many tissues and organs

diagnosis of exclusion

14

how is the diagnosis of sarcoidosis made?

biopsy showing

noncaseating granulomas
special stains
cultures

15

what are the immunologic factors involved in sarcoidosis?

cell mediated immunity type IV hypersensitivity

1. interstitial and intra-alveolar accumulation of CD4 Th1 cells
2. elevated levels of T cell derived Th1 cytokines - IL-2 and INFy
3. elevated IL-8, TNF

16

what are the genetic factors associated with sarcoidosis?

HLA-A1
HLA-B8

17

what are the "oddities" found inside sarcoid granulomas?

schaumann bodies - lamellated calcified structures usually in giant cells (aka berylliosis)

asteroid bodies - star shaped eosinophilic bodies made of compressed intermediate filaments; common in foreign body giant cells

18

what is seen on CXR in sarcoidosis?

bilateral interstitial infiltrates and hilar lymphadenopathy

19

hypersensitivity pneumonitis typically involves what lung structure?

alveoli (allergic alveolitis)

20

what type of hypersensitivity is associated with hypersensitivity pneumonitis?

type III early (abs in serum)
type IV later (poorly formed granulomas)

21

what cells are seen in acute hypersensitivity pneumonitis?

neutrophils

22

what cells are seen in chronic hypersensitivity pneumonitis?

mononuclear interstitial infiltrate (lymphs, plasma cells, macrophages)

23

what is silo fillers disease?

pulmonary edema due to widespread bronchiolotis obliterans with scar tissue forming in burned small airways

24

what is the smoker related interstitial disease?

DIP

25

what are the features of pulmonary alveolar proteinosis?

accumulation of acellular surfactant in intra-alveolar and bronchiolar spaces, PAS positive

minimal inflammatory response, normal alveolar walls

26

what are the clinical features of pulmonary alveolar proteinosis?

insidious onset of cough
chunks of white gelatinous appearing sputum (jello)
progressive dyspnea, cyanosis

27

how is pulmonary alveolar proteinosis treated?

bronchiolar lavage