Flashcards in Patterns of Lung Injury (Path) Deck (17):
Describe the normal morphology of reparatory epiethlium
psuedostratifed epithelium with cilia
Contrast acute v. chronic patterns of lung injury.
acute: inflammation (neutrophils), edema/pleural effusion,, acute lung injury (ARDS/DAD) pulmonary hemorrhage (due to infarct or vasculitis)
chronic: inflammation (lymphocytes/macrophages) and fibrosis, emphysema
Describe the associated pathogen with acute, chronic, granulamatous, or eosinophillic inflammation
acute (neutrophils) associated with bacterial infection or infarct
chronic (lymphs) due to viral or chronic infection
granulomatous: TB, fungal, sarcoid, foreign body, HP
eosinophillic: parasitic infection
Describe how an abscess is histologically different from pneumonia infiltrate?
abscess is walled of, there is loss of parenchymal structures, localized infection
Describe granulomatous inflammation and its causes?
granolas are sub-acute or chronic accompanied by giant cells and lymphocytes
can be cause by foreign body and immune reaction, note that sarcoidosis (bland and 'naked') and TB (caveating granulmas) have slightly different morphology
What are the crystalline foreign bodies likely caused by if found in the lung?
talc, visible under polarized light; usually associated with injection drug use
multi organ granlomatous disease of unknown etiology, which frequently affects the lungs but also commonly involves lymph nodes, liver, spleen, skin heart, eye and other organs
granulomas are non-caseating
Give the top 3 fungal- yeast causes of pneumonia and what are their distinguishing factors?
Histoplasma capsulatum: small yeast with narrow based budding
Blastomyces dermatitis: big yeast with broad based budding
Coccidioides immunities: spherules with endospores (CA)
note all fungi lead to necrotizing granulomatous inflammation
Describe the two types of fungi hyphea that can most commonly cause lung disease.
aspergillis: branches at 45 degree angles (think of A) septated hyphea
mucor: branches at 90 degrees, non-septated hyphae (folded ribbon appearance)
What type of disease might include caseous necrosis.
caseous necrosis of TB
What stains would you use to identify TB and fungals.
Acid fast- nocardia and TB
GMS (silver based) stain used to see fungals
Hypersensitivity pneumonitis is an immune response to inhaled antigen, analogous to asthma that occurs in interstitial area, only this disease is in the airways. Name three common types and their source of infection.
Farmer's lung- thermophilic actinomyces
Pigeon Breeders lung- avian proteins in poop
Humidifier (or air-conditioner) lung- bacteria
Granuloma formation is consistent with which type of hypersensitivity reaction.
Name the three major obstructive lung diseases.
COPD: emphysema and chronic bronchitis
Emphysema results in irreversible enlargement of airspaces distal to the _____ _____ and destruction of alveoarl walls without obvious _______ .
distal to the terminal bronchioles
without obvious fibrosis
remember smoking damage occurs in a central pattern and the resulting inflammation can cause an increase in protease activity
Contrast the location of emphysema due to smoking v. alpha-antitrypsin deficiency.
smoking is centriacinar while alpha-1 antitrypsin deficiency is panacinar.