Pulmonary Flashcards
(46 cards)
Pneumonia
One of leading causes of death.
Bacterial, viral, fungal, parasitic etiology.
Bacterial Pneumonia Predisposing Factors:
- Loss of cough reflex
- Injury to cilia
- decreased phagocytosis
- pulmonary edema
- immunocompromised condition
Bacterial Pneumonia:
Cough, dyspnea, fever, chills, sputum production.
Two types =
Bronchopneumonia: patchy, begins around small bronchi in very young/old patients.
Lobar: entire lobe, 90% caused by S. pneumoniae in healthy adults
BP Stages of inflammation (lobar pneumonia?)
- Congestion
- Red hepatization
- Gray hepatization
- Resolution (organization)
Complications of BP
Empyema (purelent pleuritis), abscess, pericarditis, bacteremia
Atypical/interstitial Pneumonia:
highly variable, mild fever, headache, dry cough, myalgia
Etiology: Mycoplasma pneumoniae and viruses
Pathology: interstitial inflammation, mononuclear cells, congestion and hyalin membranes (diffuse alveolar damage)
Acute Respiratory distress Syndrome
Etiology: shock, infections, trauma, drugs overdose, irritants.
Fast serious condition with same histo features as IP.
Injury to endothelium and alveolar epi, leaky endothelials
Pulmonary Abscess:
cough, fever, purulent sputum
Pre Factors: bronchiectasis, aspiration, septic emboli, airway obstruction, dental sepsis
Pulmonary Abscess Course
- Scar
- Cavitate
- Progressively enlarges
TB Stats
Infects 1/3 of world population.
Most common infectious cause of death.
Cases been declining in US
TB Predisposing Factors
HIV, overcrowding, poor living conditions, immigrants
Myobacterium TB
Bacillus, aerobe, non motile, slow growing
Waxy coat = resists acid destaining (Acid Fast Bacillus)
Caseating granulomatous inflammation**
TB Pathogenesis
Acquired by inhalation.
Ghon lesion - site of early infection
Ghon complex - lung lesion + hilar lymph nodes
Cavity TB:
At _____ of lung.
May seed _____ airways, _____, or _____.
Direct extension to ______
What is typically seen?
Apex.
Large, lymph nodes, blood.
Pleura = effusion
Significant scarring
Latent TB:
________ of primary cases resolve.
May reactivate years later due to?
Reactivation induces?
What could it also do?
90-95%.
Immunosenescence, immunosuppression tx.
Type 4 hypersensitivity and tissue necrosis
May widely disseminate = Miliary TB (possible multi-organ involvement)
Miliary TB
May go to other lung, CNS, kidneys, adrenals, bones and marrow, liver, spleen
Spreading via lymphatics or blood = lymphohematogenous.
“Millet Seeds”
Granulomatous lung disease
TB is the classic.
Fungal infections like histoplasmosis.
Sarcoidosis
Lung Cancer
Leading Cause of cancer deaths.
RFs: cigarette smoking, asbestos, radon gas, nickle, chromates, pollutants, lung scar
Lung Cancer - Clinical
Cough, weight loss, chest pain, hemoptysis, dyspnea
Tumors may produce hormones = paraneoplastic.
ADH, ACTH, PTH, others
Lung Cancer - Pathology
SCC = Adenocarcinoma = Small Cell = Large Cell = Bronchioloalveolar Carcinoma Mesothelioma (asbestos, pleural malignancy) Carcinoid
25-30%
30-35%
20-25%
10-15%
Prognosis for Lung Cancer
5 year survival all types =
If localized when found =
16%
45%
Pneumoconioses
Occupational/environmental causes.
Coal Workers = nodular/diffuse fibrosis with coal macules. Progressive.
Silicosis = most prevalent form
Asbestosis, bleomycin drugs
Hemoptysis: Dyspnea: Atelectasis: Pneumothorax: Empyeme:
Coughing up blood.
Difficulty breathing, perception of need breathe deeper/faster.
Collapse of lung volume.
Air in pleural space/cavity leads to collapse.
Suppuration in pleural cavity
Pleural Effusion in pleural space
Transudate: low protein, caused by increased venous pressure.
Exudate: high protein fluid, w/ w/o inflammatory cells due to damage
