Pulmonary Disorders Flashcards Preview

My Pathology > Pulmonary Disorders > Flashcards

Flashcards in Pulmonary Disorders Deck (39):
1

Obliterative bronchiolitis

• Caused by adenovirus
• Bronchiolitis —> healing by fibrosis

2

RSV

• Nosocomial infection of children
• Usually self-limited
• May cause disorganized epithelium and severe distention (? displaced surfactant)

3

Whooping cough

• Bordetella pertussis
• May cause bronchiectasis

4

Candida albicans

• May produce mucosal ulceration

5

Bronchocentric granulomatosis

• In asthmatic pts: allergic aspergillosis
• Non-asthmatic pts: TB or histoplasma; often coincides w/ autoimmune disease

6

Right middle lobe syndrome

Collapse of R middle bronchus from hilar lymphadenopathy

7

Strep pneumoniae

• Young to middle-aged adults
• Lobar PNA
• S/p aspiration of pneumococci or viral URI
• "Rusty" sputum, alveolar filling on CXR

8

Klebsiella pneumoniae

• Lobar PNA
• Mucoid lung surfaces, bulging lobes, tissue necrosis/abscesses —> bronchopleural fistula

9

Staph aureus

• Common in CF pts, nosocomial infection
• Many small abscesses; may create pneumatoceles (cystic spaces)

10

Group B strep

Newborns; Sx look like respiratory distress syndrome; w/ severe toxemia, rapid death

11

Legionella

• Hard to Cx
• Contaminated water
• Widespread bronchopneumonia w/ necrosis of inflammatory cells

12

Pseudomonas aeruginosa

• Immunocompromised, burns, CF
• Occurs w/ vasculitis

13

Mycobacterium

• Ghon lesion: granuloma at periphery of lung
• Miliary TB: multiple small granulomas in many organs
• M. avium-intracellulare: immunocompromised, extensive macrophage infiltrate w/ innumerable acid-fast orgs

14

Actinomycosis

• Multiple small lung abscesses
• Gram + filamentous bacteria
• Sulfur granules

15

Nocardia

• Beaded, thin filaments w/ R angle branching
• Pts w/ lymphomas, neutropenia, chronic granulomatous disease, alveolar proteinosis

16

Histoplasmosis

• Midwest & South
• Inhalation of bird droppings
• Resembles TB
• Granulomas prone to calcification

17

Aspergillosis

• AIDS pts or pts on cytotoxic therapy
• Invasive: blood vessel invasion —> thrombosis, lung infarcts
• Aspergilloma: fungus ball grows in pre-existing cavity
• Allergic bronchopulmonary aspergillosis: eosonophilia, increased serum IgE, proximal bronchiectasis

18

Pneumocystitis jiroveci

• Fungus
• Interstitial infiltrates, type 2 pneumocyte hyperplasia
• Alveoli filled w/ foamy exudate

19

CMV

• Interstitial infiltration
• Cytomegaly w/ nuclear inclusion

20

Diffuse alveolar damage

• Causes ARDS
• Triggered by variety of insults
• Hyaline membranes and collagen deposition in alveolar walls
• Leakage of plasma proteins
• "Honeycomb lung"

21

Goodpasture syndrome

Diffuse alveolar hemorrhage, glomerulonephritis, Ab to basement membrane

22

Eosinophilic PNA

• Loeffler syndrome: Mild or asymptomatic PNA with eosinophilia
• Acute/chronic: allergy association
• Infectious: parasites

23

Lipid PNA

• Endogenous: secondary to bronchial obstruction
• Exogenous: aspirated oils

24

Alpha 1-antitrypsin deficiency

• A1AT is an inhibitor of proteinases including elastases
• Lack of inhibition leads to alveolar wall destruction
• Possible liver disease

25

Silicosis

• Simple nodular: progression of 10-40 yrs; "whorled" collagen nodules containing needle-shaped silicates; possible "eggshell calcification" of nodes
• Progressive massive: nodules 2-10 cm wide w/ central cavitation
• Acute: progression of a few yrs; no nodules; alveoli contain eosinophilic material

26

Coal workers' pneumoconiosis

• Anthracosis or anthracosilicosis
• Scattered 1-4 mm black foci
• Carbon-laden macrophages

27

Asbestos

• Diffuse interstitial fibrosis
• Asbestos bodies: long, thin fiber surrounded by iron-protein coat
• Plaque on parietal pleura
• Mesothelioma

28

Berylliosis

• Aerospace, industrial ceramics, or nuclear industries
• Noncaseating granulomas

29

Talcosis

• Variable pathology
• FB granulomas w/ plate-like particles
• Associated w/ IV drug use

30

Acute hypersensitivity pneumonitis

• Acute or chronic interstitial inflammation
• Chronic may have poorly formed granulomas, organizing PNA

31

Sarcoidosis

• Can also involve nodes, skin, eye
• More common in African-Americans
• CD4 helper cells form multiple noncaseating granulomas
• Along pleura, interlobular septa, around bronchovascular bundles, bronchial submucosa (diagnose via bronchoscopic biopsy)
• Can progress to onion-skin fibrosis around giant cells

32

Idiopathic pulmonary fibrosis

• Patchy interstitial fibrosis adjacent to normal lung
• Loose fibroblastic tissue adjacent to dense collagen
• Epithelium grows into dilated airspaces
• Gradual DOE and dry cough over 1-3 yrs

33

Desquamative interstitial PNA

• Smokers
• Alveolar architecture is preserved w/ minimal fibrosis
• Intra-alveolar macrophages contain golden-brown pigment

34

Respiratory bronchiolitis

• Smokers
• Pigmented macrophages centered on bronchioles

35

Langerhans cell histiocytosis

• Smokers 20-40
• Nodular infiltrates w/ stellate border
• Langerhans cells: eosinophilic cytoplasm, grooved nuclei
• Eosinophils

36

Lymphangioleiomyomatosis

• Women of childbearing age
• Abnormal proliferation of smooth muscle in lung (? hormonal control)
• Tuberous sclerosis gene complex mutation

37

Pulmonary HTN

• L to R shunt
• Recurrent PEs
• Hypoxemia
• LV failure

38

Pulmonary hamartoma

• Usu. at periphery
• Popcorn calcification
• Several types of tissue interspersed w/ respiratory epithelium-lined clefts

39

Small cell carcinoma

•