Respiratory System Flashcards Preview

Pathology > Respiratory System > Flashcards

Flashcards in Respiratory System Deck (45):
1

What are the most common causes of health care associated pneumonia?

  1. MRSA
  2. Pseudomonas aeruginosa 

2

What are the most common causes of hospital acquired pneumonia?

  1. Gram-negative rods
    • Enterobacteriacae
    • Pseudomonas sp.
  2. Staph. aureus

3

What is the most likely cause of a single lung abcess in the right lung?

Aspiration

4

Genetic mutations in what structures lead to idiopathic pulmonary fibrosis?

  1. Telomerase
  2. Surfactant
  3. Mucous

5

What cytokine is responsible for lung injury in idiopathic pulmonary fibrosis?

TGF beta

6

What is the histology associated with Non-specific interstitial pneumonia?  What population is most affected?  What is the prognosis?

  • Histology
    • Diffuse fibrosis
    • No fibroblastic foci (UIP), honeycombing, hyaline membranes, or granulomas
  • Population
    • Nonsmoking females 
    • Most in 50's
  • Prognosis
    • Cellular pattern is best
    • Both patterns better than UIP

7

What is the characteristic finding of Cryptogenic Organizing Pneumonia?

Polypoid plugs (Masson bodies) of organizing loose connective tissue in the lumen of alveolar ducts, alveoli, bronchioles

8

What mediators are released by macrophages in silicosis?

  • IL-1
  • IL-18

9

Which drugs cause pneumonitis and fibrosis of the lung?

  • Bleomycin
  • Amiodarone

10

Which drugs cause Hypersensitivity Pneumonitis?

  • Methotrexate
  • Nitrofurantoin

11

Which drugs cause Bronchospasm?

  • Aspirin
  • Beta antagonists

12

What are the effects of radiation on the lung?

  • Acute radiation pneumonitis
    • Pleural effusions
    • Infiltrates
  • Chronic "
    • DAD
    • atypical and hyperplastic Type II pneumocytes
    • Foam cells in vesel walls
    • Epithelial cell atypia

13

What HLA genes are associated with sarcoidosis?

HLA-A1 and HLA-B8

14

What is the immune reaction to sarcoidosis?

  • Driven by CD4+ cells
  • Increased in Th1 cytokines
    • IL-2
    • INF-gamma

15

What causes Desquamative Interstitial Pneumonia?

100% smoking

16

Mutation in which gene predisposes to pulmonary Langerhans Cell HIstiocytosis?

Activation mutations to serine/threonine kinase BRAF

17

Mutations to which gene cause hereditary PAP and immediate onset neonatal respiratory distress?

GM-CSF

Immature macrophages do not clear surfactant from alveoli, leading to accumulation

18

Mutations in which genes lead to surfactant dysfunction disorders?  What is the pattern of inheritance for each?

  • ATP-binding casette protein member 3 (AR)
    • Most common
  • Surfactant protein C (AD)
  • Surfactant protein B (AR)

19

What is a common complication of Paraseptal Emphysema?

  • Bullous emphysema
    • Formation of cyst-like structures close to the pleura
    • Rupture can cause Pneumothorax

20

What is the mechanism leading to drug induced asthma?

  • Decreased PGE2 production
  • Loss of inhibition of production of proinflammatory LTs

21

What is the infecting organism in Bronchiectasis?  COPD?

  • Bronchiectasis:
    • Haemophilus influenzae
    • Pseudomonas aeruginosa
  • COPD:
    • Haemophilus influenzae
    • Streptococcus pneumoniae

22

What are the most common indications for lung transplantation?

  1. End stage emphysema
  2. Idiopathic pulmonary fibrosis
  3. Cystic fibrosis
  4. Idiopathic / Familial pulmonary arterial HTN
  5. Bronchiectasis

23

What types of genes are mutated in Squamous cell carcinoma of the lung?

Tumor suppressor genes

24

What types of genes are mutated in Adenocarcinoma of the lung?

Growth factors or receptors

Gain of function mutations

(EGFR, ALK, KRAS)

25

What genes are mutated in Small Cell Carcinoma of the lung?

  • TP53
  • RB1
  • Myc-N and Myc-L amplification
  • Chromosome 3p deletions

26

What is the most common mutation in Small Cell Carcinoma of the lung?

Bcl-2

27

What are the markers of mesothelioma?

  • Keratin proteins
    • calretinin
    • WT-1
    • Cytokeratin 5/6
    • D2-40
    •  

28

What cell markers are present in solitary fibrous tumor?

CD34+

(keratin negative, which differentiates them from malignant mesothelioma)

29

Which HLA subtypes are found in Goodpasture Syndrome?

HLA-DRB1

30

Germline mutation in which gene is associated with destructive pneumococcal pneumonia?

MyD88

(adaptor for TLRs important in NFkB activation

31

Which bugs cause Healthcare-Associated Pneumonia?

  1. Staph aureus
  2. MRSA
  3. Strep pneumoniae
  4. Pseudomonas aeruginosa

32

Which bugs cause Hospital Acquired Pneumonia?

  1. Staph aureus (MRSA)
  2. Enterobacteriaceae
    • Klebsiella
    • Serratia marcescens
    • E. coli
  3. Pseudomonas

33

Which bugs cause Aspiration Pneumonia?

Anaerobic oral flora

  1. Bacteroides
  2. Prevotella
  3. Fusobacterium
  4. Peptostreptococcus

Aerobes more common

34

Which bugs cause Chronic Pneumonia?

  1. Nocardia
  2. Acinomyces
  3. Granulomatous:
    1. TB
    2. Histoplasma capsulatum
    3. Coccidioides immitis
    4. Blastomyces dermatitidis 

35

What causes Pneumonia in the immunocompromised?

  1. CMV
  2. Pneumocystis jiroveci
  3. Mycobacterium avium-intracellulare
  4. Invasive aspergillosis
  5. Invasive candidiasis

36

What is the most common cause of Community acquired pneumonia?

Strep pneumoniae

37

What is the most common bacterial infection causing acute COPD exacerbations?

Haemophilus influenza

38

Which bug causes pneumonia following viral respiratory infections?  Which viruses are most common?

  • Bug:
    • S aureus
  • Viruses:
    • Children: measles, influenza 
    • Adults: Influenza

39

What is the most frequent cause of gram negative bacterial pneumonia?

Klebsiella pneumoniae

  • Current jelly sputum
  • Common in malnourished or debilitated (aspiration)

40

What is the most common cause of hospital acquired infections?

Pseudomonas aeruginosa

41

Who is most commonly affected by the Human Metapneumovirus?

  • Young children
  • Elderly
  • Imunocompromised

42

How is Human Metapneumovirus diagnosed?

Reverse transcriptase PCR

43

What are the most common causes of Health Care Associated Pneumonia?

  • MRSA
  • Pseudomonas aeruginosa

44

Which bugs are most commonly associated with lung abscess?

Anaerobes of oral cavity

  • Bacteroides
  • Fusobacterium
  • Peptococcus

45