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Flashcards in Rubin's respiratory Deck (26):

1. Lung abscess a

localized accumulation of pus accompanized by destruction of pulmonary parenchyma, including alveoli, airways, and bv's;
can complicate aspiration, lung cancer;
abscess cavities often partially filled with pus and air, accounting for X-ray finding of an "air/fluid level," and can get foul-smelling sputum if abscess connected to bronchus


5. Bronchiectasis often localized to

segment of the lung distal to mech obstruction of a bronchus by a variety of lesions, like tumors, inhaled foreign bodies, mucous plugs, and compressive LAD; look for mucopurulent sputum!!


6. Complications of bacterial pneumonia include

1. pleuritis (extension of inflamm to pleural space)
2. pleural effusion
3. pyothorax (infection of pleural effusion)
4. pulmonary abscess
5. pulmonary fibrosis;
look out for empyema!!


7. Though uncommon in terms of comm-acquired disease, think of S aureus and pulm infection in context of

influenza, vital respiratory tract infections, nosocomial staph pneumonia (if prone to aspiration and intubated)


10. CMV produces a

characteristic intersitital pneumonia; think immuno comp and children getting it transplacentally;
look for enlargement of infected cells, containing typical intranuclear and cytoplasmic inclusions!!


12. INterstitial pneumonia characterized by

hyaline membranes and interstitial inflamm (look for diffuse alveolar damage)


13. Cryptococcosis results from

inhalation of spores of C neoformans, encountered in pigeon droppings; think immunocomp;
STAINS POSITIVE with mucicarmine stain for capsular polysaccharides


14. P jiroveci can appear as

small bubbles in a background of proteinaceous exudates; in this case, centrifuged bronchoalveolar lavage specimen impregnanted with silver shows a cluster of cysts; cysts appear as round or indented (crescent moon) bodies, approx 5 micrometers in diameter


17. Traumatic pneumothorax can occur after

1. aspiration of fluid from pleura
2. pleural or lung biopsies
3. transbronchial biopsies
4. positive pressure-assisted ventilation


20. Alveolar proteinosis is a condition in which

alveoli are filled with a granular, proteinaceous, eosinophilic material, which is PAS-positive, diastase resistant, and rich in lipids; maybe associated with compromised immunity, leukemia, and lymphoma, respiratory infections, and exposure to environ inorganic dust


24. alpha1-antitrypsin deficiency leads to emphysema that is

diffuse and classified as panacinar; normally, alpha1-antitrypsin inhibits neutrophil elastase, enzyme digesting elastin and other components of the alveolar septa


28. Status asthmaticus shows on histology

a bronchus containing a luminal mucous plug, submucosal gland hyperplasia, smooth muscle hyperplasia, BM thickening, and increased numbers of eosinophils


29. Silicosis marked by

insidious development of fibrotic pulmonary nodules containing quartz crystals; disease can be asymp for prolonged periods of time or cause only mild to moderate dyspnea


30. Anthracosilicosis is

highly fibrogenic thanks to the silica;
coal-workers' pneumoconiosis known as black lung disease because of carbon particle deposition; in complicated cases, think palpable coal-dust nodules throughout lung as black foci (macrophages around with fibrotic stroma)


32. In this patient, pulmonary thromboembolism

associated with pulmonary infarction, pleuritic chest pain, hemoptysis, and pleural effusion


34. Lymphocytic interstitial pneumonia is a

rare pneumonitis where lymphoid infiltrates are distributed diffusely in the interstitial spaces of the lung; you have chronic inflamm cells and see LIP occur in context of Sjogren and HIV


36. Langerhans cell histiocytosis is

eosinophilic granuloma (think of the pulmonary form associated with CIG SMOKERS!!); see Langerhans cells with lymphocytes, eosinophils, macrophages


37. Lymphangioleiomyomatosis characterized by

women of childbearing age; widespread abnormal prolif of smooth muscle in lung, mediastinal and retroperitoneal lymph nodes, major lymphatic ducts;
look for bilateral, diffuse enlargement of lungs with cystic changes resembling emphysema;
could respond to antiestrogen and progesterone therapy!!!


39. Eosinophilic pneumonia has

inflamm exudate composed of eosinophils and macrophages in the alveolar spaces; look for hyaline membranes;
people respond to corticosteroids!!


40. Usual interstitial pneumonia demonstrates histologically

patchy, subpleural fibrosis and microscopic "honeycomb" cystic change; look for DIFFUSE FIBROSIS!!


41. Cryptogenic organizing pneumonia:

1. originally bronchiolitis obliterans-organizing pneumonia
2. look for respiratory tract infections, inhalation of toxic materials, and collagen vascular diseases
3. look for loose fibrous tissue in the alveoli and bronchioles


48. Broncioalveolar carcinoma is a

primary pulmonary adenocarcinoma originating from stem cells in terminal bronchioles;
cells might be columnar and mucus producing, or cuboidal and similar to type II pneumocytes;
grow along ALVEOLAR SEPTA!!


50. Carcinoid tumors occur most often in

the wall of the major bronchus and could protrude into its lumen; look for neuroendocrine differentiation


Hydrothorax is

elevation of hydrostatic pressure in those with CHF causing transudation of edema fluid into pleural cavity


Empyema is

variant of pyothorax (turbid effusion with many neutrophils); here, thick pus accumulates within the pleural cavity, often with loculation and fibrosis


Chylothorax is defined as

the accumulation in the pleural cavity of a milky, lipid-rich fluid as a result of lymphatic obstruction; usually a rare complication of malignant tumors in the mediastinum, like lymphoma