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Flashcards in Rubin's respiratory Deck (26):
1

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

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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!!

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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!!

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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)

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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!!

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12. INterstitial pneumonia characterized by

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

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13. Cryptococcosis results from

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

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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

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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

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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

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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

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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

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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

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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)

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32. In this patient, pulmonary thromboembolism

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

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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

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36. Langerhans cell histiocytosis is

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

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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!!!

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39. Eosinophilic pneumonia has

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

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40. Usual interstitial pneumonia demonstrates histologically

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

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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

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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!!

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50. Carcinoid tumors occur most often in

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

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Hydrothorax is

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

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Empyema is

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

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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