Patho chapter 12

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• Loss of lung volume by inadequate expansion of air by air spaces Atelectasis
• Obstruction preventing air from reaching the distal parts. Air present becomes reabsorbed. e.g. tumor in children Resorption atelectasis
• Passive/relaxation, caused by accumulation of fluid, blood, air in pleural cavity Compression atelectasis
• By local/general fibrotic changes in the lung occur in lung/pleura - which hamper expansion & incr. elastic recoil Contraction atelectasis
• Atelectasis resulting fr. elevated diaphragm - seen in bedridden patients Basal atelectasis
• (1) acute onset of ddyspnea (2) hypoxemia (3) development of bilateral pulmonry infilatrates on CR Manifestation of acute lung injury
• M: capillary congestion, edema, necrosis of alveolar epithelial cells, hyaline membrane present, fibrin exudates. Dark, red, firm, airless, heavy lungs caused by diffuse alveolar capillary & epithelial damage ARDS
• (1) Rapid onset of life threatening resp. insufficiency (2) cyanosis (3) arterial hypoxiemia leading to organ failure Usual course of ARDS
• Limitation of airflow, usually resulting fr. an incr. in resistance by partial or complete obstruction at any level Obstructive lung disease
• Reduced expansion of lung parenchyma accompanied by decr. total lung capacity Restrictive lung disease
• Abnormal permanent permanent enlargement of air spaces distal to the bronchioles accompanied by destruction fo their walls without significant fibrosis Emphysema
• A typical symptom in emphysema is barrel chest
• type of emphysema confided to the proximal parts while the distal parts of acini is spared. Seen in smoker w/o alpha-1-antitrypsin deficiency. M: deep pink, less voliminous, destruction of alveolar walls without fibrosis. Centriacinar emphysema
• Type of emphysema where all parts of acini are affected (mostly lower lung). Seen in alpha-1-antritrypsin deficiency. M: well-dev. pale, voluminous lungs that obscure the heart when ant. chest wall is removed in biopsy Panacinar emphysema
• Type of emphysema where mostly the distal parts of acini are affected. Occurs next o areas of fibrosis, scarring or atelectasis. More sever in upper half of lungs. "Bullae" are charect. Found near septal (paraseptal) Distalacinar emphysema
• Which one is the most common form of emphysema? Irregular emphysema
• what is the role of alpha-1-antitrypsin? It stops the cycle of inflammation & ECM proteolysis by removing elastases secr. by immune cells
• An fake emphysema characterized by dilation of alveoli in response to loss of lung substance e.g. surgical Compensatory emphysema
• A fake emphysema in which the lung expands b.c. air is trapped in it e.g. tumor Obstructive overinflation
• Any type of emphysema producing a subpleural bleb or bullae (1cm<space) Bollous emphysema
• A type of fake emphysema where air enters CT stroma of lung, mediastinum & subcutaneus tissue. May occur spontant with a sudden incr. in PIA (like a cough). Seen in children with whooping cough. Mediastinal (interstitial) emphysema
• chronic inflammatory disorder that causes wheezing and is mostly evident at night /early mornings. triggered by smoke, cold air, stress etc. TH2 relase IL4, 5,13 Asthma
• One type of asthmas includes atopic which begins in childhood as a type I hypersensitivity reaction. The person has a POSITIVE family history.
• One type of asthma includes non-atopic where there is no evidence of allergens sensitization. Skin results are usually negative. Respiratory infections by viruses & inhaled air pollutants are common.
• Morphology of small a^2 of atelectasis, occlusion of bronchi & bronchioles by thick mucous plugs. The mucous plugs contain whorls of shed epith (CHURSCH MANN SPIRALS). Many eosinophils & CHARCOT LEYDEN CRYSTALS are found. Occupational asthma
• permanent dilation of bronchi & bronchioles by destruction of the muscle & supporting elastic tissue. Caused by chronic necrotizing infections. Bronchiectasis
• Cryptogenic fibrosing alveolitis. A disease of unknown etiology. M: patchy, bilateral, progressive fibrosis, hypoxemia, cyanosis, fibroblastic foci lesion, honeycomb fibrosis by abnormal tissue repair. 60 + males mostly at risk. Idiopathic pulmonary fibrosis
• BOOP,is a rare lung condition in which the small airways (bronchioles), the tiny air-exchange sacs (alveoli) and the walls of small bronchi become inflamed and plugged with connective tissue. M: polypoid plugs of loose organizing CT within alveolar ducts, alveoli & bronchioles. Patchy areas of airspace consolidation in subpleural & peripleural space. Cryptogenic organizing pneumonia
• Non-neoplastic lung reaction to inhalation of minerals dusts Pneumoconioses
• Which of the Pneumoconioses is associated with TB? Silicosis
• Which one of the Pneumoconioses is assoc. w/ parenchymal interstitial fibrosis, localized fibrous plawues, pleural effusion, lung carcinomas, malignant pleural & peritoneal mesotheliomas & laryngeal carcinoma Asbestosis
• A mutlisystem disease of unkown etiology characterized by noncaseating granulomas in many tissues and organs. M: Schauman bodies, asteroid bodies. Sarcoidosis
• In sarcoidosis you are expected to find noncaseating granulomas, schauman bodies, asteroid bodies, diffuse interstitial fibrosis (honeycomb lung) in the lungs.
• In sarcoidosis you are expected to find erythema nodosum on the skin
• In sarcoidosis you are expected to find hilar & partracheal enlargement of lymph nodes.
• In sarcoidosis you are expected to find choroiditis, retinitis, optic nerve involvement of the eyes.
• a chronic condition characterized by the abnormal enlargement of glands in the head and neck, including those near the ears (parotids) and those around the eyes (lacrimal) and mouth (salivary). The tonsils and other glands in the soft tissue of the face and neck may also be involved. Although the disorder is almost always described as benign, it always occurs in association with sarcoidosis
• Hypersensitivity pneumonitis is a immonologic inflammatory disease mainly affecting the alveoli and is mostly occupational resulting fr. incr. sensitivity to inhaled antigens.
• decrease.. (1) diffusion capacity (2) lung compliance (3) totalt lung volume classically for restrictive lung diseases e.g. hypersens. pneumonitis
• Desquamative interstitial pneumonia & respiratory bronchitis are two related examples of smoking-associated intersitial lung disease
• Smoker's macrophages are found in DIP and is macrophages with abundant cytoplasm containing dusty-brown pigment in the air spaces.
• Lesions of pigmented intraluminal macrophages skin to those inn DIP but in a "bronchiolocentric" arrangement is found in Respiratory bronchitis
• Proliferative, rapidly progressive, glomerulonephritis and hemorrhage caused by antibodies targeted against type 4 collagen. M: diffuse alveolar hemorrhage, hemosiderin, linear pattern of IgG (+ A + M) deposits Goodpasture syndrome
• 2nd most common bacterial cause of acute exaboraration of COPD and one of three most commin causes of otitis media in children Marexella catarrhalis
• Most common bacterial cause of acute exaberration of COPD Haemophilus infulenzae (encapsuled & unenecapsuled)
• Pulmonary infection occuring as a complication of IV drugs andmay cause lobar pneumonia Staphylococcus aureus
• pulmonary infection causing thick & gelatinous sputum Klebsiella pneumoniae
• Interstitial pneumonia is caused by: Chlamydia, mycoplasma pneumonia
• Where can you find Azzopardi effect? Small cell carcinoma of the lung
• " crush artifact" & Azzopardi effect is seen in small cell carcinoma
• In pneumoconiosis, pleural plaques are the most common manifestation of: asbestos exposure

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