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19 Cards in this Set
- Front
- Back
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Are pigmented macrophages seen in large numbers in conducting airways?
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No, only in smokers! Usually (in normal lungs) they're rare even in the aveoli, much less in the conducting airways,
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Sarcoidosis
Hypersensitivity Pneumonitis Pneumoconiosis UIP (usual interstitial pneumonitis) Organizing DAD ..all are which type of diseases? |
peribronchial and interstitial lung diseases
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Sarcoid is a _____ granulomatous dz.
- children or adults? - dyspnea? - CXR findings? - Patholgy? - Dx of Sx or one of exclusion? - Tx? |
multi-system
yes interstitial infiltrates in bronchovascular distribution usually have hilar lymphadenopathy Tight, well-formed non-caseating (=non-necrotizing) granulomata Focal accumulations of epithelioid histiocytes = (definition of a granuloma in general) Exclusion Corticosteroids, if the Sx are bad enough. |
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Are langerhaans type giant cells specific to sarcoid?
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No, but they are specific to granulomatous dz in general.
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Hypersensitivity Pneumonitis is synonymous with...
- what do both names refer to? - presenting clinical Sx? - CXR? - Pathology? |
Extrinsic Allergic Alveolitis (EAA)
- dz characterized by accumulation of organic dusts - acute and chronic: dyspnea, cough, fatigue - bilateral interstitial linear or nodular pattern - patchy peri-bronchiolar and interstitial chronic inflammation with loosely formed granulomata. |
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What are potential organic Antigens that can cause EAA?
Where does EAA typically begin to show in X-sections of lung? |
Microorganisms from hay, sugarcane, maple bark, hot tubs, air conditioners, etc.
Animal proteins Sythetic organic chemicals Near the conducting airways --> further out (interstitium)... makes sense right? we have to breath the offending agent in. |
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Inhalation of INORGANIC dusts can lead to to...
- CXR? - Pathology? (2 types?) |
Pneumoconioses
- varies by dust - Fibrogenic: Silica, Asbestos Inert: Coal (if silica free) |
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______ caueses a sub-pleural scarring rxn.
Is this pattern unique to asbestos? |
Asbestosis
No. It can be seen in other etiologies, like autoimmune dz and UIP. |
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Which three dz can present with patchy, sub-pleural fibrosis?
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UIP, asbestos, and autoimmune dz.
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What do macrophages do with asbestos?
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can't digest the fibers, so they coal it --> ferragenous bodies --> stain nicely with prussian blue
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If coal has silicate in it, what happens?
No silicate? |
fibrosis, maybe some coal dust macules
Just coal dust macules |
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What is the pathological name for Idiopathic pulmonary fibrosis (IPF)?
- age group? - response to steroids? Should we give them? - ~% mortality? - CXR? - pathology? - temp homogenous/heterogenous? + morphology overlaps with what? |
UIP - usual interstitial pneumonia
- adults (~51) - poor, no, all it does is set them up for infection. - 66% - patchy, subpleural infiltrates (could be asbestosis or autoimmune) - patchy interstitial inflammation, fibrosis, alternating with normal parenchyma - Temporally heterogeneous +rheumatic dz (e.g. scleroderma) |
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What stains for collagen?
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Trichrome stains
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What does UIP freq. progress to? Is this change dxnostic?
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Honeycomb change: cysticly dilated airspaces
No, other etiologies exist. |
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Do we know the cause of UIP (IPF)? How about the progression?
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No. Yes.
- chronic, develops over years - no effect txt - eventually become txp candidates. |
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What does temporal heterogeneity refer to?
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looks like it occurred at different points in time.
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When do we see proliferative (Organizing) Phase DAD? What is it called clinically?
- Sx? - Tx? - Mortality %? - Radiology? - Pathology? - is this dz temporally uniform? |
>1-2wks post acute lung injury
**shock for any reason*** = it's called ARDS - decreased plum compliance --> \mechanical ventilation - txt them all agressively with mechanical ventilation - 50% - diffuse, interstitial > aveolar pattern - interstitial+/-intra-aveolar fibroblastic proliferation - Yes, NOT heterogenous. |
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How many phases does ARDS have? Describe them.
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2; the first is for the first one to two weeks... it's fibrinous; then it becomes a fibrosing process --> scarring.
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Contrast the locale of fibroblasts in ARDS and those found in BOOP/COP?
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BOOP/COP = found in the aveoli/airspaces
DAD/ARDS = found in the interstitium. |
