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32 Cards in this Set
- Front
- Back
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pneumonia
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- infectious inflammatory process of pulmonary parenchyma
- chills, fever, rusty sputum, SOB, cyanosis - bacterial: neutrophilic leukocytosis (left shift) |
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lobar, broncho-, interstitial pneumonia
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3 morphological types of pneumonia
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lobar pneumonia
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- streptococcus pneumoniae
- intra-alveolar exudate, consolidation - involves an entire lung lobe |
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bronchopneumonia
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- caused by several bugs: staph aureus, H. flu, Klebsiella pneumoniae, Strep pyogenes
- acute inflam. infiltrate from bronchioles to alveoli - patchy infiltrates |
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interstitial pneumonia (primary atypical)
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- viruses or mycoplasma pneumonia
- diffuse, patchy inflammation localized to interstitial areas of alveolar walls - one or more lobes |
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Streptococcus pneumoniae
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- elderly, debilitated pts with cardiopulmonary diseased, malnourished
- possible empyema (pus in pleural cavity) |
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Staph aureus
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- complication of influenza or viral pneumonia; result of blood-borne infections from IV drug use
- seen in debilitated hospitalized pts., elderly with chronic lung disease - focal inflamm. exudates or abscess; can lead to bacterial endocarditis, brain and kidney abscess |
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Streptococcus pyogenes
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- complication of influenza or measles
- lung abscess |
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Klebsiella pneumoniae
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- debilitated, hosp, diabetic, alcoholic pts; high mortality rate in elderly
- lots of alveolar wall damage, necrosis, occasional abscess |
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H. influenza
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- seen in infants and children, debilitated adults, most often in those with COPD
- meningitis and epiglottitis in babies and kids |
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Legionella pneumophila
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- inhalation of aerosol from contaminated water
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top 3 causes of nosocomial pneumonia
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Klebsiella, Pseudomonas aeruginosa, Escherichia coli
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ornithosis (psittacosis)
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transmitted by inhalation of bird crap
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Q fever, the most common rickettsial pneumonia, caused by Coxiella burnetii
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infects persons working with infected cattle or sheep; people who drink unpasteurized milk from infected animals
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giant cell pneumonia
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what type of pneumonia is caused by the measles virus?
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Ghon complex
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- due to initial TB lesion; a tubercle characterized by central caseous necrosis and by Langhans giant cells; calcified lesions seen by x-ray
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milliary TB
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- after lymphatic and hematogenous spread; seeding of distal organs with innumerable small millet seed-like lesions
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various areas affected by spread of TB to other body parts
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TB meningitis, Pott disease of the spine, paravertebral abscess, psoas abscess
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Langhans multinucleated giant cells and epithelioid cells
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what is created after macrophages are morphologically altered in TB
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actinomycosis
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- abscess, sinus tract formation
- exudate with sulfur granules, yellow clumps of organism - gram + anaerobic filamentous bacteria |
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nocardiosis
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- gram + aerobic, filamentous, weakly acid-fast
- opportunistic infection - can disseminate to brain and meninges |
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candidiasis
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- immunocomprimised pts., can produce bloodborne dissemination
- pulm, renal, hepatic absceses and vegetative endocarditis |
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cryptococcosis
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- infection starts in lungs, but can produce meningitis
- encapsulated appearance seen in India ink prep |
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aspergillosis
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- invasive form has predilection for growth into vessels and later spread by blood
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histoplasmosis
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- pulm. manifestation similar to TB; pulm lesions with late calcification
- disseminated form marked by multisystem involvement with macrophages filled with fungal yeast forms |
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coccidiomycosis
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- fungal spherules containing endospores in granulomas
- occurs only in dry and dusty setting |
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squamous cell carcinoma
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- central, hilar mass, cavitation, link to smoking
- can involve inappropriate PTH-like activity with hypercalcemia |
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bronchial-derived adenocarcinoma
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- peripheral, develops on prior scar from injury or inflammation
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bronchioalveolar adenocarcinoma
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- peripheral, columnar to cuboidal tumor cells line alveolar walls, mimicks pneumonia on x-ray
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small cell (oat cell) carcinoma
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- most aggressive bronchogenic carcinoma, usually already metastatic at diagnosis
- often assoc. with ectopic production of ACTH or ADH - greatly increased in smokers |
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large cell carcinoma
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- peripheral, may show features of squamous cell or adenocarcinoma on electron microscopy
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carcinoid
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- major bronchi
- low malignancy, spread to adjacent tissues, can result in carcinoid syndrome |
