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27 Cards in this Set
- Front
- Back
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Which type of asbestos is the most carcinogenic?
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Crocidolite (like crocodile!)
Straight, rigid crystals that are fragile |
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Asbestosis toxic mechanisms:
Alveolar _______ slough -> ulcer, dust gets into the ulcer, _______ seal the ulcer and pneumocytes cover them. Dust kills cell which releases cytokine storm and stimulates _____ |
pneumocytes
macrophages fibrosis (also travels to nodes producing fibrosis) |
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Asbestosis pathology:
Gross - diffuse, which part of the lobes? Micro - what kind of cells in alveoli? Edema -> fibrosis in interstitium _______ bodies are the hallmark and are a product of what kind of cell? |
Lower
macrophages Ferruginous - from mos. Fiber core, protein and hemosiderin coat |
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In pt with asbestosis, what will you see on lung surface?
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Pleural plaques - thickened and white. They are discrete, benign and typically in the lower chest. They calcify and get VERY hard
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Important point - asbestosis is typically complicated based on what fact?
Can result in pulmonary insufficiency, massive fibrosis, carcinoma, mesothelioma. Which are rare? |
Latent period for 15-30 yrs
Progressive massive fibrosis and mesothelioma are rare |
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Which form of carcinoma is most common in asbestosis and why?
How long is the average latent period before it shows up? |
Adenocarcinoma - it's peripheral and you are deeply inhaling this stuff
latent period of 17 yrs |
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What are the determinants of getting malignant mesotehlioma from asbestos exposure?
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Dose dependent
Not related to smoking! Much less common than carcinoma Mostly pleural, some peritoneal |
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Malignant mesothelioma has no ______ bodies in them.
Latent period __ years, die <1 yr after dx. Epithelial and ____ forms. Dx: PAS+, CEA-, keratin+ and big one is _____ + which is negative in carcinoma |
ferruginous
30 spindle calretinin |
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What is the most prevalent occupational disease in the world? What is the general mechanism?
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Silicosis
Silica in mos causes the release of mediators (IL1, TNF, fibronectin, free radicals) which lead to fibrosis |
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What is the gross appearance of Silicosis?
Affected individuals are more susceptible to what? |
Nodular pleural adhesions. Black pigment at nodules periphery. Nodule confluence producing massive fibrosis
TB |
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What is Anthracosis?
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Black pigmented lung without fibrosis or other damage - just deposition of carbon in lungs
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Which condition is this?
Macules consisting of carbon laden mos Upper lobes and upper regions of lobes most affected Located adjacent to resp bronchioles, leads to progressive dilation of adjacent alveoli (centrilobular emphysema) Complication: progressive massive fibrosis and scars |
Coal workers pneumoconiosis
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Which condition is this?
Particle partially suppresses fibrosis Early - iron containing alveolar mos Late - patchy pulm intersetitial pneumonitis, maybe some fibrosis Lung is red |
Hematite-miner lung (Silico-siderosis)
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Which condition?
Immune disorder more common in women and blacks Distribution wide None to moderate pulmonary Sx Noncaseating granulomas in lung, skin, eyes, liver |
Sarcoid - dx by confirming that it isn't TB
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Which condition?
ARDS acutely Immune response after latent interval - persons with HLA-DPBI glutamate 69 are susceptible Granulomas and fibrosis Giant cell inclusions |
Berylliosis
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Which condition?
Produces 3 types of pulmonary disease - Acute allergic alveolitis (sloughed type 2 pneumo) Intersititial pneumonitis with fibrosis Asthma |
Hard Metal Disease (Cobalt) - used in tungsten carbide production
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Which condition do you see in IV drug users?
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Talc granulomatosis - powdered insoluble ore that lung treats like foreign body - granulomas around talc particles
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Which condition?
Failure to catabolize surfactant => accumulation in alveoli Cough, fever, irregular streaks and nodules in xray Clusters of alveoli filled with PAS + stain |
Pulmonary alveolar proteinosis
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Which condition?
Mechanism - autoimmune IgG antibody against GM-CSF which inhibits surfactant catabolism. Rx: repeated bronchial lavage |
Pulmonary alveolar proteinosis
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What is a smoking-induced engorgement of alveoli by macrophages? Misnomer!
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Desquamative interstitial pneumonitis
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Which condition is caused by actinomycetes spores and is a hypersensitivity reaction?
Granulomas and giant cells in bronchioles and alveoli can lead to fibrosis if recurrent attacks. Antibodies in the serum. |
Farmer lung (hypersensitivity disease or extensive allergic alveolitis)
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Which condition?
Acute necrotizing bronchiolitis after exposure Broncholitis may go to organizing Pneumonia. HNO3 made destroys bronchi lining |
Silo-filler disease
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Which disease?
Part of Histiocytosis X: Letterer-Siwe disease <2 yo with skin lesions Hand-Schuller-Christian disease if in the head Eosinophilic granuloma Interstitial nodular infiltrate of Langerhans, Tlymphos and eosinophils Most are smokers |
Langerhans cell histiocytosis
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Which condition?
Ab directed at basement membranes of lung and kidney. Acute glomerulonephritis with interstitial pulmonary necroiss and hemorrhage Mostly males |
Goodpasture Syndrome
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Which condition?
Small vessel necrotizing vasculitis associated with asthma, sinusitis, lung infiltrates, EOSINOPHILIA Idiopathic cause Anti-myeloperoxidase antibodies |
Churg-Strauss Syndrome
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What is the most common form of diffuse interstitial fibrosis?
Better prognosis if nonspecific form which is more regularly distributed. If irregugular distribution - usually end stage honey comb lung |
Idiopathic pulmonary fibrosis/nonspecific interstitial pneumonia
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Which condition?
Abberant epithelial repair driven by TGF-beta1... CAVEOLIN which normally protects aginst fibrosis by suppression of TGF-beta1 is DEPRESSED in these patients |
Idiopathic pulmonary fibrosis/usual interstitial pneumonia
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