Glossary of Respiratory System: Pathology
Start Studying!
Add Cards ↓
Deck Info
Description
Tags
Recent Users
Other Decks By This User
- Cause of common cold
- Adenovirus
- Croup
- Acute laryngotracheobronchitis
Acute inflammation of larynx, trachea, and epiglottis
Potentially life-threatening in infants
Harsh cough and inspiratory stridor
Caused by parainfluenza virus, most commonly
- Main cause of epiglottitis
- H. influenza
Can be life-threatening
- Nasopharyngeal carcinoma
- Most common in adults (SE Asia) and children in East Africa
Caused by EBV
- Squamous cell carcinoma of the nose
- most frequently occurring malignant nasal tumor
- adenocarcinoma of the nose/throat
- responsible for 5% of all the nose/throat malignancies
- Plasmacytoma
- plasma cell neoplasm that in its extraosseous form, produces tumros in the upper respiratory tract
- Singer's nodules histology
cause
location
symptoms
- Benign laryngeal polyp
Associated with overuse of the voice and smoking
Localized to true vocal cords
Hoarseness
- Laryngeal papilloma
- In adults: single lesion, can turn malignant
In children: caused by HPV 6 and 11; multiple lesions, recurs after resection
- Squamous cell carcinoma of the larynx
Epidemiology
Presentation
- most common malignant tumor of the larynx
Seen in men older than 40
Associated with smoking and alcoholism (combined)
Present with persistent hoarseness
- What is glottic carcinoma?
- Most common type of laryngeal carcinoma
Has best prognosis
- What is supraglottic ad subgglottic carcinoma?
- less common laryngeal carcinoma
poorer prognosis
- Extrinsic asthma
- asthma associated witeh chronic bronchitis, exercise induced, and cold-induced asthma
Begins in adult life
Not assocaited with hx of allergy
- clinical Characteristics of asthma
- Episodic dyspnea and wheezing on expiration
Narrowing of the airways
- Histology of asthmatic airways
- Bronchial smooth muscle hypertrophy
Hyperplasia of goblet cells
Thickening and hyalinization of BM
Proliferation of eosinophils
Intrabronchial mucous plugs containing whorl-like accumulations of epithelial cells
Crystalloids of eosinophil-derived proteins
- What are Curschmann spirals
- Whorl-like accumulations of epithelial cells seen in asthma
- What are Carcot-Leyden crystals?
- Crystalloids of eosinophil-derived proteins
- Complications of asthma?
- Superimposed infection
Chronic bronchitiis
Pulmonary emphysema
Status asthmaticus
- Definition of chronic bronchitis
- Productive cough lasting 3 consecutive weeks over 3 consecutive years
- Causes of chronic bronchitis
- Cigarette smoking
pollution
infection
genetics
- What can chronic bronchitis lead to?
- cor pulmonale
- Histology of chronic bronchitis
- Hypersecretion of mucus d/t marked hyperplasia of mucus secreting submucosal glands
- What composes a respiratory acinus?
- respiratory bronchiole
alveolar duct
alveoli
- Characteristics of centrolobular emphysema
- Dilation of respiratory bronchioles
In apex/upper part of pulmonary lobes
- Characteristics of panacinar emphysema?
- Dilation of the entire acinus, starting in the alveoli and alveolar duct, then respiratory bronchiole
Most commonly occurs in the lower basal zones
- Characteristics of paraseptal emphysema
- Alveoli and alveoar ducts are dilated
Localizes subjacent to pleur interlobar septa
- Which type of emphysema is associated with alpha-1 anti-trypsin deficiency
- Panacinar emphysema
- What are complications of emphysema
- Chronic bronchitis
Interstitial emphysema
Rupture of a surface bleb with resulting pneumothorax
- What is interstitial emphysema
- air escapes into the interstitial tissue of chest from a tear in the airways
- Pathogenesis of emphysema?
- Cigarette smoke causes recruitment of neutrophils and macrophages, which release elastase
Elastase destroys elastin unless neutralized alpha-1 anti-trypsin
Cigarettes inactivate alpha-1 anti-trypsin
- What is the PiZ allele
- structural alteration in alpha-1 anti-trypsin, which interferes with the hepatic secretion of it
- What is alpha-1 anti-trypsin deficiency associated with?
- panacinar emphysema
hepatic cirrhosis
cholestasis
hepatocellular carcinoma in 1-2% of homozygous adults
- What is bronchiectasis?
- Permanent abnormal bronchial dilation
- What causes bronchiectasis
- Chronic infection wiht inflammation and necrosis of the bronchial wall
- What are predisposing factors for bronchiectasis?
- Bronchial obstruction (often by tumor)
CF
necrotizing bacterial, viral or fungal pneumonai
RA
GVHD
chronic sinusitis with post nasal drip
Kartagener syndrome
- Manifestations of Kartagener syndrome
- sinusitis
bronchiectasis
situs inversus (left-right reversal of thoracic viscera)
hearing loss
immotile sperm
- Cause of Kartagener syndrome
- structural defect in dynein arms, impairing ciliary activity
- Where in the respiratory tract does bronchiectasis most commonly appear?
- Lower lobes of both lungs
- Manifestations of bronchiectasis
- copious purulent sputum
hemoptysis
recurrent pulmonary infection --> lung abscess
- Complications of bronchiectasis
- cor pulmonale
metastatic abscess
systemic amyloidosis
- Characteristics of interstitial lung diseases
- interstitial accumulations of cells or noncellular material within the alveolar walls that restrict expansion and interfere with gaseous exchange
(increased A-a gradient... V/Q mismatch)
- EXamples of interstitial lung disease
- ARDS
Neonatal respiratory distress syndrome
Pneumoconiosis
Sarcoidosis
Idiopathic pulmonary fibrosis
SLE
Scleroderma
Goodpasture syndroem
Wegener granulomatosis
- How does pulmonary fibrosis lead to cardiac failure?
- Pulmonary fibrosis --> repeated cycles of cellular injury --> abnormal wound healing b/c of excessive fibroblast proliferation --> cor pulmonale, pulmonary insufficiency and cardiac failure
- Pathogenesis of ARDS?
- diffuse alveolar damage --> increased capillary permeability --> leakage of protein rich fluid (exudate) into alveoli
- Histology of ARDS
- intra-alveolar hyaline membrane made of fibrin and cellular debris
- Clinical result of ARDS
- impairment of respiratory gas exchange with severe hypoxia
- Causes of ARDS
- toxic agents
shock
sepsis
trauma
uremia
aspiration of gastric contents
acute pancreatitis
O2 toxicity
OD of heroin or bleomycin
SARS
- Relationship between SARS and ARDS
- SARS (a coronavirus) destroys type II pnemocytes --> diffuse alveolar damage
- Things that influence ARDS
- Neutrophils that release substances toxic to alveolar wall
Activation of coagulation cascade
O2 toxicity from free radicals
- Causes for neonatal respiratory distress syndrome
- Surfactant deficiency, from premature birth/premature lungs
seen in diabetic mom, poor glucose control, c-section
- Clinical manifestations of neonatal respiratory distress syndrome
- Dyspnea
Cyanosis
Tachypnea
- Component of surfactant
- dipalmitoyl lecithin
- Way to determine fetal pulmonary maturity
- measure ratio of surfactant lecithin to sphingomyelin in amniotic fluid
[Lecithin] increases from 33rd week of pregnancy, while sphingomyelin remains stable
L:S 2:1 or higher = pulmonary maturity
- Factors predisposing to neonatal respiratory distress syndrome
- Prematurity
Materal DM
C-section
- Pathologic findings of neonatal RDS
- lungs are heavier than normal
Areas of atelectasis alternating with dilated alveoli/alveolar ducts
Small pulmonary BV are engorged witeh blood, with leakage of blood products into alveoli
Formation of hyaline membranes within alveoli
- Components of hyaline membranes in neonatal RDS
- fibrin and cellular debris
- Complications/associated conditions with neonatal RDS
- Bronchopulmonary dysplasia
PDA
Intraventricular brain hemorrhage
Necrotizing enterocloitis (inflammation of large and small intestines)
- Morphology of necrotizing enterocolitis
- mucosal edema
hemorrhage
necrosis of terminal ileum and entire gut
- Components of coal dust
- carbon and silica
- markings of simple coal workers' pneumoconiosis
- Coal macules around bronchioles
- What can progresive massive fibrosis from coal workers' pneumoconiosis lead to?
- bronchiectasis
pulmonary HTN
death from respiratory failure
cor pulmonale
- Careers associated with silicosis
- miners
glass manufacturers
stone cutters
- dangers of silicotic nodules
- enlarge and obstruct airways and BV
- risks associated with silicosis
- increased TB risk
can also be concurrent (silicotuberculosis)
- Pathogenesis of asbestosis
- asbestos fibers are taken up by alveolar macrophages
fibroblast-stimulating GF by macrophages likely released --> diffuse interstitial fibrosis in lower lobes
- Ferruginous bodies
- seen in asbestosis
yellow-brown rod shaped bodies with clubbed ends that stain for Prussian blue
- Complications of asbestosis
- bronchogenic carcinoma
malignant mesothelioma
- Pathologic changes associated with sarcoidosis
- interstitial lung disease
enlarged hilar lymph nodes
anterior uveitis
erythema nodosum of skin
polyarthritis
- Immunologic phenomena associated with sarcoidosis
- reduced sensitivity to skin test antigens
polyclonal hyperglobulinemia
- Clinical abnormalities seen with sarcoidosis
- bilateral hilar lymphadenopathy
interstitial lung disease manifest as diffuse reticular densities
- Lab findings associated with sarcoidosis
- hypercalcemia
hypercalciuria
hypergammaglobulinemia
increased ACE
- Way to make definitive dx of sarcoidosis
- biospy showing non-casseating granuloma
- Progression of idiopathic pulmonary fibrosis
- chronic inflammation and fibrosis of alveolar wall
begins with alveolitis --> ibrosis --> distorted fibrotic lung filled with cystic spaces
- Honeycomb lung
- typical of idiopathic pulmonary fibrosis
- Prognosis for idiopathic pulmonary fibrosis
- poor
death often within 5 yrs
- morphologic changs of eosinophilic granuloma
- histiocytic cells closely related ot Langerhans cells of skin
have cytoplasmic inclusions (Birbeck granules) resembling tennis rackets
Prominent monocytes-macrophages, lymphocytes, and eosinophils
- Location of eosinophilic granulomata
- lung or bony sites (i.e. ribs)
- Location of eosinophilic granulomata
- lung or bony sites (i.e. ribs)
