Glossary of Step Up: Pulmonary Diseases

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increased Reid Index

excess mucus

productive cough for three consecutive months to 2 yrs

seen in smokers

possible cor pumonale
Chronic Bronchitis
increased sensitivity of bronchioles

Charcot-Leyden crystals or Curschmans spirals


treat with B-agonist and steroids
Decreased elastic recoil, dilated and damaged alveoli

may be assoc. with hereditary a1 antitrypsin deficiency

dyspnea, barrel shaped chest, expiration thru pursed lips
caused by bronchial obstruction or infection

dilated airways in lower lobes

cough w/ purulent sputum; hemopytosis; cyanosis

seen in CF patients or those with Kartageners syn
intra-alveolar exudate leading to consolidation

CXR shows radio-opaque lobe involvement

fever, dyspnea, productive cough
Lobar Pnuemonia
Pneumococcus (S.pnuemoniae)
multilobar involvement; neutrophil exudate extends from bronchii

CXR shows patchy opacities

Fever, dyspnea, and productive cough
Staph. aureus, H. influenza, S. pyogenes
multilobar involvement; neutrophil exudate extends from bronchii

CXR shows patchy opacities

Fever, dyspnea, and productive cough

seen in patients with alcoholism
diffuse infiltrate in alveolar wall, patchy; no consolidation

abrupt onset of fever, gradual paroxysmal cough w/ Rales at PE

positive cold agglutinin test

usually affects young adults
Mycoplasma pneumoniae
pulmonary hemorrahge, anemia, glomerulonephritis

anti basement membrane antibodies

affects middle aged males

P/W hemoptysis; hematuria
CXR bilateral fluffy infiltrates
Goodpastures Syndrome
*Chronic Inflammation of the alveolar wall

Fibrosis; csytic spaces

usually occurs in the sixth genration of life

*Honeycomb lung

fatal within years
Idiopathic Pulmonary Fibrosis
Interstitial fibrosis, uveitis, polyarthritis

*Dx based on biopsy showing non- caseating granulomatous lesions

*MC affects Young black females

may p/w dyspnea on exertion, dry cough, fever, fatigue and bilateral hilar lym
prolonged exposure to organic antigens in atopic individuals

interstitial inflammation

alveolar damage leads to chronic, fibrotic lung

affects those with occupational history of farming or bird keeping

p/w dry
Hypersensitivity Pneumonitis
presence of Langerhans like cells and Birbeck granules; subset of histiocytosis X

former smokers are at risk

shows lesions in lung or ribs; pnuemothorax
Eosinophilic granuloma
Carbon dust ingested by alveolar macrophages

*visible black deposits

usually asymptomatic

seen in smokers and urban dwellers
fibroblast proliferation and interstitial fibrosis of the lower lobes

disease specific bodies and ferruginous bodies

pleural plaques and effusions

increased risk of bronchiogenic carcinoma and malignant mesothelioma
Carbon dust ingested by alveolar macrophages forms bronchiolar macules

may progress to fibrosis

plaques are asymptomatic, often benign but may progress to fibrosis

may be fatal due to pulmonary hypertension and *cor pumon
Coal Workers Pneumoconiosis
silica dust is ingested by alveolar macrophages causing release of harmful enzymes

silicotic nodules that may obstruct air or blood flow

concurrent TB is common

seen in miners, stone cutters, and glass production
induction of cell mediated immunity leads to non-caseating granulomas

several organ systems are affected; histologically identical to sarcoidosis

increases lung cancer
most common oppurtunistic infection in AIDS patients

diffuse atypical pneumonia

extesnive pink alveolar exudate but minimal inflammation

GMS stain demonstrates organism
P. carinii
hyaline membranes

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