RESPIRATORY PATHOLOGY

FK-UHN2013

LUNG DISEASEINFECTIONNON INFECTION

LUNG DISEASEINFECTION- BRONCHITIS- BRONCHIOLITIS- PNEUMONIA* BRONCHO PNEUMONIA* LOBAR PNEUMONIA * SPECIAL PNEUMONIA

BRONCHITISACUTE : SPREAD ACUTE LARYNGOTRACHEO BRONCHITIS (CROUP) SEVERE (CHILD)ETIO : RSV, H. INFL, STREP. PNEUMONIACLINIC : COUGH, PURULENT, SPUTUM

BRONCHITISCHRONIC: - ACUTA CHRONICA - COUGH > 3 MONTH / 2 YRSETIO : SMOKER, POLUTION, INF. STR. PNEMONIA, H. INFLUENZAE, RSV, ADENOVIRUSCLINIC : MAN HYPERCAPNIA,HYPOXCEMIA, CYANOSIS ( BLUE BLOATERS ) EMPHYSEMA

PNEUMONIAALVEOLAR INFLAMMATIONHIGH PROTEIN EXUDATEPMN,LYMPHOCYTE & MACROPHAGE INFILTRATIONLOBAR & BRONCHOPNEUMONIA

PNEUMONIACLINIC : - PRIMAIR - SECUNDARYETIO : - BACTERIAL* STREP. PNEUMONIA * STAPH. AUREUS* M. TUBERCULOSA, ETC - VIRAL * INFLUENZAE, MEASLESS - YEAST* CRYPTOCOCCUS, CANDIDA, ASPERGILLUS

PNEUMONIAETIO : OTHERS PNEUMOCYSTIS CARINII, MYCOPLASMA, ASPIRA- TION, LIPID & EOSINIPHYLICHOST REACTION : - FIBROUS - SUPURATIVEANATOMIC : - BRONCHOPNEUMONIA - PNEUMONIA LOBARIS

BRONCHOPNEUMONIACONSOLIDATION PLAQUE BRONCHIOLUS & BRONCHUS AROUND ALVEOLIINFANT & OLD & WEAKNESS PATIENT ( CA, CARDIAC FAILURE, CHRONIC KIDNEY FAILURE, TRAUMA-TIC CEREBROVASCULAR), ACUTE BRONCHITIS, CHRONIC OBSTR. RESP. TRACT,OR CYSTIC FIBROSIS & POST OP.

BRONCHOPNEUMONIALESION : FOCAL (CENTRE OF RESPIRATORY TRACT) / PLAQUEBILATERAL ( BASAL )AUSCULTATION CREPITATION ETIO : Staphylococcus StreptococcusH. influenzae Coliform, YeastHP : ACUTE INFLAMMATION + EXUDATE

LOBAR PNEUMONIAALL OF LOBUSINFANT & OLD PATIENT WOMEN90 % STREP. PNEUMONIA (PNEUMOCOCCUS)CLINIC COUGH RUSHTY SPUTUM FEBRIS (40OC), INSPIRATION PAIN, BRONCH ASPIRATIONKLEBSIELLA OLD, DM, ALKOHOLIC

PNEUMONIA (STADIUM)CONGESTION :- I 24 HRS - EXUDATE (PROTEIN) ALVEOLI SPACE - OEDEMA PULMONAL - RED COLOUR

RED HEPATISATION- > 24 HRS DAYS- ACCUMULATION (LYMPHOCYTE, MACROPHAGE) ALVEOLAR- EXTRAVASATION RED CELLS- FIBRINOUS EXUDATE (PLEURAL)- GAS (-) , CONSOLIDATION (HEPAR)

GRAY HEPATISATION- FEW DAYS (STAD II)- FIBRINE (ACCUMULATION)- WHITE & RED CELLS (LYSIS) - DARK GRAY

RESOLUTION :- 8 10 DAYS UNTREATED- EXUDATE & INFILTRATION DEBRIS (ABSORB)- ALVEOLUS WALL (N)- ALL OF CASE RECOVERY

PNEUMONIA NON INFECTIONASPIRATION- LIQUID / FOOD CONSOLIDATION INFLAMMATION (SECONDAIRY)- RISK FACTOR : POST OP, COMA, STUPOR, LARYNX CA, ETC- LESION : POSITION !!

LIPID PNEUMONIA- ENDOGEN OBSTRUCTION (MACROPHAGE GIANT CELL)- EXOGEN PARAFFIN LIQUID INTERSTITIAL FIBROSIS

EOSINIPHYLIC PNEUMONIA- EOSINOPHYL > INTERSTITIAL & ALVEOLI (ASTHMA, ASPERGILLUS, MICROPHYLARIA), LOEFFLER SYNDROME (IDIOPATIC)

TUBERCULOSISETIO : M. TUBERCULOSELOC : - LUNG >> - ETCCLINIC : - VARIATION - DYSPNOE - LOSS BODY WEIGH - FEBRIS - DISTRESS - SWEATING - COUGH

TYPE : - PRIMAIR - SECUNDAIR - MILIERDX CLINICAL SIGNLAB : - SPUTUM - MANTOUX - BLOODRADIOLOGY IMMUNISATION BCG

PRIMAIR :- FIRST CONTACT- PRIMAIR LESION (GHON LESION) + REG. LYMPHNODE (GHON COMPLEX)- FIBROCALCIFICATION, BACIL (+)

SECUNDAIR :- REACTIVATION (PRIMAIR)- LOC APEX ( +/- BILATERAL )- FIBROCALCIFICATION

MILIER- PRIMAIR / SECUNDAIR- IMMUNITY >, - POLUTION STREP. PNEUMONIA H. INFLUENZAE & VIRAL SEVERE HYPERCAPNIA, HYPOXIA & CYANOSIS (BLUE BLOATERS)

EMPHYSEMAALVEOLUS DILATATION + ELASTICITY (

OTHER FORM - BULOSA EMPHYSEMA- INTERSTITIAL EMPHYSEMA- SENILE EMPHYSEMACLINIC : - DYSPNOE - COUGH - SPUTUM

ASTHMABRONCHUS IRRITABLE (+) BRONCHUS SPASM MUCOUS (>>) OBSTRUCTION DYSPNOETYPE : - ATOPIC - NON ATOPIC - ASPIRINE INDUCED - OCCUPATIONAL - ALLERGIC (ASPERGILLUS)

ATOPIC ASTHMA ENVIRONMENT MATERIAL HYPERSENSIVITY REACTION BRONCHUS CONSTRICTION TACHYPNOE, DYSPNOESTATUS ASTHMATICUS DEAD

NON ATOPIC ASTHMAT. RESP. INFECTION CHRONIC BRONCHITISALLERGEN TEST (-)LOCAL IRRITATION BRONCHUS CONSTRICTION

ASPIRINE INDUCED ASTHMAMECHANISM (?) +/- PROSTAGLANDINE DECREASE / LEUKORINE INCREASE RESP. TR. IRRITABLERHINITIS, NASAL POLYPS, URTICARIA (+)

OCCUPATIONAL ASTHMAREACTIVE HYPERSENSIVITY (ALLERGEN) DYSPNOE COUGH (CHRONIC)ALLERGEN : - WOOD - CHEMICAL - ETC

ASPERGILLUS BRONCHITIS ALLERGYSPORA ASPERGILLUS FUMIGATUS HYPERSEN- SITIVITAS REAC DYSPNOE MUCOUS GLOBULE ASPERGILLUS HYPAE (+)

BROCHIECTASISETIO : - BRONCHUS OBSTRUCTION - INFECTION (SEVERE) - CONGENITAL () + BLOOD

CLINIC :- LOBUS INFERIOR + INFECTION- CLUBBING FINGERCOMPLICATION PNEUMONIA, EMPIEMA, SEPTICAEMIA, MENINGITIS, ABSCESS METASTASIS (CEREBRAL), AMYLOID (+)

PNEUMOCONIOSISDUST: INORGANIC / ORGANICTISSUE REACTION :- MILD - FIBROUS- ALLERGIC- NEOPLASTIC

COAL WORKERS PNEUMOCONIOSISSILICOSISASBESTOSISHYPERSENSITIVITY

CARCINOMA OF THE LUNGSquamous cell.Adenocarcinoma.Large Cell Undifferentiated Carcinoma.Small Cell Undifferentiated (Oat Cell) Carcinoma.

PLEURA

EFFUSIONNEOPLASMS OF THE PLEURA

PLEURAL EFFUSION A collection of fluid in the pleural cavity.Transudate Low specific gravity, low protein concentrat, and lack of inflammatory cells. Exudates : specific gravity over 1.015, a protein level of over 1.5 g/dL, and many inflammatory cells.

Empyema : Bacterial infection commonly produces a frankly purulent exudate. Hemorrhagic exudates occur in malignant effusions, TB, uremia, and pulmonary infarction.Cytologic examination of effusion sediment malignant neoplasia .

CHYLOTHORAXChylothorax : Secific kind of pleural effusion characterized by accumulation of chyle in the pleural cavity. Chyle : Milky fluid of high fat content that is normally present in the thoracic duct. Evidence of an abnormal communication between the thoracic duct and the pleura.

Neoplasms of the Pleura

Primary Mesothelial Neoplasm.Secondary Pleural Neoplasms.

Primary Mesothelial NeoplasmBenign Fibrous Mesothelioma.Malignant mesothelioma. Rare neoplasm strongly related etiologically to asbestos exposure; many cases have occurred in World War II shipyard workers. There is a long lag period (as long as 40 years) between asbestos exposure and tumor development.

Secondary Pleural NeoplasmsDirect involvement of the pleura by lung carcinoma is the most common secondary pleural neoplasm. Metastases from distant sites the breast, colon, kidney, and thyroid.