Otitis Media, Exophthalmos, Diabetes Insipidus. Histiocytes & Eosinophil Infiltrate Assymptomatic (Diabetes) Arrythmias, Mitral Insufficiency …
Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other | |
|Hemolytic Disease|Antigen |Anemia, Liver Failure, |Rh D Antigen |Incompatability doesnt become |
|of the Newborn |incompatibility |Hypoproteinemia | |problematic until second pregnancy|
| |between fetus and |CHF Hydrops Fetalis | | |
| |mother |Jaundice | | |
| |Rh treatable | | | |
| |ABO not treatable | | | |
|Hyaline Membrane |Preterm |Immature Lung, Decreased|Ground Glass CXR |Most Common Cause of Neonatal |
|Disease |Maternal Diabetes |Surfactant |PDA |Respiratory Distress Syndrome |
| |C Section |Hyaline Membranes | |Resuscitation at |
| | |Difficult Respiration, |
|birthNormalRespiratory Distress |
| | |Expiratory Grunt | |in 30 min |
| | |Cyanosis, Fine Rales, | |Treated with corticosteroids |
| | |Ground Glass CXR | |induce maturation |
| | | | |Risks: PDA, Retrolental |
| | | | |Fibroplasia, Bronchopulmonary |
| | | | |Dysplasia |
|Retrolental |Hyaline Membrane/RDS|Retinal Vessel | | |
|Fibroplasia | |Proliferation on return | | |
| | O2 |to room O2 | | |
| |vVascular | |
| |
| |Endothelial Growth | | | |
| |Factor | | | |
|Bronchopulmonary |Very Low Birth |O2 Dependence at 28 | |Prevented using High Frequency |
|Dysplasia |Weight |days, | |Ventilation, Extracorporeal |
| | |Persistant Respiratory | |membrane oxygenation, Liquid |
| | |Distress at 3 months | |Ventilation |
| | |Epithelial Hyperplasia, | | |
| | |Squamous Metaplasia | | |
| | |Alveolar thickening, | | |
| | |Interstitial Fibrosis |
| |
|Necrotizing |Gut Immaturity, Oral|Abdominal Distension, | | |
|Enterocolitis |Feeding |Tenderness, Ileus, | | |
| |Colonization with |Bloody Diarrhea, | | |
| |bacteria |Pneumatosis intestinalis| | |
| |Mucosal Injury | | | |
| |Impaired blood flow |Mucosal Sloughing, | | |
| | |Necrosis Inflammation | | |
|Hirschsprungs |Downs Syndrome |Failure to pass meconium| |Male Predominance |
|Disease |Neurologic Defect | | | |
| |Abnormal Migration |Abdominal Distention, |
| |
| |of neural crest |Constipation | | |
| | |Absence of ganglionic | | |
| | |nerves in | | |
| | |submucosal/myenteric | | |
| | |plexi | | |
|Cystic Fibrosis |CFTR Defect 7q31-32|v Resorption/ Sweat |?F508 |Most Common Lethal Genetic Disease|
| |- ?F508 |NaCl |Elevated Sweat |in White Population |
| | |Pulmonary Infections |Chloride | |
| | |Pseudomonas | | |
| | |Pancreatic | |
|
| | |Insufficiency; Male | | |
| | |Infertility | | |
| | |Cirrhosis; Malabsorption| | |
|Sudden Infant |URIs, Prone Sleeping|Unexplained Death 1 | | |
|Death Syndrome |Position |year old | | |
| |Thermal Stress, |Agonal Petechiae | | |
| |Males |Astrogliosis of | | |
| |African American, |brainstem | | |
| |Prematurity | | | |
| |Maternal | | |
|
| |Smoking/Drug Abuse | | | |
|Child | | | |Shaken Baby: Subdural CN II |
|Abuse/Neglect | | | |Hemorrhages, Posterior Fractures |
| | | | |Battered Child: Bruises, Pattern |
| | | | |Injury, Abdominal Trauma, |
| | | | |Fractures of varying ages, |
| | | | |Lacerated Frenulum |
| | | | |Sexual Abuse: Geniral trauma, torn|
| | | | |hymen |
|Munchausen | | |
|Caregiver simulates illness in |
|Syndrome by Proxy| | | |child for secondary gain |
| | | | |Unwitnessed Events Repeat |
| | | | |Hospitalizations |
|Hemangioma | | | |Benign |
| | | | |Common in infancy, spontaneously |
| | | | |regresses |
| | | | |Associated with Tuberous Slcerosis|
| | | | | von Hippel Lindau |
|Lymphangioma | |Deep neck, axilla, | |Benign |
| | |mediastinum or |
|Usually cystic or cavernous |
| | |retroperitoneal | | |
Pediatric Pathology
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Teratoma | |Teeth, hair, bone, skin | |Benign cystic to malignant solid |
|Sacrococcygeal |Congenital Anomalies|Teeth, hair, bone, skin | |75 mature, benign; |
|Teratoma | | | | |
|Neuroblastoma | |Adrenal Mudulla mass, |Homer-Wright |Most common malignant tumor 1 yo |
| | |fever, weight loss |Pseudorosettes |Can become ganglioneuroma |
| | |Encapsulated or |Small Blue Cells |Bad Diploid, del 1p, N-myc, |
| | |infiltrative, cystic, | |Stage IV Blueberry Muffin Baby|
| |
|hemorrhagic | | |
| | |Calcified, Sheets of | |GoodStage IV-S, 1 yo, |
| | |small blue cells | |Hyperdiploid |
| | |Homer-Wright | | |
| | |Pseudorosettes; | | |
| | |Peri-orbital mets | | |
|Wilms Tumor |WT-1 2 |Large palpable abdominal| |2nd most common malignant tumor |
|Nephroblastoma | |mass, Hematuria | |3 cell types: Blastema small |
| | |Intestinal obstruction, | |round cells, Epithelial Stromal|
| | |pulmonary mets | | |
| |
|Nephroblastomatosis | |Amount of Blastema prognosis |
| | |Precursor | |90 long term survival |
| | |Large, circumscribed, | | |
| | |cystic | | |
|WAGR Syndrome |11p13 aniridia |Wilms Tumor | | |
| |WT-1 |Aniridia | | |
| | |Genital Anomalies | | |
| | |Retardation | | |
|Denys-Drash |WT-1 |Gonadal Dysgenesis | | |
|Syndrome | |Wilms Tumor | | |
|Beckwith-Wiedeman|WT-2 11p155
|Hemihypertrophy, | |Other Tumors: Hepatoblastoma, |
|n Syndrome | |Organomegaly, | |Adrenocortical tumors, RMS, |
| | |Macroglossia | |Pancreatic Tumors |
| | |Renal Medullar Cysts, | | |
| | |Adrenal Cytomegaly | | |
| | |Wilms Tumor, Other | | |
| | |Tumors | | |
|Ewing Sarcoma |t11:22 |Diaphysis of long bones |Small Blue Cells |White male never black |
| | |Sheets of small round | |Metastatic in 25 of cases |
| | |blue tumor, glycogen | | |
|Extraosseous |t11:22
|Neural differentiation | | |
|Ewing Sarcoma | |Rosettes | | |
|Primitive | | | | |
|Neuroectodermal | | | | |
|Tumor | | | | |
|PNET | | | | |
|Rhabdomyosarcoma |t2:13 Alveolar |Painless, proptosis, CN |Small Blue Cells |Most common soft tissue sarcoma of|
| | |palsies, chronic | |children |
| | |drainage | |Peak 2-5 yo again in adolescence|
| | |Urinary obstruction, | | |
| |
|constipation, Hematuria | |Good Embryonal: Botryoid grapes|
| | |Small blue cell tumor | |from vagina or Spindle Cell |
| | | | |Bad Alveolar in extremities |
| | | | |trunk |
|Hepatoblastoma | |Enlarging Abdomen | | |
| | |Fetal or Embryonal Stem | | |
| | |Cells | | |
|Retinoblastoma |Rb1 on Ch 13 |Leukocoria white | | |
| | |papillary reflex | | |
| | |Assymetry, Strabismus, | | |
| |
|Painful Eye | | |
| | |Rosettes, Calcifications| | |
Pediatric Pathology contd
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Hand-Schuller-Chr|Household Smoking |Solitary, esp bone |Birbeck Granules | |
|istian Diease | |Histiocytes | | |
|Langerhans Cell | |Eosinophil Infiltrate | | |
|Histiocytosis | |Birbeck Granules | | |
|Eosinophilic |Household Smoking |MultifocalBone Lesions, |Birbeck Granules | |
|Granuloma | |Weight Loss, | | |
|Langerhans Cell | |Otitis Media, | |
|
|Histiocytosis | |Exophthalmos, Diabetes | | |
| | |Insipidus | | |
| | |Histiocytes | | |
| | |Eosinophil Infiltrate | | |
| | |Birbeck Granules | | |
|Letterer-Siwe |Household Smoking |Disseminated, Blood |Birbeck Granules |Often Fatal |
|Disease | |Abnormalities, Fever | | |
|Langerhans Cell | |Seborrheic Skin Rash, | | |
|Histiocytosis | |Weight Loss, HSmegaly | | |
| | |Lymphadenopathy, | |
|
| | |Histiocytes | | |
| | |Eosinophil Infiltrate, | | |
| | |Birbeck Granules | | |
|Atrioventricular |Trisomy 21 Down |Left to Right | |Partial: Primum ASD Cleft |
|Septal Defect |Syndrome |Acyanotic, | |Anterior Mitral Leaflet, Mitral |
|AV Canal | |Eisenmenger Syndrome | |Insufficiency, Two valve orifices |
| | |Later | |Complete AVSD: Large AVSD Common|
| | |Poorly formed AV Valves | |AV Valve |
| | | | |Subtypes Rastelli A,B,C based on|
| | | | |bridging of anterior leaflet
|
|Coarctation of |Monosomy X Turner |Narrowed or Constricted | |If with PDA, manifests early, |
|Aorta |Syndrome |Aorta | |lower body cyanosis |
| | |50 bicuspid aortic | |If without PDA, less severe, upper|
| | |valve | |body hypertension |
| | |Systolic murmur | | |
| | |thrill | | |
| | |LVH Cardiomegaly | | |
|Truncus |DiGeorge del 22q11|Right to Left Cyanotic| |Early Repair to avoid late |
|Arteriosus | | | |complications |
| | |No division into Aorta | | |
|
| |Pulmonary Artery | | |
| | |Single Vessel w/ | | |
| | |vareiable of cusps in | | |
| | |valve | | |
|Pulmonic Stenosis|Noonan Syndrome Chr|RVH, Post stenotic | |Variable severity |
| |12q22 |dilation of arteries | | |
|Supravalvular |Williams Syndrome | | | |
|Aortic Stenosis |Chr 7 - Elastin | | | |
|Patent Ductus |Rubella Infection |Left to Right |Machinery Murmur |Treatment: Surgery or Indomethacin|
|Arteriosus | |Acyanotic, | |PG Inhibitor |
| |
|Eisenmenger Syndrome | | |
| | |Later | | |
| | |Machinery Like Murmur | | |
| | |Assymptomatic | | |
|Tetrology of | |Right to Left Cyanotic| |Boot Shaped Heart; VSD usually |
|Fallot | | | |large |
| | |1 VSD 2 Rt Ventricular| |Hypercyanotic episodes due to RVOT|
| | |Outflow Obstruction | |spasm |
| | |3 Rt Ventriculare | |Usually accompanied with Pulmonary|
| | |Hypertrophy | |Stenosis |
| |
|4 Overriding Aorta | | |
|Transposition of | |Right to Left Cyanotic| |Requires shunt for survival |
|Great Arteries | | | |usually PDA |
| | |Abnormal Formation of | |Aorta is anterior and to right of |
| | |Septa | |Pulmonary Artery nl posterior |
| | |Separation of | | |
| | |Systemic/Pulmonary | | |
| | |Circulation | | |
| | |Right Ventricular | | |
| | |Hypertrophy | | |
|Corrected TGA |
|TGA with Inversion of | |Late decompensation of right |
| | |ventricles | |ventricle due to systemic demand |
| | |Aorta in parallel and to| | |
| | |left of Pulmonary Artery| | |
Pediatric Pathology Contd 2
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Tricuspid Atresia| |Right to Left Cyanotic| |Requires a right to left shunt |
| | | | |ASD or PFO as outlet from RA |
| | |Unequal division of AV | |VSD allows outflow from Pulmonary |
| | |canal, large mitral | |Artery |
| | |orifice | |High Mortality
|
| | |RV Hypoplasia | | |
|Total Anomylous | |Right to Left Cyanotic| |Requires ASD or PFO to allow |
|Pulmonary Veinous| | | |pulmonary blood into the left |
|Return | |No pulmonary veins into | |atrium |
| | |left atrium | |RA or RV hypertrophy |
| | |RA or RV hypertrophy | | |
|Atrial Septal | |Left to Right | |Secundum: Midseptal, fossa ovale, |
|Defect | |Acyanotic, | |least problematic, most common |
| | |Eisenmenger Syndrome | |Primum: Adjacent to AV Valves, |
| | |Later | |Cleft Anterior Mitral Valve
|
| | |Pulmonary | |Leaflet |
| | |Overcirculation Flow | |Sinus Venosus Defect: Near |
| | |Murmur | |Superior Vena Cava |
|Ventricular | |Left to Right | |Usually associated with other CHD |
|Septal Defect | |Acyanotic, | |Membranous: Large, more common |
| | |Eisenmenger Syndrome | |Muscular: Multiple, smaller, well |
| | |Later | |tolerated |
| | |Harsh Holosystolic | |Infundibular: Below pulmonary |
| | |Murmur | |valve, large |
|Eisenmenger |Pulmonary |Cyanotic | |Ireeversible
|
|Syndrome |Hypertension |Constriction of | | |
| | |Pulmonary Arteries, | | |
| | |Intimal Lesions | | |
| | |Plexiform Lesions at | | |
| | |branches | | |
| | |Cor Pulmonale | | |
|Valvular Aortic | |If severe, may cause | |HLHS: LV arch hypolplasia; LV |
|Stenosis | |hypoplastic left heart | |endocardial fibroelastosis |
| | |syndrome HLHS | | |
| | |LV Hypertrophy, | | |
|
| |Systolic murmur | | |
| | |thrill | | |
|Supravalvular |Chr 7q Williams |Thickened wall of | |Williams Syndrome: Facies, |
|Aortic Stenosis |Syndrome |ascending aorta | |Cocktail Personality, MR |
| | |Associated with Williams| | |
| | |Syndrome | | |
| | |LV Hypertrophy, | | |
| | |Systolic murmur | | |
| | |thrill | | |
|Subvalvular | |Thickened ring below | | |
|Aortic
Stenosis | |aortic cusps | | |
| | |Usually isolated | | |
| | |May be associated with | | |
| | |coarctation PDA | | |
| | |LV Hypertrophy, | | |
| | |Systolic murmur | | |
| | |thrill | | |
Pediatric Pathology contd 3
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Atherosclerosis |Atheromas at Branch |Medium Large Arteries |Foam Cells |Located in intima |
| |Points |Foam Cells Macrophage
|Intima |Consists of a fatty core covered |
| | LDL, HT, Smoking, |Smooth Muscle | |by a fibrous cap endothelium |
| |DM, Fam Hx | | | |
| |Fatty Streaks? | | | |
|Atherothrombotic |Atherosclerosis |Mural Thrombosis | |Exposed Rough Surface allows |
|Erosion |Ulceration | | |attachment of platelets and fibrin|
|Atherothrombosis| | | | |
| | | | |May embolize thromboembolism |
| | | | |Can cause sudden occlusion |
| | | | |Main cause of myocardial infarcts |
|Atherothrombotic |Atherosclerosis |Atheromatous Embolus |
|Disintegration of the fibrous cap |
|Rupture | | | |with release into bloodstream |
| | | | |May allow for formation of |
| | | | |thrombus within the plaque |
| | | | |Can cause sudden occlusion |
|Atherosclerotic | | | |Crack in cap allows blood in or |
|Hemorrhage | | | |neovessels within plaque may burst|
| | | | | |
| | | | |Can cause sudden occlusion |
| | | | |May cause infarcts |
|Atherosclerotic | |Brittle Arteries |
|Hardening of arteries with time |
|Calcification | | | | |
|Atherosclerotic | |Aneurysm | |Enlarged plaque compresses media |
|Degeneration | | | |layer pressure atrophy |
| | | | |Causes ballooning aneurysm |
| | | | |Focal area of wall saccular |
| | | | |aneurysm |
| | | | |Circumferential Involvement |
| | | | |Fusiform aneurysm |
|Intermittent |Atherosclerosis in |Walking pain | |If thrombosis is complete it may |
|Claudication |Femoral Artery | |
|cause necrosis of the toe or |
| |Atherosclerosis in | | |footsn Feemoral Arteryurysm |
| |Popliteal Artery | | |pressure atrophymay burst |
|Acute Aortic |Hypertension |Chest Pain |Chest Pain |Rapidly spreading intramural |
|Dissection |Cystic Medial |Hypotension |Tamponade |hemorrhage |
| |Necrosis |Pericardial Tamponade |Compressed Aortic |Creates a second lumen in the |
| |Marfans Syndrome | |Valve |media layer |
| |Pregnancy, | | |Initial intimal tear accompanied |
| |Coarctation of the | | |by a distal reentry tear |
| |Aorta | | |May compress the aortic valve |
| | | |
|cause insufficiency |
|Coarctation of |Congenital |Proximal |Rib Notching |Located opposite the ligamentum |
|the Aorta |Turners Syndrome |Hypertension/Distal |Bicuspid Valve |arteriosum |
| | |Hypotension | |Lower half of the body is supplied|
| | |CHF | |by collaterals |
| | |Rib notching on CXR | |Associated with a bicuspid valve |
|Giant Cell | | |Granulomatous | |
|Arteritis | | |Age 50 | |
| | | |Large Arteries - | |
| | | |Cranial Arteries | |
| | | |Destruction of IEL|
|
|Takayusus | | |Granulomatous | |
|Arteritis | | |Age 40 often | |
| | | |Female | |
| | | |Aortic Narrowing; | |
| | | |Weak pulses | |
| | | |Extremities | |
|Polyarteritis | | |Medium Sized |Many organs |
|Nodosa | | |Arteries not | |
| | | |lungs | |
| | | |No |
|
| | | |Glomerulonephritis| |
| | | | | |
| | | |Dilated Aneurysms | |
Cardiac Pathology
Cardiac Pathology contd
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Kawasaki Syndrome| | |Large Medium |Infantile Polyarteritis |
| | | |Sized Arteries | |
| | | |Children | |
| | | |Coronary Arteries | |
| | | |Aneurysms |
|
|Hypersensitivity | | |Small Vessels |All organs |
|Angitis | | |Glomerulonephritis| |
| | | | | |
| | | |No Immune Deposits| |
|Wegeners | | |Small Vessels | |
|Arteritis | | |Granulomas in | |
| | | |Lungs | |
| | | |Granulomatous | |
| | | |Vasculitis | |
| | | |Renal Disease |
|
|Buergers | | |Medium Small | |
|Arteritis | | |Arteries | |
| | | |Heavy Smokers | |
| | | |Extremities | |
| | | |Microabscesses | |
|Congestive Heart |Many |Poor Tissue |Hemosideran Laden |Cardiogenic Shock occurs w/ loss |
|Failure |Chronic Ischemia |Perfusion/Venous Backup |Macrophages |of 40 of left ventricle |
| |Inflammation |Edema | |function |
| | |Tachycardia; | | |
| | |Angiotensin II | | |
|
| |Pre-renal Azotemia; | | |
| | |Ischemic Colitis | | |
| | |Liver Necrosis, Muscle | | |
| | |Wasting; Lung Edema | | |
|Ischemic Heart |Atherosclerosis; |Assymptomatic Diabetes| |Right Coronary Artery: Posterior |
|Diseaes |Arterial Spasm | | |LV AV Node |
| |Hypotension |Arrythmias, Mitral | |Left Anterior Descending: Anterior|
| |Aortic Valve |Insufficiency | |LV AV Node |
| |Disease: |Pericardial Tamponade, | |Left Circumflex: Lateral LV |
| |Syphilis, |Aneurysm, Thrombus | |Papillary Muscles |
|
|Polyarteritis, |Pericarditis | | |
| |Kawasaki | | | |
|Stable Angina |Exertion Relieved |Pain with exertion | |Reversible Ischemic Injury |
|Pectoris |by Rest | | | |
| |Stenosis | | | |
|Atypical Angina |Spasm |Pain at rest | | |
|Prinzmetals | |spontaneous reduction | | |
| | |in supply | | |
|Myocardial |Underperfusion | Troponin 1st, CK | |Subendocardial: |
|Infarction |Severe |later | |Transmural: Full thickness of |
|
|atherosclerotic | ST ,Q Waves, Loss of R| |wall, more common |
| |narrowing |Waves, Arrhthmias | |Troponin I T are gold standard |
| | |Leukocytosis, SR | |sensitivity elevated for days |
| | |PainSqueezing, | |LDH1LDH2 after 24 hours |
| | |Radiation, Diaphoresis, | | |
| | |NV | | |
|Rheumatic Heart |Genetic? |Arthritis, Rash, Nodules| |Pancarditis Bread Butter, |
|Disease |Group A Strep | Chorea | |Myocarditis, Endocarditis |
| | |B Cell Alloantigens | | |
| | |Verrucae on Vavles | | |
| |
|Mitral Stenosis | | |
| | |Aschofff Bodies no | | |
| | |organisms | | |
|Mitral Stensosis |Rheumatic Fever |Diastolic Murmur with | | |
| |Disease |opening snap | | |
| |Young Females |Fishmouth appearance | | |
| | |Atrial Fibrillation | | |
|Mitral Prolapse |Marfans Syndrome |Late Systolic Murmur | |Can cause CHF, Arrhythmias, Sudden|
| |Post MI LV Dilation |with Midsystolic click | |death endocarditis |
Cardiac Pathology contd 2
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other
|
|Bacterial |Diseased Valves |Fever, Splinter | |Staph, Pneumonia Gonococcus are |
|Endocarditis |Congenital Defects |Hemorrhages, Oslers | |especially destructive |
| |IV Drug Use |Nodes | |Biggest problem is septic emboli |
| | |Heart Failure, | | |
| | |Hemiplegia, Changing | | |
| | |Murmur | | |
| | |Anemia, Hematuria, | | |
| | |Culture | | |
|Valve Replacement|Fen-Phen | | |Porcine: 5-10 year durability |
| | | | |Mechanical: Requires
|
| | | | |anti-coagulation; concern for |
| | | | |hemolysis |
|Cardiac Myxoma | | | |Usually benign |
| | | | |Polypoid, pedunculated, extends |
| | | | |into chamber |
|Hypertension |Renovascular, |Normal 120/80; Pre | |Essential Hypertension is the |
| |Chronic Renal |130/90; Stage I | |majority and has no known cause |
| |Disease, |160/100 | |Estrogens are the most common |
| |Hyperaldosteronism, |Subintimal fibrosis | |reversible cause OCT |
| |Cushings |hyalinization | |
|
| |Pheochromocytoma, | | | |
| |Coarctation | | | |
| |Estrogens, Alcohol, | | | |
| |Amphetamines | | | |
|Dilated |Primary: Idiopathic |Dilation of all 4 | | |
|Cardiomyopathy |Secondary: Alcohol, |chambers | | |
| |DMD |DOE/Rest, Weakness, | | |
| |Viral Coxsackie |HSmegaly | | |
| |B3, |Risk of | | |
| |Genetic?, Drugs |thromboemboli/infarction| |
|
| |Adriamycin, | | | |
| | |Death within 5 years | | |
| | |without transplant | | |
|Restrictive |Primary: Idiopathic |Dilated Atria | |Decreased compliance like |
|Cardiomyopathy |Secondary: |Low Voltage on ECG | |constrictive pericarditis |
| |Amyloidosis, | | | |
| |Hemochromatosis | | | |
| |Thalessemia | | | |
| |Sarcoidosis, Glyc | | | |
| |Storage Disease | | |
|
|Hypertrophic |Primary: Idiopathic |Young People | |Decreased LV Volume/Mitral Valve |
|Cardiomyopathy |Secondary: Genetic |Profound IVS/LV | |Insufficiency/Obstruction |
|IHSS |B Myosin, |Hypertrophy | |Sub-aortic Stenosis |
| |Tropomyosin, |Systolic Murmur | |Prone to arrythmias CHF |
| |Troponin |Q Waves | |Better prognosis than dilated |
| |Myosin Binding | | |cardiomyopathy |
| |Protein C: older | | | |
| |pts | | | |
Pulmonary Pathology
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Atelectasis |Post-op most |SOB, Cough, Cyanosis, |
|1Obstructive: O2 distal to |
| |common |Chest Pain | |obstruction is resorbed |
| |Tumor, Foreign Body,|Prone to infection | |2Compressive: Pressure from |
| |Mucus |Reversible | |outside pleura |
| |Fluid, Air, Loss of | | |3Patchy: Loss of surfactant |
| |Surfactant ARDS | | |4Contraction: Fibrotic change |
| |Fibrotic Change | | |prevents expansion |
|Pulmonary Edema |1 Hemodynamic most|Cyanosis, SOB, Cough, | |Transudate in alveoli, |
| |common |Pallor | |Interstitium Perivascular Space |
| |2 Microvascular |Crackles in bases | |1Hemodynamic: LV Failure, Mitral |
| |Injury |Positive CXR |
|Stenosis, Volume, v Protein |
| |3 Undetermined |Frothy Transudate, | |2 Microvascular: Infection, |
| | |Hemosiderin Macrophages | |Inhaled Gas, Aspiration, Drugs, |
| | | | |Shock |
| | | | |3 Undetermined: High Altitude, |
| | | | |Neurogenic |
|Adult Respiratory|Infection |Acute Dyspnea, Hypoxemia|Hyaline |Acute Phase: Exudative with |
| |Injury |not responsive to O2 |Injury |Diffuse Alveolar Damage, |
|Distress Syndrome| |Decreased lung |Exudate |Hyaline membranes Type II |
| | |compliance, VQ Mismatch | |Pneumocyte Proliferation |
|ARDS or Hyaline | |Bilateral Infiltrates on|
|Organizing Phase: Fibroblast |
|Membrane | |CXR | |Proliferation Scarring |
| | |Death in 60 | | |
|Pulmonary Embolus|Embolus Inadequate|SOB, Tachypnea, Chest |Lines of Zahn |Thromboembolus usually from DVT |
| |Circulation |Pain, Cough, Hemoptysis | |At risk: Immobilized, |
| |Thromboembolism |Saddle Embolus Instant| |Hypercoaguable, Burn, Indwelling |
| |most common |Death | |Catheter |
| | | | |Dx: D-DImer, Doppler US, VQ Scan, |
| | | | |Spiral CT, Arteriography |
| | | | |Microscopic Lines of Zahn or wedge|
| | | |
|infarct at autopsy |
|Pulmonary |Unknown |Assymptomatic until |Cor Pulmonale |Primary: Unknown Cause |
|Hypertension |COPD, Heart Disease,|advanced |Plexiform |Secondary: COPD, Heart Disease, |
| |Recurrent PEs, Drugs|Dyspnea Fatigue, Chest| |Recurrent PEs, Drugs Fen-Phen |
| | |Pain, Cyanosis, RVH | |Dx: Catheterization standard, |
| | |Plexogenic Vascular | |Echo screen, Biopsy |
| | |Proliferation on biopsy | |Plexiform Phase is irreversible |
| | |Death within 2 years in | | |
| | |80 Cor Pulmonale | | |
|Centriacinar |Smoking |Airspace enlargement |Smoking |Most Common |
|Emphysema | |without fibrosis | |Involves
Respiratory Bronchiole |
|COPD | |Involves upper lobes | |Alvelolar spared |
| | |Barrel Chested, SOB, | |Smoke: Stimulates M?s PMNs |
| | |lean forward | |inhibits ?-1-antitripsin |
| | |Slowed Forced Expiration| |Death from acidosis or ruptured |
| | | | |bleb Pneumothorax |
|Panacinar |Alpha-1-antitrypsin |Airspace enlargement |Alpha-1-antitrypsi|Both Respiratory Alveolar |
|Emphysema |Deficiency |without fibrosis |n |Death from acidosis or ruptured |
|COPD | |Voluminous Lungs overlap| |bleb Pneumothorax |
| | |Heart | | |
| | |Barrel Chested, SOB, | |
|
| | |lean forward | | |
| | |Slowed Forced Expiration| | |
|Distal Acinar |Spontaneous |Airspace enlargement |Young adults |Young adults |
|Emphysema |Pneumothorax |without fibrosis | |Distal Acini Only |
|COPD | |Barrel Chested, SOB, | |Death from acidosis or ruptured |
| | |lean forward | |bleb Pneumothorax |
| | |Slowed Forced Expiration| | |
|Irregular |Previous Scarring |Airspace enlargement | |Any part of the acinus |
|Emphysema | |without fibrosis | |Death from acidosis or ruptured |
|COPD | |Barrel Chested, SOB, | |bleb Pneumothorax
|
| | |lean forward | | |
| | |Slowed Forced Expiration| | |
|Chronic |Smoking |Cough, Hypercapnea DOE| |Persistant cough w/ sputum for 3 |
|Bronchitis |Pollution |later | |mos in 2 years |
|COPD |Infectious Agents |Hypertrophy of Bronchi | |Problematic when Respiratory |
| | |Submucosal Glands | |Bronchi get mucous plugs |
| | |Goblet Cell Hyperplasia | |O2 drives breathing; Usually die |
| | |of smaller airways | |from respiratory failure |
| | | | |If chronic, can cause Cor Pulomale|
|Extrinsic Asthma |Environmental |SOB, Wheezing Cough |Charcot-Leyden |Chronic Inflammatory; Episoidic, |
|COPD
|Allergens |Thickening of Basement |Crystals |Reversible Bronchoconstriction |
| |Workplace Chemicals |Membrane | |Gross plugging of airways with |
| |Colonizing Fungi | Eosinophils, Mucous | |mucous |
| | |Gland Size | |Breakdown products of eosinophils |
| | |Bronchial Smooth Muscle | | Charcot-Leyden Crystals |
| | |THickening | | |
|Intrinsic Asthma |Cold; Exercise |SOB, Wheezing Cough |Charcot-Leyden |Chronic Inflammatory; Episoidic, |
|COPD |Stress |Thickening of Basement |Crystals |Reversible Bronchoconstriction |
| |Viral Infections |Membrane | |Gross plugging of airways with |
| |Aspirin | Eosinophils, Mucous | |mucous |
|
| |Gland Size | |Breakdown products of eosinophils |
| | |Bronchial Smooth Muscle | | Charcot-Leyden Crystals |
| | |THickening | | |
Pulmonary Pathology contd
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Atopic Asthma |Initial Subsequent|Mast Cell |Most Common Type |Most common type |
|An Extrinsic |Exposures |Activation/Eosinophil |Charcot-Leyden |Chronic Inflammatory; Episoidic, |
|Type | |Recruitment |Crystals |Reversible Bronchoconstriction |
|COPD | |Edema, Mucous | |Gross plugging of airways with |
| | |Bronchoconstriction | |mucous |
| | | |
|Breakdown products of eosinophils |
| | | | | Charcot-Leyden Crystals |
|Nonatopic Asthma |Viral Infection |SOB, Wheezing Cough |Charcot-Leyden |Viral Trigger lowers threshold to |
|An Intrinsic | |Thickening of Basement |Crystals |air pollutants Gross plugging of |
|Type | |Membrane | |airways with mucous |
|COPD | | Eosinophils, Mucous | |Breakdown products of eosinophils |
| | |Gland Size | | Charcot-Leyden Crystals |
| | |Bronchial Smooth Muscle | | |
| | |THickening | | |
|Drug Induced |Aspirin |SOB, Wheezing Cough |Charcot-Leyden |Aspirin blocks COX which causes an|
|An Intrinsic | |Thickening of Basement |Crystals |increase
in leukotrienes Gross |
|Type | |Membrane | |plugging of airways with mucous |
|COPD | | Eosinophils, Mucous | |Breakdown products of eosinophils |
| | |Gland Size | | Charcot-Leyden Crystals |
| | |Bronchial Smooth Muscle | | |
| | |THickening | | |
|Occupational |Varies |SOB, Wheezing Cough |Charcot-Leyden |IgE mediated |
|Asthma | |Thickening of Basement |Crystals |Gross plugging of airways with |
|COPD | |Membrane | |mucous |
| | | Eosinophils, Mucous | |Breakdown products of eosinophils |
| | |Gland Size | | Charcot-Leyden
Crystals |
| | |Bronchial Smooth Muscle | | |
| | |THickening | | |
|Bronchiectasis |Obstruction |Cough, Fever, Copious | |Necrotizing Infection of Bronchi |
|COPD |Tumor, Mucous Plug, |Foul Sputum | |Bronchioles |
| |Foreign Body |Worse in the morning | |Usually located in lower airways |
| |Cystic Fibrosis, |Atelectasis of distal | |Bronchi can be followed out to |
| |Congenital |lung; Patent bronchi | |pleura - Drastically dilated |
| |Kartageners |Peribronchiolar Fibrosis| |bronchi |
| |Syndrome, Pneumonia | | | |
|Lung Abscess |Aspiration of |Cough, Fever, Copious | |If from aspiration:
in right lower|
| |infected material |Foul Sputum | |lobe |
| |Pneumonia |Confirmed by CXR | |If from sepsis: scattered |
| |Septic Embolism | | |throughout |
| |Cancer | | |Must rule out cancer |
|Primary Pulmonary|TB |Assymptomatic | |Ghon Complex: Parenchymal |
|Tuberculosis | |Caseating Granuloma | |subpleural lesion at interlobar |
| | | | |fissure |
| | | | |If resolved, lesion becomes |
| | | | |calcified/fibrotic |
| | | | |May spread in
children or |
| | | | |immunodeficient |
|Secondary |TB |Fever Night Sweats | |Reactivation of old subclinical |
|Reactivation | |Caseating Granulomas | |infection only 5-10 of cases |
|Pulmonary TB | | | |Lesion at apex of lungs |
| | | | |May involve regional lymph nodes |
| | | | |Fibrocalcific scar |
|Progressive |TB |Caseating Granulomas | |Cavitary: Caseous Focus erodes |
|Pulmonary TB | | | |into bronchiole |
| | | | |Miliary: Spread by |
| | | | |lymphohematogenous
dissemination |
| | | | |Small lesions without central |
| | | | |necrosis |
| | | | |Bronchopneumonia: Rapid spread, |
| | | | |tubercles may not form |
|Wegeners |Immunologic? CMI |Necrotizing granulomas | |Good response to |
|Granulomatosis | |of airways | |immunosuppression; untreated 80 |
| | |Vasculitis of | |die within 1 yr |
| | |small-medium vessels | | |
| | |Renal Disease | | |
| | |crescentic | |
|
| | |C-ANCA | | |
|Sarcoidosis |Infection? |Dyspnea, Cough, Chest |Mikulicz Syndrome |Diagnosis of exclusion; |
| | |Pain, Hemoptysis |Women |Non-caseating granulomas |
| | |Bilateral hilar |Non-caseating |Mikulicz Syndrome - salivary gland|
| | |lymphadenopathy |Granuloma | eye involvement |
| | |Lung Spleen most often|Schaumann |Schaumann Bodies: Concretions of |
| | |involved |Asteroid Bodies |calcium protein |
| | |Skin involvement in half| |Asteroid Bodies: Stellate |
| | | | |inclusions in giant cells |
|Anthracosis |Coal Mining |Assymptomatic | |
|
|Coal Workers |Soot |Innocuous Lesion | | |
|Pneumoconiosis |Smoke |Carbon Pigment Ingested | | |
| | |by Macrophages | | |
Pulmonary Pathology contd 2
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Simple CWP |Coal Mining |Coal Macules Nodules | |Coal Macules: 1-2 mm lesions of |
|Coal Workers | |More commonly in upper | |carbon laden M?s |
|Pneumoconiosis | |lobes | |Coal Nodules: Slightly larger |
| | |No dysfunciton | |lesions with collagen fibers |
| | | | |Small percentage may progress to |
| | | |
|complicated type |
|Complicated CWP |Simple CWP | Pulmonary Hypertension |Caplans Syndrome |No association with cancer |
|Coal Workers | | Cor Pulmonale | |Caplans Syndrome: Rheumatoid |
|Pneumoconiosis | |Larger Lesions 2-10 cm| |Arthritis Pneumoconiosis |
|Progressive | | | |Central necrosis with surrounding |
|Massive Fibrosis| |Multiple black scars | |fibroblasts, M?s collagen |
| | |Dense collagen | | |
| | |pigment; necrotic center| | |
|Silicosis |Inhaled crystalline |Slowly progressive |Birefringent |No association with cancer |
| |silica |nodular fibrosis |particles |Most prevalent occupational lung |
| |Inhaled amorphous |Dine nodularity of upper|
|disease |
| |siulica rarely |lobes on CXR | |Later lesions: hard Collagenous |
| | |Birefringent particles | |scars w/ central cavitation |
| | |with polarized light | |Hilar Node calcification |
| | | | |fibrosis |
|Berylliosis |Inhaled Beryllium |Sarcoid like granulomas |Cancer |Increased incidence of lung cancer|
| |More commonly |SOB, Cough, Weight loss,|Non-caseating | |
| |chronic |Arthralgia |granulomas |Noncaseating granulomas in lungs |
| | |Variable course | |and hilar nodes |
|Asbestosis |Asbestos |SOB Cough |Asbestos Bodies |Asbestos Bodies: Golden-Brown Dumb|
| |Serpentine Fiber: |Diffuse pulmonary |Honeycomb Change |bells
iron coated fibers |
| |more common |interstitial fibrosis | |Fibrosis starts aroundrespiratory |
| |Amphibole Fiber: |Airspace | |bronchioles extends to alveoli |
| |more pathogenic |Enlargement/Honeycomb | |Starts in lower lobes, progresses |
| | |Change | |upwards |
|Pleural Plaques |Asbestos |Well circumscribed | |Anterior Posterolateral portions|
| |Serpentine Fiber: |plaques of dense | |of parietal pleura daphragm |
| |more common |collagen | | |
| |Amphibole Fiber: |May be calcified | | |
| |more pathogenic |No Asbestos Bodies | | |
|Idiopathic |Idiopathic |Dyspnea, Cough |Honeycomb Change |Diagnosis
of exlusion |
|Pulmonary | |Hypoxemia | |Median Survival Less than 5 years |
|Fibrosis IPF | |Honeycomb Change | | |
|Usual | |Organizing Fibrosis | | |
|Interstitial | | | | |
|Pneumonia UIP | | | | |
|Cryptogenic | | | | |
|Fibrosinf | | | | |
|Alveolitis | | | | |
|Desquamative |Smoking |Slowly developing cough |Ground Glass |Intra-alveolar Macrophage |
|Interstitial |Only seen in | dyspnea |Intra-alveolar |Accumulation
|
|Pneumonia DIP |smokers |Ground Glass Infiltrates|Macrophages |No real desquamationof epithelial |
| | |on CXR | |cells |
| | | | |Diffuse Accumulation of M?s with |
| | | | |brown pigment; PAS |
| | | | |Good Prognosis |
|Bronchiolitis |Idiopathic |Cough, SOB | |Polypoid plugs of loose fibrous |
|Obliterans | |History of Recent | |connective tissue within alveoli |
|Organizing | |Illness one month | |Mild interstitial inflammation |
|Pneumonia | |prior | |Improves with steroids |
|Idiopathic BOOP| |Patchy Infiltrates on | |
|
| | |CXR | | |
|Cryptogenic | | | | |
|Organizing | | | | |
|Pneumonia | | | | |
|BOOP |Rheumatoid Arthritis|Cough, SOB | |Polypoid plugs of loose fibrous |
| | |Patchy Infiltrates on | |connective tissue within alveoli |
| |Ongoing Infection; |CXR | |Mild interstitial inflammation |
| |GVHD | | |Improves with steroids |
| |Inhaled Toxins | | | |
| |Drugs | | |
|
|Hypersensitivity |Inhaled Organic |Acute Attacks fever, |Acute Attack |Ex: Farmers Lung, Pigeon |
|Pneumonitis |Dusts |dyspnea, cough |Small poorly |Breeders Lung, Air Conditioner |
| |Abnormal Sensitivity|Diffuse nodular |formed granulomas |Lung |
| |to Antigens |infiltrates on CXR | |Interstitial pneumonitis |
| | |Small poorly formed | |Lymphs, few plasma eosinophils |
| | |granulomas | |M?s |
|Goodpastures |Idiopathic |Hemoptysis |Young Men |Necrotizing Interstitial |
|Syndrome |Virus? |Consolidation on CXR |IgG C3 BM |Pneumonitis / Crescentic |
| |Dry Cleaner Solvent?|Anti-basement membrane |deposits |Glomerulonephritis |
| | |antibodies |Hemosiderin Laden |Most common in young esp men |
|
|Smoking? |Hemosiderin lagen |M?s |Rx: Plasma Exchange |
| | |macrophages | |Immunosuppression |
| | | | |Focal necrosis of alveolar walls |
| | | | |with intra-alveolar hemorrhage |
Pulmonary Pathology contd 3
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Idiopathic |Idiopathic |Cough, Hemoptysis, | |No antiBM antibody, No renal |
|Pulmonary | |Anemia Weight Loss | |involvement |
|Hemosiderosis | |Diffuse Infiltrates on | |Children Young Adults |
| | |CXR | | |
|Pulmonary |Elevated IL-5? |If Chronic:
|Eosinophils within|Similar to DIP |
|Eosinophilia |parasites |Fever, Night Sweats |alveoli |Simple Loffler Syndrome: |
| | |Dyspnea | |Transient Benign |
| | | | |Tropical: Microfilariae infection |
| | | | |Secondary: Parasite, Fungal |
| | | | |Bacterial Infections; Drugs |
|Pulmonary |Dysfunction of |Cough, Sputum, Fever, |Protein within |No chronic fibrosis |
|Alveolar |alveolar |Dyspnea |alveoli |Intra-alveolar accumulation of PAS|
|Proteinosis |macrophages? | | | lipid material |
| |Immunosuppression? | | |Rx: Whole lung lavage |
| |Malignancy? | |
| |
|Therapy Induced |Drugs |Drugs: Edema, | | |
|Lung Disease |Radiation |Pneumonitis Fibrosis | | |
| | |Acute XRT: fever, | | |
| | |dyspnea, diffuse | | |
| | |infiltrates | | |
| | |Chronic XRT: | | |
| | |Interstitial fibrosis | | |
| | |atypia | | |
|Squamous Cell |Smoking |Cough, Weight Loss, |Central/Bronchi |More Common in Men; Local spread |
|Carcinoma | |Pain, Dyspnea, |Location
|with late mets |
| | |Hemoptysis |Keratin Pearls |Rx: Surgery, Chemo, Radiation |
| | |Central Location Major | | |
| | |Bronchus | | |
| | |PTH-like Paraneoplasm | | |
| | |Ca2 | | |
| | |Keratin Pearls; Tadpole| | |
| | |Cells | | |
|Adenocarcinoma |Radiation, Asbestos,|Cough, Weight Loss, |Not smoking |More Common in non-smokers women|
| |Uranium, Nickel, |Pain, Dyspnea, |Women | |
| |Chromates, Coal |Hemoptysis |Peripheral
|Smaller lesions |
| |Mustard Gas, |Peripheral Location | |May be associated with pleura |
| |Arsenic, Beryllium, |Mucin Production | |Rx: Surgery, Chemo, Radiation |
| |Iron |Cells try to stick | | |
| |Genetics, Scarring |together | | |
|Bronchioalveolar |Radiation, Asbestos,|Cough, Weight Loss, |Peripheral |A type of adenocarcinoma |
|Carcinoma |Uranium, Nickel, |Pain, Dyspnea, |Confluent |Lines alveolar septa |
| |Chromates, Coal |Hemoptysis | |May be solitary, diffuse or have a|
| |Mustard Gas, |Peripheral Location | |pneumonia-like confluence |
| |Arsenic, Beryllium, |Usually well | |Rx: Surgery, Chemo, Radiation |
| |Iron |differentiated tall |
| |
| |Genetics, Scarring |columnar cells | | |
|Small Cell |Smoking, Radiation, |Cough, Weight Loss, |Central/Hilar |Neuriendocrine Differentiated |
|Carcinoma |Asbestos, Uranium, |Pain, Dyspnea, |Aggressive |Most Aggressive Type - Metastatic |
|Oat Cell |Nickel, Chromates, |Hemoptysis |Crush Artifact |at Diagnosis |
| |Coal |Central/Hilar Location | |Rx: Surgery not an option |
| |Mustard Gas, |Small Cells little | | |
| |Arsenic, Beryllium, |cytoplasm - Crush | | |
| |Iron |Artifact | | |
| |Genetics, Scarring | | | |
|Large Cell |Smoking |Polygonal Shaped with |
|Undifferentiated Tumor |
|Carcinoma | |moderate cytoplasm | |Features of adenocarcinoma at EM |
| | |Giant, Clear or Spindle | |level |
| | |Cells | |Rx: Surgery, Chemo, Radiation |
|Bronchial |Radiation, Asbestos,|Cough, Hemoptysis, |Not smoking |Rare |
|Carcinoid |Uranium, Nickel, |Pneumonia, |Younger Patients |Neuroendocrine Differentiation |
| |Chromates, Coal |Bronchiectasis |Bleed |More common in younger patients |
| |Mustard Gas, |Emphysema, Atelectasis | |40 |
| |Arsenic, Beryllium, |Small nests cords | |Good prognosis, rarely metastasize|
| |Iron |separated by thin bands | | |
| |Genetics, Scarring |Bleed if biopsied | |
|
|Hamartoma | |Solitary, Round, 4 cm | |Overgrowth of normal tissue |
| | |Predominantly Cartilage | | |
|Malignant |Asbestos |Chest Pain, Dyspnea | |Long Latent/Development Period |
|Mesothelioma |Serpentine Fiber: |Pleural Effusion | |Diffuse lesion of pleural space, |
| |more common | | |but may invade |
| |Amphibole Fiber: | | |50 12 month survival |
| |more pathogenic | | |Epithelial, Sarcomatoid or Mixed |
| | | | |Type |
Pulmonary Pathology contd 4
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Serofibrinous |
|suppurative | |Exudate |
|Pleuritis | | | |Inflammatory condition involving |
| | | | |lung with extension to pleura |
|Empyema | |Pus | |Infection seeds into pleural space|
| | |Suppurative Infection in| | |
| | |adjacent Lung | | |
|Hemorrhagic |Rickettsial Disease |Bloody Inflammtory | | |
|Pleuritis | |Exudate | | |
|Lobar Pneumonia |Strep pneumoniae |Consolidation of one |Strep |Congestion: Red Boggy Lung |
| | |lobe | |Red Hepatization: Alveoli filled |
| |
| | |with RBCs PMNs |
| | | | |Grey Hepatization: RBCs are lysed |
| | | | |so no red color, PMNs present |
| | | | |Resolution: Alveolar exudate |
| | | | |broken down |
|Bronchopneumonia |Staph |Multilobal Patchy | |Common terminal event in |
| |Strep |Consolidation | |chronically ill patients |
| |Haemophilus |Frequently Bilateral | |PMN rich exudate fills bronchi |
| |Pneumococcus |Scattered 3-4 cm | | |
| | |grey-red areas | | |
|Interstitial |Mycoplasma
|Alveolar Space contains |Mycoplasma | |
|Pneumonitis |Pneumoniae common |Proteinaceous fluid | | |
| |Influenza, RSV, |No consolidation | | |
| |Adenovirus, |Mononuclear cell | | |
| |Chlamydia, Coxiella |infiltrate - no PMNs | | |
| |Q Fever |Not dull to percussion | | |
|Typical Pneumonia|Pneumococci |Sudden onset of fever | | |
| | |chills | | |
|Community | |Consolidation CXR | | |
|Acquired | |Intraalveolar exudate - | | |
|Pneumonia |
|productive cough | | |
|Atypical |Mycoplasma |Slow onset of fever | | |
|Pneumonia | |chills | | |
|Community | |Scattered Rales - No | | |
|Acquired | |Consolidation | | |
|Pneumonia | |Dry Cough Interstitium| | |
|Pneumococcal |Strep pneumonia |A Typical Pneumonia | |Aspirated from pneumopharynx - |
|Pneumonia |1,2,3 7 | | |stimulates a brisk PMN response |
|Community |Especially Type 3 | | |Encapsulation allows evasion |
|Acquired | | | |Classic pneumonia with 4 stages of|
| | |
| |congestion |
|Haemophilus |H influenza Type |Laryngotracheobronchitis|Laryngotracheobron|Transmitted via respiratory |
|Influenza |B |fatal |chitis |droplets - aspirated from |
|Pneumonia | |Patchy consolidation to |Epiglottitis |oropharynx |
|Community | |lobar | |Encapsulation allows evasion |
|Acquired | |Intraalveolar PMNs | |Most often seen in young children |
| | |Epiglottitis or | |- a pediatric emergency |
| | |Meningitis | | |
|Mycoplasma | |Mild URI to fatal lower | |Transmitted via respiratory |
|Pneumonia | |respiratory infection | |droplets |
|Community | |Congested lungs
without | |May progress to ARDS with hyaline |
|Acquired | |consolidation | |membranes |
| | |Fever, Headache, | |Most common in young adults |
| | |Myalgia, Mild dry cough | |An Interstitial Pneumonitits |
| | |Cold Agglutinins | | |
|Chlamydial |Chlamydia pneumoniae|Patchy bilateral to | |Aerosol Transmission? |
|Pneumonia | |focal consolidation | |Produces a patchy atypical |
|Community | |Interstitial collections| |pneumonia |
|Acquired | |of lymphocytes | | |
| | |Pharyngitis progresses | | |
| | |to pneumonia
| | |
| | |Fever, cough crackles | | |
Pulmonary Pathology contd 5
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Viral Pneumonia |Influenza A B |Patchy or diffuse | |Transmitted via respiratory |
|Community |winter |congestion | |droplets |
|Acquired |RSV winter in |No consolidation | |Influenza damages ciliary elevator|
| |children |Dry Cough | |- prone to superinfection fatal |
| |Adenovirus all | | | |
| |year | | | |
| |Rubeola Varicella | | | |
|Legionaires
|Legionella |Patchy consolidation - | |Transmitted via respiratory |
|Disease | |involves entire lobes | |droplets |
|Community | |Intraalveolar infiltrate| |Pontiac Fever mild case no |
|Acquired | | | |pneumonia |
| | |Higher mononuclear/PMN | | |
| | |ratio | | |
| | |Focal areas of necrosis | | |
| | |with silver stain | | |
|Anaerobic |Bacteroides Strep|Bronchopneumonia to |Alcoholics |Frequently combined with oral |
|Pneumonia |viridans |lobar pattern rare |Abscesses |aerobes S viridans |
|Community
|Fusobacteria |Abscesses | |Seen in patients with periodontal |
|Acquired |Actinomycetes |Lots of PMNs | |disease prone to aspiration |
|Pseudomonas |Pseudomonas |Bronchopneumonia to |Fleur-de-Lis |Very Common |
|Pneumonia |aeruginosa |lobar pattern | |Aspirated from oropharynx |
|Hospital-Acquire| |Necrotizing Fleur-de-Lis| |Produces elastase phospholipase |
|d | | | | |
| | |PMN rich exudate filling| | |
| | |bronchi alveoli | | |
|Enteric Pneumonia|Klebsiella |Bronchopneumonia to |Low Body Temp |Aspirated from oropharynx |
| |Serratia |lobar pattern like | |Klebsiella has an antiphagocytic
|
|Hospital-Acquire|Enterobacter |strep | |capsule |
|d | |Ocassional abscesses | | |
| | |High or Low Body Temp | | |
| | |with productive cough | | |
|Staphylococcal |Staph aureus |Focal Abscesses |Abscesses |Aspirated from oropharynx or from |
|Pneumonia |Drug Use, IV, |Bronchopneumonia to | |bacteremia |
|Hospital-Acquire|Wounds, Endocarditis|lobar pattern | | |
|d | |PMN rich exudate | | |
| | |Insidious: Fever, | | |
| | |Tachycardia, Resp Rate| |
|
|Pneumocystis |Pneumocystis |Patchy or diffuse | |Often a coexistant infection is |
|Pneumonia |cariniii |Beefy Red Airless Lungs | |seen CMV |
|Immunocompromise|AIDS |Foamy Alveolar Space | |Most common cause of death in HIV |
|d Pneumonia |Children with |filled with debris | |patients |
| |protein malnutrition|bugs | | |
| | |Hyaline Membranes | | |
| | |Interstitial Infiltrate | | |
|CMV Pneumonia |CMV |Patchy or Diffuse | |Usually coexists with PCP in AIDS |
|Immunocompromise|Immunosuppressd |Infiltrate | |patients, but not BM Transplant |
|d Pneumonia |Neonates |Intranuclear Inclusions | | |
|
| |Minimal Interstitial | | |
| | |Inflammation | | |
| | |Hyaline Membranes | | |
| | |Proteinaceous Fluid | | |
|Histoplasmosis |Histoplasma |Granulomatous or Airless| |Inhalation of organism from |
|Pneumonia |capsulatum |If Compromised | |contaminated soil bird droppings|
|Immunocompromise| |Show up on silver stain | | |
|d Pneumonia | |Fever, Weight Loss, | |Attaches to integrin receptors on |
| | |Night Sweats | |macrophages |
Blood Pathology
|Disease |Cause/Risk Factors |Symptoms |Buzzwords
|Other |
|Anisocytosis |Sideroblastic Anemia|Variation in size | | |
| | |Increased RDW | | |
|Microcytosis |Iron Deficiency |Small Cells | | |
| |Anemia |Low MCV | | |
| |Thalassemia |Hypochromic | | |
|Macrocytosis |Folate B12 |Large Cells | | |
| |Deficiencies |High MCV | | |
| |Alcoholism | | | |
| |Hypothyroidism | | | |
| |Post Chemotherapy | | |
|
|Hypochromia |Iron Deficiency |Decreased hemoglobin | | |
| |Anemia |Increased zone of | | |
| |Thalassemia |central pallor | | |
| | |Usually microcytic | | |
|Hyperchromasia |Spehrocytosis |Increased Hemoglobin | | |
| | |Increased MCHC | | |
|Polychromasia |Henolysis |Blue Reticulocytes | | |
| |Blood Loss |Wrights Stain | | |
| | |Basophilic stippling in | | |
| | |reticulocytes | |
|
|Ovalocyte |Normal 10 of |Variation in shape | | |
|Poikilocytosis |blood |oval | | |
| |B12 Folate | | | |
| |Deficiency | | | |
|Elliptoocyte |Normal 10 of |Variation in shape | | |
|Poikilocytosis |blood |elliptical | | |
| |Heriditary | | | |
| |Elliptocytosis | | | |
| |Iron Deficiency, | | | |
| |Thalassemia | | |
|
| |Hemoglobinopathies | | | |
|Target Cells |Thalassemia | | |Liver Disease causes lipid |
| |Hemoglobinopathies | | |metabolism abnormalities |
| |Iron Deficiency | | | |
| |Obstructive Liver | | | |
| |Disease Splenectomy | | | |
|Spherocytes |Heriditary |Lack biconcave shape | |Defect in internal support |
| |Spherocytosis |central pallor | |proteins in hereditary condition |
| |Warm antibody immune|Increased MCHC | | |
| |hemolysis | | |
|
|Schistocytes |Fibrin Strand Damage|Cell fragments | |AKA Helmet Cells |
| | | | | |
| |Heart Valve | | | |
| |Replacements | | | |
| |Microangiopathic | | | |
| |Hemolytic Anemia | | | |
| |DIC, Burns | | | |
|Echinocytes |Hyperosomolarity |Irregular Margin | | |
| |Renal Failure |Bumpy surface | | |
Blood Pathology contd
|Disease |Cause/Risk Factors |Symptoms
|Buzzwords |Other |
|Acanthocytes |Liver Disease |Spicules with bulbous | | |
| |Abetalipoproteinemia|ends | | |
| | | | | |
| |Post-SPlenectomy | | | |
|Dacrocytes |Myeloproliferative |Teardrop shape | | |
|Teardrop cells |Disease | | | |
| |Megaloblastic Anemia| | | |
| | | | | |
| |Thalassemia | | | |
|Drepanocytes |Hemoglobin S |
| | |
|Sickle Cells |Decreased O2 or pH | | | |
|Howell-Jolly |Splenectomy |Remnants of nuclear | | |
|Bodies |Megaloblastic Anemia|chromatin | | |
| | |Single Marginal Clump | | |
| |Abnormal | | | |
| |Erythropoeisis | | | |
| |Hemolytic Anemia | | | |
|Heinz Bodies |G6PD Deficiency |Fragments of denatured | | |
| |Toxin Damage |hemoglobin | | |
| | |Single Marginal Clump
| | |
|Basophilic |Lead Poisoning | | | |
|Stippling |Thalassemia | | | |
|Pappenheimer |Excess Iron | | | |
|Bodies |Splenectomy | | | |
| |Sideroblastic | | | |
| |Anemias | | | |
|Normoblasts |Erythroblastosis |Normal in newborn | | |
| |Fatalis | | | |
| |Space Occupying | | | |
| |Marrow Lesions |
| | |
|Rouleaux |Multiple Myeloma |Increased Plasma Protein| | |
|Formation | | | | |
|Blackfan Diamond | |Pure Red Cell Aplasia | | |
|Syndrome | | | | |
|Bernard-Soulier |Genetic AD |Bleeding Tendency | |Deficiency of GP Ib Receptors |
|Syndrome | |Large platelets with | | |
| | |thrombocytopenia | | |
|Glanzmanns |Genetic AD |Absence of platelet | |Deficiency of GP IIb/IIIa |
|Thrombasthenia | |aggregation | |Receptors |
| | |Minimal Bruising to |
| |
| | |Severe Hemorrhage | | |
Blood Pathology contd 2
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Storage Pool |Genetic |Mild to moderate | |Deficiency of Dense Granules ADP |
|Deficiency | |bleeding diathesis | | Serotonin |
| | |Impaired aggregation | | |
|Hemophilia A |Favtor VIII |Intrinsic Pathway | |More Common Type |
|Classical |Deficiency |Deficiency - Abnormal | |APTT of 50-65 sec moderate |
|Hemophilia |X-Linked |APTT | |Rx: 1 unit of VIII 2 increase |
| |Mutation 30 |20 develop IgG4 | |for 11 hours minimal 30 |
| |
|antibodies | |Can also use Desmopressin, |
| | | | |E-Aminocaproic and Tranexamic Acid|
|Hemophilia B |Favtor IX Deficiency|Intrinsic Pathway | |Rx: 1 unit of IX 1 increase for|
|Christmas |X-Linked |Deficiency - Abnormal | |22 hours minimal 30 |
|Disease |Mutation 30 |APTT | | |
| | |20 develop IgG4 | | |
| | |antibodies | | |
|Type 1 Von |Genetic AD - low |Muco-cutaneous bleeding | | |
|Willebrand |penetrance |v VWF activity antigen| | |
|Disease | | | | |
| | |v Factor VIII
| | |
|Type 2a Von |Genetic AD |No HMW VWF | |Impaired polymerization |
|Willebrand | |Moderate v Factor VIII | |cytoplasmic retention or |
|Disease | |VWF Antigen | |degradation |
| | |Severe v VWF Activity | | |
| | |Bleeding from defect in | | |
| | |1 Hemostasis | | |
|Type 2b Von |Genetic AD |No HMW VWF | |Increased affinity of HMW VWF to |
|Willebrand | |Grossly abnormal PFA-100| |GP1b receptors clearance |
|Disease | |test | |Increased affinity of platelets |
| | |Moderate v VWF Activity
| |for ristocetin VEF:RCof |
| | | Antigen | | |
|Type 2M Von | |Normal VWF lefels | |Decreased platelet directed |
|Willebrand | |Normal level of Factor | |function of VWF |
|Disease | |VIII | | |
|Type 2N Von |Genetic AR |Mimics Mild Hemophilia A| |Decreased affinity of VWF for |
|Willebrand | | | |Factor VIII |
|Disease | |Facotr VIII levels of | |Inability of VWF to bind and |
| | |10 | |stabilize Factor VIII |
| | |Normal levels of VWF | | |
|Type 3 Von |Genetic AR |Abnormal PFA-100 |
|Absent VWF synthesis in |
|Willebrand | |Prolonged APTT due to v| |megakaryocytes endothelium |
|Disease | |VIII | | |
| | |Bleeding from mucous | | |
| | |membranes | | |
| | |Bleeding into muscles | | |
| | |joints | | |
|Factor XI |Ashkenazi Jews |Variable | |Prophylactic transfusions with |
|Deficiency | |Assymptomatic to | |antifibrinolytic therapy for |
| | |Transfusions Required | |surgery |
|Factor XIII | |Severe Bleeding Early in|
|Treat with plasma or cryo |
|Deficiency | |life | |t1/2 of Factor XIII is 8 days |
| | |Normal coagulation tests| |prevents bleeding at 1 notmal |
|Afibrinogenemia |Genetic AR |Intermittant Hemorrhage | |Rx: Cryo |
| | |PT, APTT, TCT all | | |
| | |prolonged | | |
Blood Pathology contd 3
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Dysfibrinogenemia|Genetic AD |Majority are | |Fibrinogen doesnt convert to |
| | |assymptomatic | |fibrin |
| | |Abnormally functioning | | |
| |
|fibrinogen | | |
| | |Coagulation tests | | |
| | |prolonged | | |
|Aquired |Autoimmune |Antibodies to Factor | |Rx: Immunosuppression |
|Hemophilia | |VIII | | |
| | |Similar to Hemophilia A | | |
|Aquired Type 3 |Autoimmune |Antibodies to VWF | |Rapid Clearance of VWF |
|VWD | | | |Rx: Desmopressin release of VEF |
| | | | |from stores |
|Venous Thrombosis|1 Stasis |May cause Edema | |Outcomes: Propagation, |
| |2 Endothelial
|congestion, | |Embolization, Dissolution, |
| |Damage |Infarction or | |Organization, Recanalization |
| |3 Hypercoaguable |Embolization | | |
| |State | | | |
|White Infarct | |Solid Tissue: Heart, | |Tissue is so dense that hemorrhage|
| | |Kidney, Spleen, etc | |is minimal |
| | |Wedge Shaped | |Result from arterial occlusion |
|Red Infarct | |Hemorrhagic | |Tissues where bleeding is profuse |
| | |Wedge Shaped | | |
|Septic Infarcts | |Abscess Formation | |Usually bacterial and embolic from|
| | |
| |valve vegetations |
|Disseminated |Obstetric |Microangiopathic |Ooozing |Activation of coagulation casecade|
|Intravascular |Complications most|Hemolytic Anemia | |with microthrombi |
|Coagulation DIC| |Low platelets | |Consumptive Coagulopathy |
| |Infection |coagulative factors PT| |Activation of fibrolytic pathway |
| |Neoplasia | PTT | | D DImers |
| |Massive Tissue |Infarction | | |
| |Injury |Petichiae, Ecchymoses | | |
| | |Oozing | | |
|Heriditary |Genetic AD |Thromboembolism Types | |Type 1: Absence of protein |
|Deficiency of AT |Pregnancy, Surgery, |1,2 Homozygous 3
| |synthesis |
| | |Juvenile onset with | |Type 2: Defect in enzyme binding |
| |Trauma, Infection |thrombosis in unusual | |domain |
| | |sites | |Type 3: Defect in heparin binding|
| | | | |domain |
| | | | |Rx: Oral Anticoagulants |
|Heriditary |Genetic AR |Neonatal Purpura | |Protein C is normally activated by|
|Deficiency of | |Fulminans | |Thrombomodulin/Thrombin |
|Protein C | |DIC | |APC normally cleaves VIIIa Va |
| | | | |Heterozygous patients at no |
| | |
| |increased risk |
| | | | |Rx: Recombinant Protein C |
|Heriditary |Genetic AD |Thrombosis |Carriers at risk |Two Types: 1 Free Bound Reduced|
|Deficiency of | | | |2 Free Reduced |
|Protein S | | | |Carriers at risk |
|Factor V Leiden |Genetic AD |Decreased Sensitivity of| |Replacement of Arginine by |
|Mutation | |Factor V to APC | |Glutamine |
| | |Thrombosis | | |
Blood Pathology contd 4
|Disease |Cause/Risk Factors |Symptoms |Buzzwords |Other |
|Prothrombin-Gene | |Increased level of | |Guanine to Adenine mutation in 3 |
|Mutation |
|prothrombin activity | |UTR of Prothrombin gene |
|Prothrombin | |Risk for venous | | |
|G20210A | |thromboembolism | | |
|Sickle Cell |Genetic AR |Anemia, |HbSS | |
|Disease |Homozygous |Hyperbilirubinemia, | | |
| |Hemoglobin S |Siderosis | | |
| | |Reticulocytosis, | | |
| | |HSmegaly, PE, Priapism | | |
| | |Fever, Pain | | |
| | |Spiky head XRay | | |
|Sickle Cell Trait|Genetic
AR |Benign |HbAS | |
| |Heterozygous |Hematuria | | |
| |Hemoglobin S |Crisis with extreme | | |
| | |hypoxia | | |
|Homozygous |Genetic AR |Mild Hemolytic Anemia |HbCC | |
|Hemoglobin C | |Abdominal Pain | | |
| | |Splenomegaly Jaundice | | |
|Heterozygous | |Benign Assymptomatic |HBAC | |
|Hemoglobin C | |Slight HbA2 HbF | | |
| | |elevations | | |
|Hemoglobin SC |
|Similar to Sickle Cell | | |
|Disease | |Disease less severe | | |
|Thalassemia Major| |Severe anemia in infancy| |Requires lifelong blood |
| | | | |transfusions |
| | |Splenic Enlargement, | | |
| | |Iron Overload, Early | | |
| | |Death | | |
| | |Anisocytosis, | | |
| | |Poikilocytosis, | | |
| | |Microcytosis, | | |
| |
|Hypochromia, Target | | |
| | |Cells | | |
| | |Polychromatophilia | | |
|Thalassemia | |Moderate anemia | | |
|Intermedia | |Thalassemic morphology | | |
|Thalassemia Minor| |No anemia or mild anemia| | |
| | | | | |
| | |Thalassemic morphology | | |
|Thalassemia | |Normal | | |
|Minima | |Detected only by family | | |
| |
|studies | | |
Source:waynesburg.edu
