RESPIRATORY PATHOLOGY

BLOK IV KBK FK-UMI

LUNG DISEASE

INFECTION NON INFECTION TUBERCULOSIS

LUNG DISEASE

INFECTION - BRONCHITIS - BRONCHIOLITIS - PNEUMONIA * BRONCHO PNEUMONIA * LOBAR PNEUMONIA SPECIAL PNEUMONIA

BRONCHITIS

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

BRONCHITIS

CHRONIC: - ACUTA CHRONICA - COUGH > 3 MONTH / 2 YRS ETIO : SMOKER, POLUTION, INF. STR. PNEMONIA, H. INFLUENZAE, RSV, ADENOVIRUS CLINIC : MAN HYPERCAPNIA, HYPOXCEMIA, CYANOSIS ( BLUE BLOATERS ) EMPHYSEMA

PNEUMONIA

ALVEOLAR INFLAMMATION HIGH PROTEIN EXUDATE PMN,LYMPHOCYTE & MACROPHAGE INFILTRATION LOBAR & BRONCHOPNEUMONIA

PNEUMONIA

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

PNEUMONIA

ETIO : OTHERS PNEUMOCYSTIS CARINII, MYCOPLASMA, ASPIRATION, LIPID & EOSINIPHYLIC HOST REACTION : - FIBROUS - SUPURATIVE ANATOMIC : - BRONCHOPNEUMONIA - PNEUMONIA LOBARIS

BRONCHOPNEUMONIA

CONSOLIDATION PLAQUE BRONCHIOLUS & BRONCHUS AROUND ALVEOLI INFANT & OLD & WEAKNESS PATIENT ( CA, CARDIAC FAILURE, CHRONIC KIDNEY FAILURE, TRAUMATIC CEREBROVASCULAR), ACUTE BRONCHITIS, CHRONIC OBSTR. RESP. TRACT,OR CYSTIC FIBROSIS & POST OP.

BRONCHOPNEUMONIA
-

LESION : - FOCAL (CENTRE OF RESPIRATORY TRACT) / PLAQUE - BILATERAL ( BASAL ) - AUSCULTATION CREPITATION ETIO :
-

Staphylococcus Streptococcus H. influenzae Coliform, Yeast

ACUTE INFLAMMATION + EXUDATE

HP :
-

LOBAR PNEUMONIA

ALL OF LOBUS INFANT & OLD PATIENT << AGE : 20 50 YRS MAN > WOMEN 90 % STREP. PNEUMONIA (PNEUMOCOCCUS) CLINIC COUGH RUSHTY SPUTUM FEBRIS (40OC), INSPIRATION PAIN, BRONCH ASPIRATION KLEBSIELLA 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 INFECTION

ASPIRATION - 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)

TUBERCULOSIS

ETIO : M. TUBERCULOSE LOC : - LUNG >> - ETC CLINIC : - VARIATION - DYSPNOE - LOSS BODY WEIGH - FEBRIS - DISTRESS - SWEATING - COUGH

TYPE : - PRIMAIR - SECUNDAIR - MILIER DX CLINICAL SIGN LAB : - SPUTUM - MANTOUX - BLOOD RADIOLOGY 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 < - ORGAN * MENINGES * KIDNEY * BRAIN * LIVER * OSTEO * LYMPHA - GRANULOMA M. TUBERCULOSA (+)

OBSTRUCTION LUNG DISEASE

LOCAL DIFUSE ( CHRONIC ) - CHRONIC BRONCHITIS - EMPHYSEMA - ASTHMA - BRONCHIECTASIS

LOCAL OBSTRUCTION LUNG DISEASE

MECHANIC FACTOR OBSTRUCTION (C. AL, TUMOR) COLLAPS / EXPANSIVE COMPLICATION ( LIPID, INF. PNEUMONIA) FINCTION TEST NORMAL

DIFUSE OBSTRUCTION LUNG DISEASE

CHRONIC BRONCHITIS EMPHYSEMA ASTHMA BRONCHIECTASE

CHRONIC BRONCHITIS

ETIO : - SMOKERS >>, - POLUTION STREP. PNEUMONIA H. INFLUENZAE & VIRAL SEVERE HYPERCAPNIA, HYPOXIA & CYANOSIS (BLUE BLOATERS)

EMPHYSEMA

ALVEOLUS DILATATION + ELASTICITY (<<) FORM : - CENTRILOBULAR EMPHYSEMA - PANLOBULAR EMPHYSEMA - PARASEPTAL EMPHYSEMA - IRREGULAR EMPHYSEMA

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

ASTHMA

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

ATOPIC ASTHMA

ENVIRONMENT MATERIAL HYPERSENSIVITY REACTION BRONCHUS CONSTRICTION TACHYPNOE, DYSPNOE STATUS ASTHMATICUS DEAD

NON ATOPIC ASTHMA

T. RESP. INFECTION CHRONIC BRONCHITIS ALLERGEN TEST (-) LOCAL IRRITATION BRONCHUS CONSTRICTION

ASPIRINE INDUCED ASTHMA

MECHANISM (?) +/- PROSTAGLANDINE DECREASE / LEUKORINE INCREASE RESP. TR. IRRITABLE RHINITIS, NASAL POLYPS, URTICARIA (+)

OCCUPATIONAL ASTHMA

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

ASPERGILLUS BRONCHITIS ALLERGY

SPORA ASPERGILLUS FUMIGATUS HYPERSENSITIVITAS REAC DYSPNOE MUCOUS GLOBULE ASPERGILLUS HYPAE (+)

BROCHIECTASIS

ETIO : - BRONCHUS OBSTRUCTION - INFECTION (SEVERE) - CONGENITAL (<<<) BRONCHUS & BRONCHIOLUS DILATATION COUGH (CHRONIC), DYSPNOE, SPUTUM (>>>) + BLOOD

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

PNEUMOCONIOSIS

DUST: INORGANIC / ORGANIC TISSUE REACTION : - MILD - FIBROUS - ALLERGIC - NEOPLASTIC

COAL WORKERS PNEUMOCONIOSIS SILICOSIS ASBESTOSIS HYPERSENSITIVITY

CARCINOMA OF THE LUNG

Squamous cell. Adenocarcinoma. Large Cell Undifferentiated Carcinoma. Small Cell Undifferentiated (Oat Cell) Carcinoma.

PLEURA

EFFUSION NEOPLASMS 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 .

CHYLOTHORAX

Chylothorax : 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 Neoplasm

Benign 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 Neoplasms

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