Congenital Anomalies, ARDS, Infections MCQs

Causes of atypical pneumonia: Mycoplasma, Chlamydia pneumonia, Influenza, Adenovirus, RSV, Legionella, Coxiella burnetti and Pneumocytis carnii. Reference: Robbins Basic Pathology, 9 th ed, Pg-703-05

Primary tuberculosis is the form of disease that develops in a previously unexposed and therefore unsensitized patient. Ghon focus, ghon complex and ranke complex are features of primary tuberculosis. Secondary tuberculosis is the pattern of disease that arises in a previously sensitized host. It may appear shortly after primary tuberculosis, but more commonly arises from reactivation of dormant primary lesion. The upper parts of both lungs are riddled with gray-white areas of caseation and multiple areas of softening and cavitation. Reference: Robbins Basic Pathology, 10 th ed, Pg-528

Involved areas of the lung contain a characteristic intraalveolar foamy, pink-staining exudate with hematoxylin-eosin (H&E) stain ("cotton candy" exudate). The septa are thickened by edema and a minimal mononuclear infiltrate. Special stains are required to visualize the organism. Silver stain of tissue sections reveals round- to cup-shaped cysts (4 to 10 µm in diameter) within the alveolar exudates. Reference: Robbins Basic Pathology, 10 th ed, Pg-534

Secondary pulmonary tuberculosis is classically localized to the apex of one or both upper lobes. The reason is obscure but may relate to high oxygen tension in the apices. Reference: Robbins Basic Pathology, 10 th ed, Pg-529

Tb granuloma has characteristic feature of layering of lymphocytes outside. If no lymphocytes are present are on outside it is called naked granuloma seen in sarcoidosis. Reference: Robbins & Cotran Pathologic Basis of Diseases 10 th edition, chapter 3, pg 96

In the final stage of resolution, the exudate within the alveolar spaces is broken down by enzymatic digestion to produce granular, semifluid debris that is resorbed, ingested by macrophages, expectorated, or organized by fibroblasts growing into it. Reference: Robbins Basic Pathology, 10 th ed, Pg-522

In lobar pneumonia, four stages of the inflammatory response have classically been described. The stage of gray hepatization that follows is marked by progressive disintegration of red cells and the persistence of a fibrinosuppurative exudate, resulting in a colour change to grayish-brown. In the final stage of resolution, the exudate within the alveolar spaces is broken down by enzymatic digestion to produce granular, semifluid debris that is resorbed, ingested by macrophages, expectorated, or organized by fibroblasts growing into it. Reference: Robbins Basic Pathology,10 th ed. Pg-522

In lobar pneumonia, there are four inflammatory stages: Stage of congestion, Red hepatisation, Grey hepatisation stage of resolution. Reference: Robbins Basic Pathology, 10 th ed, Pg-522