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Where am I going ? Asking quality questions is the key!
CPC-4-Mr.T.P.58 Yr male, presents to GP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical examination ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathology of  Pneumonia Dr Richa Dua Lecturer- Pathology 030309
Introduction: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Normal Lung
Normal Lung
Host – Parasite Relationship ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification of Lung disorders: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*  Infections
Pathogenesis of Pulmonary Infections ,[object Object],[object Object]
Pneumonia Types: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Comm. Acq   –  Pneumonia  -  Nosocomial  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Common Pathogens ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Types of Pneumonias & Causative agents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiologic agents in Pneumonia:
Lobar Pneumonia: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathogenesis of Pneumonia Congestion Red Hepatisation Grey Hepatization Resolution
"In the presence of greatness, pettiness disappears.   In the absence of a great dream, pettiness prevails." Robert Fritz Composer, Filmmaker and Author
Lobar  Pneumonia:
Lobar  Pneumonia:  Grey Hepatization
Lobar  Pneumonia:
Lobar Pneumonia – Gray hep…
Lobar Pneumonia:
Lobar Pneumonia:
First step to make your dreams come true  is to…... wake up! —  Paul Valery
Congestion- to - Red hepatization. Exudate filling alveoli Few RBC and Inflammatory cells.
Lobar Pneumonia:  Red Hepatization:
Red – to - Grey hepatization:
Red    Grey hepatization. ,[object Object],[object Object]
Red    Grey hepatization.
Grey Hepatization
Lobar Pneumonia: Grey hepat.
Sputum Cytology: (gram positive diplococci) Streptococcus pneumoniae
Bronchopneumonia (patchy) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Broncho-pneumonia
Broncho-pneumonia
Broncho Pneumonia
Bronchopneumonia - CT
Bronchopneumonia
Bronchopneumonia:
Bronchopneumonia
Broncho  –  Pneumonia  - Lobar  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Big Jobs usually go to the men who prove their ability to outgrow small ones.”    –Ralph Waldo Emerson
Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Atypical / Mycoplasma Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Interstitial Pneumonia:
Interstitial Pneumonia: Lymphocyte Infiltrate in alveloar wall
Chronic Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tuberculosis: Typical + Miliary spread
Acid Fast Bacilli
Aspergilloma in Lung:
Aspergillus in sputum
Pathogenesis of Clinical features: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Non-infective pneumonias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Investigations for Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gram Positive Cocci in Sputum
Gram Negative Bacilli in sputum
Pneumocystis jirovecii  cysts from BAL stained with  Toluidin blue O stain
Agar? Morphology? diagnosis? Further tests?
Klebsiella colonies on MacConkey Agar
Complications of Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Abscess formation
Lung Abscess:
Lung Abscess:
Abscess formation following pneumonia:
Lung Abscess:
Lung Fungal Abscess: Candida
The only place where  success comes before work is in a dictionary … ! Vidal Sassoon
75y male, admitted with stroke. GCS 6, was intubated. Develops fever, tachycardia & Tachypnea after 3 days. X-Ray shows right lower zone haziness. BAL culture shows growth.  Most likely organism? ,[object Object],[object Object],[object Object],[object Object],[object Object]
34y, M, AIDS patient, Fever, Chest infection, not responding to usual antibiotics  ? Pathogen ,[object Object],[object Object],[object Object],[object Object],[object Object]
40y Male Fever, increasing SOB, Not responding to Ampicillin. Sputum culture negative, X-ray Chest normal.  What is the Next best option for diagnosis? ,[object Object],[object Object],[object Object],[object Object],[object Object]
40y Male Fever, increasing SOB, Not responding to Ampicillin. Sputum culture negative, X-ray Chest normal. Image shows Lung Biopsy.  Likely diagnosis? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Same patient...  Most likely Pathogen? ,[object Object],[object Object],[object Object],[object Object],[object Object]
54y, M, on Ventilator, ICU, Develops fever and Chest infiltrates  sputum Gram stain  ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
34y, M, H. Fever & Cough. Lung Bx  ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
29y M, High fever, cough, dyspnoea,  Chest Radiograph  ? Likely Etiologic Agent ,[object Object],[object Object],[object Object],[object Object],[object Object]
29y M, High fever, cough, dyspnoea,  Sputum gram stain  ? Possible type of pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object]
34y, M, High Fever – Lung specimen.  ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
74y, Ca prostate, Lung Specimen-  ? diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
74y, Ca prostate, Lung - lobar pneumonia. ? Which  Lobe ,[object Object],[object Object],[object Object],[object Object],[object Object]
39y, M chronic smoker, High fever, Lung  ? What type of pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object]
29y M, High fever, cough, dyspnoea,  Chest Radiograph ? Likely Etiologic Agent ,[object Object],[object Object],[object Object],[object Object],[object Object]
Problems in learning  Pathology ?  Need a personal coach … .? Help is available. Email me for an appointment [email_address] Take the challenge >  Pass with distinction  not less..!
Impressive….! Keep it up…..! 9/3/2006 From Clinical coordinator Mr. Isa centre. I have no concerns that this group of students are in any way resting on their laurels. So far the feedback from the medical staff has been excellent. There have been a number of preceptors who have noted the substantial difference between this years 4th yrs and last years 4th yrs. A number of their preceptors in the hospital, who are not easily impressed, have gone out of their way to tell me how impressed they have been with this group. …………
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Today is the First Day,  of  Rest of Your Life...!

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