Surgical notes

Crushmann spiral in asthma

Bronchial asthma Feature Charcot laden crystals

Asthma c.f: _hyperplasia and hypertrophy of the SMs. _features of inflammation (odema ,neutrophils infiltarate and eosinophilic infiltrate in case of atopic asthma) _hyperplasia of mucus glands

Emphysema Features: Dilated alveoli And thin walls without fibrosis

Emphysema Features: _ centriacinar ( dilated respiratory bronchioles) _ panacinar (dilated alveolai)

Diffuse alveolar damage Features: _Remnants of alveoli are present _Epithelial cells death _wall converted to hyaline membrane _inflammation of the wall and haemorrhage _destruction of the alveolar

Diffuse alveolar damage: Features: _ death of epithelial cells _ wall converted to hyaline membrane _ inflammation of the wall and haemorrhage _destruction of the alveolar wall Lead to ARDS

Severe pulmonary odema Features: _ transudate in the alveolar lumen _ dilated capillaries in the alveolar wall _ thickened alveolar walls ( dilated capillaries and interstitial odema)

Pulmonary odema Features: Normal alveolar wall Accumulation of fluids in the alveolar space

Atelectasis ( adult aquired type ) Features : Resorption Compression Contraction

🌺 lung neoplasms: The most common cancer in the lung is metastasis ( secondary) The primary cancer is bronchogenic The most common neoplasm in the lung is the malignant Carcinomas include _ squamous cell carcinoma _ adenocarcinoma _ small cell carcinoma _ large cell carcinoma Also there are also benign tumors بهذا نكون كملنا الجانب النظري من كلام الدكتور وضاح حفظه الله #معمل_باثو #اللجنه_العلميه

❤️ respiratory system ❤️ بنركز على : ( lung diseases) We will begin with 🌺 congenital anomalies : 1_ forgut cyst جزء من نسيج الGIT طبيعي موجود داخل الرئة وعامل زي الcyst 2_ hypoplasia الرئة صغيره واحده أو الثنتين 3_ lung aplasia واحده من الرئتين مش موجوده 🌺 lung atelectasis ( collapse of lung) This may be congenital or aquired 1_Neonatal ( congenital) atelectasis collapse as a result of deceased surfuctant يعني واحده رئة أو جزء منها أو الرئتين ماراح تنتفخ أول مايولد الجنين 2_ adult (aquired)atelectasis Its causes are : _ complete obstruction _ compresion from outside _ fibrosis Then we have specific diseases of the lung : 🌺 inflammatory diseases(pneumonia) We can classify it to typical ( lobar) and atypical ( bronchopneumonia) Or we can classify it to community aquired and hospital aquired وطبعا الاخطر هو الhospital لانو بيحصل multidrug resistance Autoimmune disease cause interstitial pneumonia Then we have specific diseases 🌺acute lung injury 1_ lung odema Serious condition الرئة ممتلئة سوائل فما بيحصلش gas exchange Causes _ hemodynamic causes Which include لها علاقه بالvascular disease 🍀increase the hydrostatic pressure or 🍀decrese osmotic pressure _ local causes like 🍀 severe pneumonia ( infection) 🍀fluid aspiration 🍀 inhalation of toxic gases اللي عنده lung odema يكون عنده صعوبة في التنفس ومزرق ولازم نعطيه lasix ( furosemide) 2_ acute respiratory distress syndrome Two types : Neonatal and adult المريض يحاول يأخذ نفسه مايقدرش 🍀 Neonatal Due to lack of surfuctant 🍀Adult Pathogenesis is Severe diffuse alveolar damage ويتحول إلى hyaline material مافيش تبادل غازي ويزرق الشخص Due to _ shock _ severe systemic infection _ major trauma _ toxic gases _ long period surgical procedures _ drowning الغرق 🌺 obtructive lung diseases There is resistance to air flow 1_ COPD Include emphysema and chronich bronchitis جمعوهم لأن السبب واحد التدخين والalpha one antitrypsin deficiency ولأنهم يوجدو مع بعض In emphysema there is functional obstruction so it is called obstruction 2_ asthma Which may be 🍀atopic بسبب عوامل تحسس بيحصل Type 1 hypersensitivity reaction and 🍀non atopic Due to hyperactivity of the smooth muscles بيكون متحسس زياده للبرد وغيره في هذه الحاله ماتنفعش الantihistamins ولازم نعطيه bronchodilator 3_ bronchiectasis This occure in large bronchi Due to recurrent infection بيتكون cavity مليان pus There is profound productive cough 🌺 restrictive lung diseases also called interstitial lung disease There is loss of cmpliance ( decreased total lung capacity) The diseases include : 1_ granulomatous diseases _ TB _ sarcoidosis : non casiating granuloma It's multisystemic disease 2_ fibrosing diseases Affect the adults and include : _ UIP ( usual interstitial pneumonia ) _ NIP ( nonspecific interstitial pneumonia ) _ COP ( cryptogenic organizing pneumonia ) All are of unknown causes they may be autoimmune diseases They are different in histologic pecture 🍀UIP The most dangerous and severe Here we see All stages of inflammation at the same time : We see inflammation of the interstitial tissue in sites and alse we see fibrosis in other site but in the same time 🍀 NIP Here we see one stage Either inflammation or fibrosis The prognosis is better than UIP 🍀 COP May idiopathic or may secondary to other diseases like tumor There is lymphocytic infiltarate and fibrous tissue الشيء المميز هو The presence of fibroplastic plugs which extend to the alveolar space 3_ pneumoconiosis موجوده كثير في صنعاء بسبب الكسارات حق الكري الاجزاء اللي تطلع من الكسارات تدخل مع الهواء تعمل granuloma Pneumoconiosis include _ silicosis _ asbestosis مثل الماده زي الألياف في الثلاجه ماده الاسبيستوس أيضا تسبب mesothelioma نعطيه مضاد للالتهاب ويبتعد عن المسبب باقي الأمراض النادره مش مهمه وهي الآتي 4_ hypersensitivity pneumonitis يشبه الasthma لكن هي تصيب الalveoli فقط 5_ smoking related interstitial lung disease 6_ alveolar proteinosis 🌺 vascular lung diseases As the embolism and the thrombus

Name : choclete agar Type: enriched medium ( solid) Use: for cultification and growth of the fastidious bacteria 😅المدلله which include _ Streptococcus pneumoni _ nessieria species _ heamophilus influenzi

Staphylococcus >> Large golden colonies Catalase +coagulase (positive )

Alpha Heamolysis >> Streptococcus Pnemoniea >> sensitive to Optochin Beta Heamolysis >> Streptococcus pyogens >> sensitive to Bacteriacin

Name : blood agar Types : enriched medium ( solid ) Use: to detect type of hemolysis Result: 1_ B hemolysis لما نشوف clear area Complete hemolysis مثل Streptococcus pyogens 2_ alpha hemolysis Partial hemolysis ويوجد تغيير قلليل في اللون إلى الأخضر مثل Streptococcus viridans 3_ gamma hemolysis No change مثل Enterococcus

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من ملزمة الدكتور بسام .. صورة منهم كانت في إختبار السنة الماضية .. #معمل_مايكرو

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