Pathology of Obstructive Airway Disease

Question 1

These are extrusions of mucus plugs commonly found in cases of asthma exacerbation.

Answer 1

Curschmann spirals

Question 2

Cor pulmonale is most associated with what type of COPD?

Answer 2

Chronic bronchitis

Question 3

This disorder is autosomal recessive and caused by mutations resulting in ciliary dysfunction the prevents mucus clearance.

Answer 3

Primary ciliary dyskinesia

Question 4

What is bronchiectasis?

Answer 4

Permanent dilation of the airways due to excess mucus

Question 5

Acute lung injury is caused by abrupt onset hypoxemia and bilateral pulmonary edema. What is the cause of edema?

Answer 5

Increased vascular permeability due to inflammation

Question 6

What trisomies are associated with pulmonary hypoplasia?

Answer 6

Trisomies 13, 18, & 21

Question 7

What symptoms characterize Samter’s triad?

Answer 7

Asthma, sinus disease with nasal polyps, NSAID sensitivity (esp. aspirin)

Question 8

What occurs during the proliferative phase of ARDS?

Answer 8

Proliferation of Type 2 pneumocytes and alveolar thickening by fibroblasts

Question 9

What are the different mechanisms of atelectasis?

Answer 9

Resorption, compression, contraction (fibrosis)

Question 10

True/False. Bronchogenic cysts present early in life with acute respiratory distress and cyanosis.

Answer 10

False - bronchogenic cysts present later in life and are often asymptomatic.

Congenital cystic adenomatoid malformation present early in life with acute respiratory distress and cyanosis.

Question 11

What is atelectasis?

Answer 11

Incomplete expansion or collapse of a lung

Question 12

This is a specific type of atelectasis caused by compression from the hilar lymph nodes.

Answer 12

Right middle lobe syndrome - obstruction of the right bronchus to the right middle lobe

Question 13

What acid/base imbalance is associated with ARDS?

Answer 13

Respiratory acidosis

Question 14

This is a nonspecific histologic finding common in patients with chronic lung disease.

Answer 14

Creola bodies - groups of reactive bronchial cells

Question 15

What is the cause of neonatal respiratory distress syndrome?

Answer 15

Deficiency in pulmonary surfactant produced by type 2 pneumocytes

Question 16

What are Charcot-Leyden crystals?

Answer 16

Crystals of eosinophils found in asthmatics

Question 17

This pulmonary congenital anomaly is characterized by incomplete of defective lung development.

Answer 17

Pulmonary hypoplasia

Question 18

This type of emphysema is associated with spontaneous pneumothorax in young adults.

Answer 18

Paraseptal/Localized emphysema - bullae lesions adjacent the pleura

Question 19

What is the most common type of emphysema?

Answer 19

Centriacinar - lesions in the upper lobes associated with cancer

Question 20

This type of emphysema presents with lesions in the lower zones and is associated with a1-antitrypsin deficiency.

Answer 20

Panacinar emphysema

Question 21

What are the stages of acute respiratory distress syndrome?

Answer 21

Acute exudative phase, proliferative phase, late fibrotic stage

Question 22

Hyaline membranes form during what phase of ARDS?

Answer 22

Acute exudative phase - within one week of injury

Question 23

This pulmonary congenital anomaly is characterized by focal obliteration of the proximal segment of a bronchus.

Answer 23

Bronchial atresia

Question 24

This is a classic histologic finding in acute respiratory distress syndrome.

Answer 24

Hyaline membranes

Question 25

What is the mechanism of allergic asthma?

Answer 25

IgE-mediated type 1 hypersensitivity reaction (Th2 response)

Question 26

This pulmonary congenital anomaly presents in the first two years of life with respiratory distress and cyanosis.

Answer 26

Congenital cystic adenomatoid malformation

Question 27

What histologic findings are present in an asthmatic airway?

Answer 27

Goblet cell hyperplasia, fibrosis of the basement membrane, eosinophilic inflammation, smooth muscle hyperplasia

Question 28

What is pulmonary sequestration?

Answer 28

A congenital anomaly in which a discrete area of lung tissue is not connected to the airways. May be intralobar or extralobar