8. Pulmonary Path.-4 Flashcards
Rachel a 42 year old woman has been complaining of cough and dyspnea. She recently had a bone marrow transplant. It is concluded that she has a fibrotic restrictive disease A CXR is done with finding of patchy peribronchial and subpleural consolidations. What is her diagnosis?
A. IPF B. NSIP C. UIP D. Bronchiectasis E. BOOP
RFA
Ans. E BOOP- Bronchiolitis obliterans organizing pneumonia or Cryptogenic Organizing Pneumonia. Would have the radiologic finding listed.
A. IPF (Idiopathic Pulmonary Fibrosis)& C UIP(Usually Interstitial Pneumonia) are the same x ray would show “honey comb appearance”
B. NSIP-Nonspecific interstitial Pneumonia would have a chicken wire appearance
D. Bronchiectasis- while having fibrotic changes isn’t a restrictive lung disease
A 59 year old smoker complains of a dry cough and dyspnea. A histological examination is done and it is found that alveolar space have been filled with macrophages. What is the diagnosis?
A. Sarcoidosis B. R.B.I.L.D C.EAA D. LIP E. DIP
RFA
ANS. E. DIP- Desquamative Interstitial Pneumonia is a rare long disease in smokers with minimal fibrosis noted by alveolar space filling by macrophages
A. Sarcoidosis- is an idiopathic systemic disease noted by Non-necrotizing epithelioid granulomas in many tissues and organs more in non smokers . Type IV sensitivity
B. R.B.I.L.D- Respiratory bronchiolitis associated interstitial lung disease is associated with smoker and would have macrophages in the lumen of respiratory bronchioles and would show peribronchiolar fibrosis.
C. EAA- Extrinsic Allergic Alveolitis or Hypersensitivity Pneumonia(HP) is due to inhaled antigen it forms non-necrotizing granuloma with giant cells
D. LIP- Lymphoid Interstitial Pneumonia is expansion of the institution by lymphoid cells happens in patients with connective tissue diseases and HIV
A 30 y/o female of European ancestry presents to the doctors with SOB and prolonged dry cough. He is also complaining of vague discomfort for the last few weeks. A sputum sample is obtained and he does not have an active infection. Which of the following would be present on further testing?
A. Cobblestoned pleural surface B. Schaumann bodies C. Asteroid bodies D. Masson bodies E. Uniform fibrosis (chickenwire)
SZ
Ans. B & C Schaumann bodies and asteroid bodies
A. Cobblestoned pleural surface - diopathic Pulm Fibrosis
D. Masson Bodies- Crytogenic organizing pneumonia
E. Uniform fibrosis (chickenwire)- nonspecific interstitial pneumonia
A 25 y/o male is trying to have a baby with his new wife. He is found to be sterile. On exam his heart sounds are present on the right sided chest. He presents to his PCP for complaints of SOB, cough with foul smelling sputum. Which of the following diagnosis does the patient exhibit?
A. Idiopathic Pulmonary Fibrosis B. Sarcoidosis C. Emphysema D. Chronic Bronchitis E. Bronchiectasis
SZ
Ans. E Bronchiectasis
The patient has Kartagner syndrome which is a defect in the dynein arm of the cilia. It is associated with situs inversus, infertility and damage to the airway walls. Bronchioles are permanently dilated and air trapping occurs.
A 30 year old African American female presents with SOB, dry cough, and fever. She reports recent unexplained weight loss of 15lb and has had night sweats frequently. Infection has already been ruled out by tests. Blood tests show elevated serum ACE and CXR shows bilateral hilar lymphadenopathy with parenchymal infiltrates. What would mostly likely been seen if a lung biopsy was performed and the tissue was viewed under light microscopy? (MG)
A. Caseating granulomas B. Eosinophils C. Neutrophilic infiltrate D. Non-caseating granulomas E. Abundant fibroblasts
D. Non-caseating granulomas
A 40 year old farmer presents with signs of pneumonia. The causative organism was inhaled when he was bailing moldy hay. This is the first time he has worked with moldy hay so it is not a case of chronic exposure. What type of hypersensitivity reaction is he experiencing? (MG)
A. type I
B. type II
C. type III
D. type IV
C. type III
disease is hypersensitivity pneumonia/extrinsic allergic alveolitis
type IV would be correct if this was a case of chronic exposure
