Respiratory pathology

Question 1

Oat cells
Smokers
Paraneoplastic syndromes
Centrally located
p53 + RB1 mutations

Answer 1

Small cell lung cancer

oats are small, central smoker small

Question 2

Trauma, burns, sepsis (adult), premature babies with insufficient surfactant (neonates)
Diffuse alveolar damage, plum coloured lungs
Bilateral pulmonary infiltrates on CXR

Answer 2

ARDS (adults) / hyaline membrane disease of newborn (neonates)

Question 3

Lung cancer classification

Answer 3

Small cell

Non-small cell (adenocarcinoma, SCC, large cell)

Question 4

Most common in non-smokers

Peripherally located

Answer 4

Adenocarcinoma

Question 5

Smokers
Centrally located
Keratin pearls + intercellular prickles

Answer 5

Squamous cell carcinoma

‘Squamous central smokers’

Question 6

Pleural malignancy

Asbestos exposure

Answer 6

Mesothelioma

Question 7

Caused by smoking or alpha1-antitrypsin deficiency

Answer 7

Emphysema

Question 8

Increasing shortness of breath
Gross clubbing
Bibasal fine end-inspiratory crackles

Answer 8

Cryptogenic fibrosing alveolitis

Question 9

CFTR gene chromosome 7
F508 mutation - loss of phenylalanine amino acid
Abnormal CFTR = lack of chloride, Na and water being pumped out into secretions = thick viscous secretions
Lungs, pancreas, GI
P aeruginosa
Widespread bronchiectasis
AR

Answer 9

Cystic fibrosis

Question 10

Persistent productive cough + haemoptysis

Chronic inflammation in wall = scarring = permanent dilatation

Answer 10

Bronchiectasis

Question 11

Dilated terminal bronchioles with alveolar destruction

Dilated airways, mucus gland hyperplasia + hypertrophy (Reif index), Goblet cell hyperplasia

Answer 11

COPD (Emphysema + chronic bronchitis)

Question 12

Wheezing, chest tightness, night-time cough

Eosinophil infiltration, Charcot-Leyden crystals, Curschmann spirals

Answer 12

Asthma