Lung Pathology

Question 1

Define emphysema

Answer 1

Destruction of lung parenchyma distal to terminal bronchioles

Question 2

Causes of emphysema?

Answer 2

Smoking

a1AT deficiency (protease switched off by cigarette smoking)

Question 3

Define bronchiectasis

Answer 3

Permanent dilatation of large airways with impaired mucociliary clearance

Question 4

Define chronic bronchitis

Answer 4

Productive cough most days for at least 3 months of the year for more than 2 years

Question 5

Complications of bronchiectais?

Answer 5

Recurrent infection

Pulmonary hypertension (leading to cor pulmonale)

Haemoptysis

Fibrosis

Amyloidosis

Question 6

Bronchiectasis on CXR?

Answer 6

Tram lines

Question 7

Diagnostic test for bronchiectasis?

Answer 7

CT

Question 8

Curschmann spirals
Charcot Leyden crystals
Eosinophils

Answer 8

Asthma

Question 9

Youngs syndrome?

Answer 9

Rhinosinusitis

Azoospermia

Bronchiectasis

Question 10

Interstitial lung disease follow what spirometer picture?

Answer 10

Restrictive

Question 11

Two types of interstitial lung disease?

Answer 11

Fibrosing and granulomatous

Question 12

Extrinsic allergy alvelolitis is a ……… interstitial lung disease?

Answer 12

Granulomatous

Question 13

Usual interstitial pneumonia

Honeycomb change at periphery of lobule and which is sub pleural

Type 2 pneumocyte hyperplasia

Answer 13

Idiopathic pulmonary fibrosis

75% due to smoking

Question 14

Fibrosing Lung disease due to inhalation of inorganic antigens?

Answer 14

Pneumoconiosis

Question 15

Pneumoconiosis affects which zones?

Answer 15

Upper lobes except asbestosis (lower and pleura)

Question 16

Polyploid plugs of loose connective tissue?

Answer 16

Extrinsic allergic alveolitis

Question 17

4 stages of lobar pneumonia?

Answer 17

Consolidation

Red hepatisation (neutrophilia)

Grey hepatisation (fibrosis)

Resolution

Question 18

CENTRALLY occurring lung cancer with Kulchitsky cells

Answer 18

Small cell

Question 19

Small cell metastasises….?

Answer 19

Early

Question 20

Lung cancer with highest rate of p53/c myc mutations

Answer 20

Squamous cell

Question 21

Occurs in women and non smokers

Answer 21

Adeno Ca

Question 22

Large cells
large nuclei
Poor prognosis

Answer 22

Large cell Ca

Question 23

Lung Ca showing keratinisation and intercellular prickles

Answer 23

Squamous cell (prickles = desmosomes)

Question 24

Which is more chemosensitive and why?

Answer 24

Small cell more chemosensitive as NSCLC has ERCC1 mutation that gives poorer response to cisplatin

Question 25

Definition of pulmonary hypertension?

Answer 25

Mean pulmonary arterial BP > 25 mmHg

Question 26

Expanded lung, firm, airless and plum coloured

Answer 26

Diffuse alveolar damage

Question 27

Heart failure cells

Answer 27

Iron-laden macrophages seen in pulmonary oedema

Question 28

Saddle embolus for PE?

Answer 28

Occludes pulmonary trunk *risk death if more than 69% pulmonary bed occluded

Question 29

EGFR targeted in which lung Ca?

Answer 29

AdenoCa

Question 30

EML4-ALK mutation in?

Answer 30

AdenoCa

Question 31

Centrilobular emphysema?

Answer 31

Smoking

Question 32

Panacinar emphysema?

Answer 32

a1AT deficiency