pathology 15 (pg 702-724) the lung

Question 1

what is the most common cause of death in viral influenza epidemics

Answer 1

superimposed bacterial pneumonia

Question 2

what is the most common cause of community-acquired acute pneumonia

Answer 2

streptococcus pneumoniae

Question 3

what appears in the sputum for streptococcus pneumoniae

Answer 3

presence of numerous neutrophils containing the typical gram-positive, lancet-shaped diplococci

Question 4

what serotype of haemophilus influenza is most virulent

Answer 4

type B

Question 5

what is the most frequent cause of gram negative bacterial pneumonia

Answer 5

klebsiella pneumoniae

Question 6

who does klebsiella pneumoniae primarily effect

Answer 6

debilitated and malnourished people, particularly chronic alcoholics

Question 7

what are the 2 patterns of anatomical distributions for bacterial pneumonia

Answer 7

lobular bronchopneumonia and lobar pneumonia

Question 8

what is the dominant feature in bronchopneumonia

Answer 8

patchy consolidation

Question 9

what are the 4 stages of inflammatory response in lobar pneumonia

Answer 9

congestion, red hepatization, gray hepatization, and resolution

Question 10

what are the foci of bronchopneumonia

Answer 10

consolidated areas of acute suppurative inflammation

Question 11

what are the major symptoms of community acquired acute bacterial pneumonia

Answer 11

abrupt onset of high fever, shaking chills, and cough producting mucopurulent sputum

Question 12

what type of virus is human metapneumovirus

Answer 12

paramyxovirus

Question 13

what are the similar morphological changes that all viral infections produce

Answer 13

URI marked by mucosal hyperemia and swelling, lymphomonocytic and plasmacytic infiltration of the submucosa, and overproduction of mucus secretions

Question 14

what term describes a local suppurative process that produces necrosis of lung tissue

Answer 14

pulmonary abscess

Question 15

what is the cardinal histological change in all abscesses

Answer 15

suppurative destruction of the lung parenchyma within the central area of cavitation

Question 16

how is histoplasma capsulate infection acquired

Answer 16

by inhalation of duct particles from soil contaminated with bird or bat droppings that contain small spores

Question 17

what are the major target of histoplasmosis

Answer 17

macrophages

Question 18

what cells help control histoplasma infections

Answer 18

helper T cells that recognize fungal cell wall antigens and heat shock proteins and subsequently secrete IFN_gamma, which activates macrophages to kill intracellular yeasts

Question 19

what does histoplasma infections produce in the lungs of otherwise healthy adults

Answer 19

granulomas

Question 20

what are the 2 major complications of a transplanted lung

Answer 20

infection and rejection

Question 21

what are the morphological features of acute rejection in lung transplantation

Answer 21

inflammatory infiltrates

Question 22

what is the major morphologic correlate of chronic rejection in lung transplantation

Answer 22

bronchiolitis obliterans

Question 23

what type of cancer is the most frequently diagnosed major cancer in the world

Answer 23

lung cancer

Question 24

what type of lung cancer has the strongest association with smoking

Answer 24

small cell carcinoma

Question 25

what is adenocarcinoma marked by

Answer 25

oncogenic gain-of-function mutations involving components of growth factor receptor signaling pathways

Question 26

what are the 4 types of morphologic precursor epithelial lesions that are recognized for lung cancer

Answer 26

squamous dysplasia and carcinoma in situ; atypical adenomatous hyperplasia, adenocarcinoma in situ, and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia

Question 27

what is the most common form of lung cancer in women

Answer 27

adenocarcinoma

Question 28

what is atypical adenomatous hyperplasia characterized by

Answer 28

dysplastic pneumocytes lining alveolar walls that are mildly fibrotic

Question 29

what is adenocarcinoma in situ composed of

Answer 29

entirely of dysplastic cells growing along preexisting alveolar septa

Question 30

how is squamous cell carcinoma characterized histologically

Answer 30

the presence of keratinization and/or intracellular bridges

Question 31

where do most squamous cell carcinomas occur

Answer 31

centrally from the segmental or sub segmental bronchi

Question 32

where do small cell carcinomas typically occur

Answer 32

major bronchi or in periphery of lung

Question 33

describe large cell carcinoma

Answer 33

undifferentiated malignant epithelial tumor that lacks the cytologic features of other forms of lung cancer

Question 34

how are small cell lung carcinomas best treated

Answer 34

chemotherapy because almost all are metastatic in presentation

Question 35

what is carcinoid syndrome characterized by

Answer 35

intermittent attacks of diarrhea, flushing and cyanosis

Question 36

what is the most common connective tissue in hamartomas

Answer 36

cartilage

Question 37

who does lymphangioleiomyomatosis primarily effect

Answer 37

young woman of childbearing age

Question 38

what is lymphangioleiomyomatosis characterized by

Answer 38

proliferation of perivascular epithelioid cells that express markers of both melanocytes and smooth muscle cells

Question 39

what is the most common site of metastatic neoplasms

Answer 39

the lung

Question 40

what is empyema characterized by

Answer 40

located, yellow-green, creamy pus composed of masses of neutrophils admixed with other leukocytes

Question 41

define hydrothorax

Answer 41

noninflammatory collections of serous fluids within the pleural cavity

Question 42

describe the fluid involved in hydrothorax

Answer 42

clear and straw colored

Question 43

what is the most common cause of hydrothorax

Answer 43

cardiac failure

Question 44

describe the effected lung with malignant mesothelioma

Answer 44

ensheathed by a thick layer of soft, gelatinous, grayish pink tumor tissue

Question 45

what are the presenting complaints with malignant mesothelioma

Answer 45

chest pain, dyspnea, and recurrent pleural effusions