PATHOLOGY 2

Question 1

What happened to a lung that weighs less than it should and has less alveoli than projected for gestational age?

Answer 1

Hypoplasia from oligohydramnios or decreased intrathoracic space

Question 2

What may cause non-bilious vomiting with an air bubble in the stomach?

Answer 2

Tracheoesophageal fistula

Question 3

What is the major complication of a bronchogenic cyst? Another name for these?

Answer 3

Infection; Foregut cyst

Question 4

This presents as a nodule with a pleural lining and served by the aorta

Answer 4

Extralobar sequestration

Question 5

What is the most common cause of resorption atelectasis?

Answer 5

Excess Secretion

Question 6

What happens to 1) Nearby lung tissue 2) Diaphragm and 3) Chest wall in a resorption atelectasis?

Answer 6

The nearby tissue distends, the diaphragm elevates, and the chest wall flattens

Question 7

Fibrotic changes of lung and/or pleura are the major cause of this type of atelectasis

Answer 7

Restrictive Atelectasis

Question 8

When does alveolar fibrosis occur in pulmonary edema?

Answer 8

if the edema is long-standing, as in mitral stenosis

Question 9

What is the hallmark of ARDS?

Answer 9

Hyaline membranes at the blood-air barrier

Question 10

What is the hallmark of acute interstitial pneumonia? AKA?

Answer 10

Diffuse damage with ridiculously thickened alveolar walls–lots of macro’s but few neutro’s b/c not infected? HAMMAN-RICH SYNDROME

Question 11

What are the CXR findings in pulmonary embolus?

Answer 11

NORMAL, usually–that’s why you do spiral CT

Question 12

What lung pathology can Fen-Phen cause? Cardiac?

Answer 12

Pulmonary HTN; Phen-Fen valvulitis

Question 13

A middle aged man presents with sinusitis, hemoptysis and hematuria. What test should you order?

Answer 13

c-ANCA, this is a classic presentation of Wegener’s Granulomatosis

Question 14

What are the 4 general obstructive diseases of lungs? Which are COPD?

Answer 14

Chronic Bronchitis, Emphysema, Asthma, and Bronchiectasis. COPD = Chronic Bronchitis and Emphysema

Question 15

What differentiates asthma from COPD, in general?

Answer 15

Reversible bronchospasm

Question 16

Which types of emphysema both predominately affect the upper lungs?

Answer 16

Centricacinar/Centrilobular caused by smoking and Distal Acinar/Paraseptal–bullous emphysema

Question 17

Why would a person with emphysema get heart failure?

Answer 17

Because the lung disease can cause pulmonary hypertension = cor pulmonale

Question 18

Differentiate the implication of smoking in chronic bronchitis from centroacinar emphysema:

Answer 18

In centroacinar emphysema the issue is that the smoke is inhibiting antitrypsin and allowing elastase to destroy alveoli, in CB the smoke is killing off the cilia and producing inflammation.

Question 19

What is the cause of the type of emphysema that mostly affects the lower parts of the lungs?

Answer 19

This is Panacinar emphysema and is caused by homozygous A1AT deficiency

Question 20

Essentially, how do you define chronic bronchitis?

Answer 20

Persistent cough with copious sputum for greater than 3 months over a period of 2 years

Question 21

Who are the blue bloaters? Who are the pink puffers?

Answer 21

Blue bloaters = chronic bronchitis and pink puffers = emphysema

Question 22

What are the early microscopic findings in chronic bronchitis (2)?

Answer 22

Mucus in the airway, hypertrophy of submucosal glands

Question 23

What are the late microscopic findings in chronic bronchitis (3)?

Answer 23

Goblet cell hyperplasia, increased Reid index, and squamous metaplasia

Question 24

What is the deadly, unrefractory form of asthma?

Answer 24

Status asthmaticus

Question 25

Which type of asthma has normal serum IgE, most common cause?

Answer 25

Non-Atopic asthma from infection, usually

Question 26

What are the 2 general causes of bronchiectasis? End result?

Answer 26

Congenital malformation of bronchial tree, or post-infection? Either way it is a PERMANENT DILATION of the bronchus

Question 27

What antibody isotype is present in lung disease caused by Aspergillus fumigatus? Name of disease?

Answer 27

IgE, Allergic Bronchopulmonary Aspergillosis

Question 28

What are the genetics of Kartagener Syndrome?

Answer 28

Autosomal Recessive

Question 29

Who gets Curshmann spirals and Charcot-Leyden crystals? What would a Charcot-Leyden crystal in a stool sample indicate?

Answer 29

Asthmatics; it would indicate a parasitic GI infection

Question 30

What exactly is a Charcot-Leyden crystal?

Answer 30

It is a crystal formed from EOSINOPHIL MEMBRANE PROTEIN, indicating eosinophils are present

Question 31

What kind of emphysema is caused by Coal Worker Pneumoconiosis? Why is this a weird form of emphysema?

Answer 31

Centriacinar emphysema, it is weird bc black lung also has fibrosis, which is atypical for emphysema

Question 32

What kind of emphysema is caused by A1AT deficiency? Affects what aspect of lungs?

Answer 32

Panacinar emphysema, affects lower lobes

Question 33

Which obstructive disease is most likely to result in lung cancer, why?

Answer 33

Chronic bronchitis because in late stages it can lead to squamous metaplasia to deal with the chronic inflammation, this predisposes to CA

Question 34

Explain why chronic bronchitis and bronchiectasis lead to recurrent pneumonia:

Answer 34

Chronic bronchitis involves loss of cilia and bronchiectasis involves widening of bronchi so the cilia are not as effective at moving stuff up.

Question 35

Which obstructive disease is most likely caused by insipissated mucus? What is the cause for this mucus?

Answer 35

Bronchiectasis from cystic fibrosis

Question 36

Where do laryngeal cartilages come from? Airway cartilages?

Answer 36

Laryngeal cartilage is from neural crest (ectoderm) and airway cartilage is from splanchnic mesoderm

Question 37

Where is the cricothyroid muscle from? What innervates it?

Answer 37

Pharyngeal arch 4, superior laryngeal nerve

Question 38

Laryngeal muscles innervated by the recurrent laryngeal nerve are from which pharyngeal arch?

Answer 38

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