Respiratory

Question 1

IC

Answer 1

IRV + TV

Question 2

FRC

Answer 2

RV + ERV

Question 3

VC

Answer 3

TV + IRV + ERV

Question 4

TLC

Answer 4

IRV + TV + ERV + RV

Question 5

hypoxemia, neurologic abnormalities, and petechial rash, bone trauma

Answer 5

fat embolism

Question 6

hyperplasia of mucus secreting glands in the bronchi

Answer 6

chronic bronchitis

Question 7

What does elastase do in emphysema to lung compliance?

Answer 7

Increased elastase activity results in loss of elastic fibers and increased lung compliance

Question 8

smooth muscle hypertrophy, mucus plugs

Answer 8

Asthma–Curschmann spirals (from shed epithelium forming mucus plugs), Charcot-leyen crystals (breakdown of eosinophils in sputum)

Question 9

permanently dilated airways, purulent sputum, recurrent infections, hemoptysis

Answer 9

bronchiectasis–chronic necrotzing infection of bronchi: associated with bronchial obstruction, poor ciliary motility (smoking), Kartagener’s, cystic fibrosis, allergic bronchopulmonary aspergillosis

Question 10

Drugs that cause pulmonary fibrosis

Answer 10

bleomycin, busulfan, amiodarone, methotrexate

Question 11

shipbuilding, roofing, plumbing, white calcified pleural plaques

Answer 11

asbestosis–not precancerous–associated with increased risk of bronchogenic carcinoma and mesothelioma

Question 12

Asbestosis, silcosis, coal worker’s pneumoconiosis affect which parts of the lung?

Answer 12

Asbestosis–base of lung; silicosis and coal affect upper lobes

Question 13

golden brown fusiform rods that are dumbell shaped

Answer 13

asbestos (ferruginous bodies) rods

Question 14

macrophages laden with carbon, inflammation and fibrosis

Answer 14

coal worker’s pneumoconiosis

Question 15

eggshell calcification of hilar lymph nodes; foundries, sandblasting, mines

Answer 15

Silicosis–macrophages respond to silica and release fibrogenic factors–>fibrosis; silica may impair macrophages causing increased susceptibility to TB. increased risk of bronchogenic carcinoma

Question 16

alveolar fluid, thickened hyaline membrane

Answer 16

ARDS–initial damage due to release of neutrophil substances toxic to alveolar wall, activation of coagulation cascade, free radical via O2

Question 17

Primary pulmonary HTN

Answer 17

inactivating mutation in BMPR2 gene which normally functions to inhibit vascular smooth muscle proliferation

Question 18

lung cancer associated with hypertrophic osteoarthropathy

Answer 18

adenocarcinoma–activating kRas, EGFR, ALK mutations

Question 19

keratin pearls and intercellular bridges

Answer 19

Squamous cell carcinoma: cavitation; cigarettes; hyperCalcemia (produces PTHrP)

Question 20

Neoplasm of neuroendocrine Kulchitsky cells

Answer 20

Small cell (oat cell) carcinoma that may produce ACTH, ADH, Antibodies against presynaptic Ca challens (Lambert eaton syndrome); Amplification of myc oncogenes is common; small dark blue cells

Question 21

pleomorphic giant cells

Answer 21

Large cell carcinoma–removed surgically

Question 22

nests of neuroendocrine cells, chromogranin A +

Answer 22

Bronchial carcinoid tumor (only lung cancer not associated with smoking) occasionally has carcinoid syndrome (5HT secretion–>flushing, diarrhea, wheezing)