Respiratory Pathology

Question 1

the “common cold”, usually viral with bacterial infection developing thereafter; may involve pharynx, tonsils, bronchi?

Answer 1

rhinitis

Question 2

allergic from of rhinitis?

Answer 2

hay fever

Question 3

catarrhal discharge; mucopurulent discharge secondary to bacterial infection; recurrences may lead to polyp formation?

Answer 3

rhinitis

Question 4

common infection secondary to breakdown in the normal secretion elimination system; predisposing factors: typically upper viral respiratory infection?

Answer 4

sinusitis

Question 5

bacteria associated with sinusitis?

Answer 5

s. pneumoniae and h. influenzae

Question 6

headache, fever, facial pain, malaise; nasal discharge; maxillary sinusitis may mimic a toothache?

Answer 6

sinusitis

Question 7

treatment for acute sinusitis?

Answer 7

amoxicillin or appropriate antibiotic

Question 8

treatment for chronic sinusitis?

Answer 8

sinus surgery

Question 9

necrotizing granulomatous process of unknown etiology, classically affects upper airway, lungs, kidneys; epitaxis, pain, nasal obstruction; later signs include ulceration and destruction of adjacent tissue or structures; any organ may be involved?

Answer 9

Wegener’s granulomatosis

Question 10

oral lesions: large, chronic ulcers, “strawberry gums”?

Answer 10

Wegener’s granulomatosis

Question 11

subepithelial hemorrhage; poorly formed granulomas; scattered giant cells; vasculitis?

Answer 11

Wegener’s granulomatosis

Question 12

in diagnosis of Wegener’s, look for …?

Answer 12

c-ANCA

Question 13

treatment of Wegener’s?

Answer 13

prednisone and cyclophosphamide

Question 14

aggressive, destructive process of T lymphocytes; adults; nasal stuffiness, epitaxis; deep necrotic ulcerations; may progress to palatal perforations?

Answer 14

extranodal NK/T-cell lymphoma, nasal type

Question 15

necrosis and angiocentric arrangement of atypical inflammatory cells?

Answer 15

extranodal NK/T-cell lymphoma, nasal type

Question 16

benign but aggressive vascular neoplasm of the nasopharynx; almost exclusively of male adolescents; resemblance to nasal turbinates?

Answer 16

nasopharyngeal angiofibroma

Question 17

nasal obstruction, epitaxis; anterior bowing of the posterior wall of the maxillary sinus?

Answer 17

nasopharyngeal angiofibroma

Question 18

dense fibrous connective tissue with myofibroblasts; numerous, variably-sized, thin-walled vessels?

Answer 18

nasopharyngeal angiofibroma

Question 19

benign, papillary overgrowth of epithelium primarily on nasal septum?

Answer 19

papilloma

Question 20

benign but aggressive neoplasm of the sinuses; high rate of recurrence and destruction with possible invasion of the orbit and cranial vault; inward growth of squamous epithelium?

Answer 20

inverted papilloma

Question 21

malignancy of the nasopharyngeal mucosa that is more common in parts of Asia; associated with Epstein-Barr virus, vit. C deficiency; diets high in salted fish (nitrosamines)?

Answer 21

nasopharyngeal carcinoma

Question 22

enlarged cervical nodes usually the first sign; unilateral serous otitis media and hearing loss?

Answer 22

nasopharyngeal carcinoma

Question 23

common; secondary to viruses, diphtheria, cig smoking; may result in obstruction

Answer 23

laryngitis

Question 24

“croup”; under age of 3; upper respiratory viral infection; loud breathing and cough with difficulty in breathing?

Answer 24

acute laryngotracheobronchitis

Question 25

tumors; overgrowths of edematous inflammatory tissue, "Singer's nodes"

Answer 25

polyps

Question 26

tumors; HPV related, single or multiple (children)

Answer 26

papillomas

Question 27

associated with smoking, asbestos; ulcerated, fungated; hemoptysis, increasing hoarseness

Answer 27

squamous cell carcinoma of the larynx

Question 28

heavy and wet lungs; development of pneumonia; left sided heart disease, allergies, CNS disorders

Answer 28

pulmonary congestion and edema

Question 29

most common preventable cause of hospital death; deep vein thrombosis; dyspnea w/ or w/o shock or sudden death, pain, hemoptysis, acute or chronic cor pulmonale?

Answer 29

pulmonary embolism

Question 30

large embolus at bifurcation of the pulmonary artery?

Answer 30

saddle embolus

Question 31

appears as wedge shaped area of necrosis?

Answer 31

small or multiple emboli

Question 32

arteriosclerosis or increased pulmonary vascular blood flow associated with pulmonary hypertension; pulmonary hypertension secondary to mitral stenosis, fibrosis, COPD; death secondary to right-sided heart failure

Answer 32

pulmonary vascular sclerosis

Question 33

airless lung, appearing shrunken, red-blue, rubbery and non-crepitate?

Answer 33

atelectasis

Question 34

infant (neonatal) respiratory distress syndrome (hyaline membrane disease); secondary to over-sedation of the mother, aspiration of blood or amniotic fluid, birth injuries, prematurity

Answer 34

primary atelectasis

Question 35

the fundamental defect of hyaline membrane disease (RDS) is ...?

Answer 35

deficiency of pulmonary surfactant

Question 36

hyaline membranes and necrosis of alveolar walls?

Answer 36

hyaline membrane disease of the newborn

Question 37

main treatment of hyaline membrane disease of newborn is ...?

Answer 37

prevention

Question 38

complete airway obstruction; resorption of air distal to the obstruction?

Answer 38

secondary atelectasis (collapse), obstructive (resorption) type

Question 39

mechanical collapse due to external pressure; entire lung or portion?

Answer 39

secondary atelectasis (collapse), compression type

Question 40

adult version of hyaline membrane disease; secondary to alveolar epithelium and endothelial damage; increase in permeability leading to fluid in the septa and alveolar sacs; hyaline membrane formation

Answer 40

acute respiratory distress syndrome (ARDS)

Question 41

resistance to expiration

Answer 41

COPD

Question 42

examples of COPD

Answer 42

emphysema; chronic bronchitis; bronchiectasis; asthma

Question 43

progressive dyspnea; reduced recoil; cyanosis; weight loss; hypoxic brain damage; bronchopneumonia; cor pulmonale

Answer 43

COPD

Question 44

enlargement and destruction of air spaces distal to the terminal bronchioles?

Answer 44

emphysema

Question 45

affecting respiratory bronchioles of the upper lobes (strongly associated with smoking)

Answer 45

centrilobular (centriacinar) emphysema

Question 46

affects respiratory bronchioles and distal alveoli (alpha-1-antitrypsin deficiency)

Answer 46

panacinar emyphsema

Question 47

persistent cough with copious sputum for at least 3 months for 2 consecutive years; common in smokers and smog-ridden cities; inflammation, fibrosis and narrowing of bronchioles?

Answer 47

chronic bronchitis

Question 48

hypertrophy of mucous glands, metaplastic formation of mucin-secreting goblet cells in the surface epithelium of bronchi; chronic inflammation; late fibrosis?

Answer 48

chronic bronchitis

Question 49

some chronic bronchitis patients develop significant ... with outflow obstruction?

Answer 49

COPD

Question 50

many patients will have both chronic bronchitis and ...

Answer 50

emphysema

Question 51

abnormal, permanent and irregular dilation of bronchi associated with superimposed, necrotizing infection; typically secondary to other pulmonary diseases

Answer 51

bronchiectasis

Question 52

especially before age 20; cyanosis, coughing, copious purulent and/or bloody sputum, fever, digital clubbing?

Answer 52

bronchiectasis

Question 53

chronic inflammatory disorder that causes sudden episodes of wheezing, breathlessness, chest tightening and cough; increased responsiveness to stimuli-bronchoconstriction, inflammation, mucous secretion

Answer 53

bronchial asthma

Question 54

IgE mediated, type 1 hypersensitivity broncial asthma

Answer 54

atopic

Question 55

bronchial asthma triggered by respiratory viral infections, which probably lower the threshold of the vagal receptors of the irritants?

Answer 55

non-atopic

Question 56

bronchial asthma with leukotriene production?

Answer 56

drug-induced

Question 57

curshmanns spirals-accumulation of epithelial cells and mucous and charcot-leyden crystals-granules of eosinophils seen in sputum

Answer 57

bronchial asthma

Question 58

prolonged bronchial asthmatic attack that can last days or weeks, sometimes resulting in death?

Answer 58

status asthmaticus

Question 59

entire lobe; severe fibropurulent reaction with massive edema; bacterial pneumonia

Answer 59

lobar pneumonia

Question 60

four discrete stages of lobar pneumonia

Answer 60

congestion; red hepatization; gray hepatization; resolution

Question 61

patchy distribution within lobes; multilobar and bilateral; neutrophil rich exudate; bacterial pneumonia

Answer 61

bronchopneumonia

Question 62

which pneumonia carries a better prognosis: community or hospital acquired

Answer 62

community

Question 63

mycobacterium tuberculosis?

Answer 63

tuberculosis

Question 64

ghon complex; low grade fever, night sweats, fatigue (secondary tuberculosis); weight loss (consumption); chronic bloody cough?

Answer 64

tuberculosis

Question 65

diffuse dissemination seen in the immune compromised patient?

Answer 65

miliary tuberculosis

Question 66

necrotizing granulomatous inflammation; multinucleated giant cells; demonstrated by acid fast method?

Answer 66

tuberculosis

Question 67

histoplasma capsulatum; endemic to mississippi and ohio river valleys; spores in soil contaminated with bird or bat droppings?

Answer 67

histoplasmosis

Question 68

calcified hilar nodes; acute-flu like; granulomatous inflammation; 1-2 micron yeasts in macrophages; silver stain or PAS

Answer 68

histoplasmosis

Question 69

T or F: for acute histoplasmosis, no treatment is usually necessary

Answer 69

T

Question 70

treatment of choice for mild cases or as maintenance therapy of histoplasmosis

Answer 70

itraconazole

Question 71

#1 cause of lung abscess?

Answer 71

aspiration

Question 72

secondary to aspiration or complication of pneumonia, obstruction, septic emboli, trauma; cough with foul smelling mucus, fever, pain

Answer 72

lung abscess

Question 73

idiopathic multisystem granulomatous process; improper degradation of antigenic material; effects lungs, lymph nodes, skin, eyes, and salivary glands

Answer 73

sarcoidosis

Question 74

variable onset; dyspnea; dry cough; fever, malaise; fatigue, athralgia; lymphadenopathy?

Answer 74

sarcoidosis

Question 75

granulomatous inflammation; langhans or foreign body giant cell; schaumann bodies; asteroid bodies

Answer 75

sarcoidosis

Question 76

elevated angiotensin converting enzyme; kveim test

Answer 76

sarcoidosis

Question 77

#1 fatal cancer in US (associated with smoking, asbestos, radioactive ores)

Answer 77

bronchogenic carcinoma

Question 78

histologic subtypes of bronchogenic carcinoma

Answer 78

squamous cell; adenocarcinoma, undifferentiated

Question 79

most common subtype of bronchogenic carcinoma

Answer 79

adenocarcinoma

Question 80

spread to hilar and scalene nodes, then to adrenals, liver, brain, bone and kidney; weight loss, chest pain, dyspnea, hemoptysis; paraneoplastic syndromes; many secondary diseases associated

Answer 80

bronchogenic carcinoma