Block 11 Pulmonary Path Dr Bellot Prt 1
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- 1.After 20 years as a rock crusher, a 55‑year‑old man complains of shortness of breath, and you discover nodular lung shadows on chest x‑ray. Pleural biopsy reveals lesions with whorls of fibrous tissue containing birefringent particles. He has
- A.
Sarcoidosis
- B.
Silicosis
- C.
Asbestosis
- D.
Bagassosis
- E.
Tuberculosis
- 2.A 68-year-old woman has solitary 2.0 cm peripheral (subpleural) right lung nodule discovered by x-ray during investigation of recent weight loss. She is a non-smoker. Biopsy confirms a malignant neoplasm. The tumor is LIKELY to be which of the following histologic types?
- A.
Undifferentiated small cell carcinoma
- B.
Squamous cell carcinoma
- C.
Mesothelioma – cancer of serous membrane; easily metasticized; you are done for
- D.
Adenocarcinoma
- E.
Carcinoid tumor
- 3.A 68-year-old man who smoked heavily for more than 40 years suddenly develops a tension pneumothorax. During emergency thorocotomy the lung was noted to show a blackish discoloration and several pleural bullous cyst-like projections, one of which had apparently ruptured. Regarding the underlying pathological process:
- A.
The history of heavy smoking is unrelated to the disease
- B.
It is more commonly seen in patients younger than 40 years of age- 1°pulmonary hypertension/corpulmonale
- C.
Fibrosis of the lung is the underlying pathological problem
- D.
Enzymatic destruction of lung tissue is likely
- E.
The lung disease is usually self-healing
- 4.A 70-year-old man is seen in the ER with severe dyspnea. X-ray demonstrates collapse of the right upper lobe of the lung. He has been a heavy smoker for more than 40 years and has COPD. Which is a LIKELY cause of his symptoms?
- A.
Thromboembolism
- B.
Pneumothorax
- C.
Hemothorax
- D.
Aspiration of vomitus
- E.
Massive pleural transudate
- 5.A 29-year-old man complains of frequent chest infections and chronic productive cough since early childhood. He also suffers from chronic sinusitis He has been married for more than five years but has no children. His pulmonary disease is MOST LIKELY:
- A.
Bronchopneumonia
- B.
Bronchial asthma
- C.
Centriacinar emphysema
- D.
Bronchiectasis – kartagener syndrome
- E.
Tuberculosis
- 6.Which of the following is LIKELY to occur following recurrent pulmonary thromboembolism?
- A.
Increased pulmonary vascular resistance
- B.
Red hepatization-The first stage of hepatization of lung tissue in pneumonia, in which the exudate is blood-stained
- C.
Gray hepatization- The second stage of hepatization of lung tissue in pneumonia, when the yellowish-gray exudate is beginning to degenerate before breaking down
- D.
Subpleural adenocarcinoma
- E.
Lung abscess
- 7.A mother brings her previously healthy three-year-old child to the clinic with a history of cough for one month and blood tinged sputum for one day. A chest x-ray reveals increased density of the right lower lobe, and slight shift of the mediastinum to the right. The MOST LIKELY diagnosis is:
- A.
Bronchial asthma
- B.
Hemorrhagic infarct of the lung
- C.
Primary pulmonary tuberculosis
- D.
Bronchopneumonia
- E.
Foreign body in the right lower lobe bronchus – obstructive/resorption atelectasis
- 8.An asymptomatic 15-year-old child with a chest radiograph showing a small subpleural nodule in the middle lung zone and enlarged mediastinal lymph nodes MOST PROBABLY has:
- A.
Bronchopulmonary sequestration
- B.
Lobar pneumonia
- C.
Primary tuberculosis- combination of peripheral nodule and mediastinal lymph nodes is ghon complex
- D.
Primary atypical pneumonia
- E.
Bronchioloalveolar carcinoma
- 9.An 8-year-old child with a chronic productive cough is being investigated for cystic fibrosis and is discovered to have an elevated sweat chloride. This child is at great risk of developing:
- A.
Hypersensitivity pneumonitis
- B.
Bronchiectasis
- C.
Pleural mesothelioma
- D.
Bronchial asthma
- E.
Panacinar emphysema
- 10.On the 11th post-operative day, a patient walks to the bathroom, but upon returning to bed becomes extremely dyspneic and diaphoretic. His recovery to this point had been "uneventful". You strongly suspect which of the following?
- A.
Postoperative atelectasis
- B.
Adult respiratory distress syndrome (ARDS)
- C.
Pulmonary embolism
- D.
Massive pleural effusion
- E.
Nosocomial pneumonia
- 11.A 50-year-old man died after being hospitalized for six days. At autopsy examination the lungs were found to be heavy, congested and stiff. Microscopic examination revealed thickening of the alveolar septa with interstitial edema, fibrin deposition and a mononuclear cell infiltration. Type-I pneumocytes were replaced partly by hyaline membrane and partly by proliferating type-II pneumocytes. The MOST LIKELY cause of these changes is:
- A.
Bronchopneumonia –acute inflammatory infiltrates extending from bronchioles to alveoli
- B.
Lobar pneumonia-intra alveolar exudates; congestion, red hepatization;gray hepatization; resolution; most often caused by strep pneu
- C.
Viral pneumonia/interstitial pneumonia
- D.
Bronchial asthma
- E.
Bronchiectasis
- 12.After 30 years working as a sandblaster, a 58-year-old man developed progressive dyspnea. X-ray revealed small nodules in bilateral upper lobes. It is LIKELY that he is developing:
- A.
Hypersensitivity pneumonitis- farmers lung
- B.
A restrictive lung disease –coal workers pneumocosis w/ massive pulmonary fibrosis; upper>lower
- C.
An obstructive lung disease
- D.
Tuberculosis
- E.
Viral pneumonia
- 13.A 28-year-old Black woman is discovered to have bilateral hilar adenopathy and gives a history of fever, chest pain and weight loss. Prominant in your diagnostic considerations is:
- A.
Squamous cell carcinoma
- B.
Asbestosis
- C.
Silicosis
- D.
Sarcoidosis
- E.
Undifferentiated small cell carcinoma
- 14.Pulmonary abscesses are particularly prone to develop in the right lung, rather than the left, when they follow:
- A.
Chest trauma
- B.
Pneumonia
- C.
Pulmonary embolism
- D.
Cancer of the lung
- E.
Aspiration of foreign material – prone to deposition in R lung
- 15.Your patient has been complaining of night fevers and loss of weight. He is a non‑smoker. Radiological studies show cavitary disease at the apex of the right lung. You strongly suspect
- A.
Pneumococcal pneumonia
- B.
Hypersensitivity pneumonia
- C.
Secondary tuberculosis
- D.
Pancoast tumor
- E.
Sarcoidosis
- 16.A predominantly interstitial reaction in the lung is MOST LIKELY associated with
- A.
Asbestosis
- B.
Bronchopneumonia-brocilo
- C.
Lobar pneumonia-inta alveolar
- D.
Fungal infection
- E.
Viral infection
- 17.Which statement concerning asbestos is correct?
- A.
There is a time lag of 20 40 years between exposure and evidence of neoplasm
- B.
All asbestos fibers are equally toxic- serpentine and amphimobile(worse one)
- C.
The biological effect of exposure is determined entirely by the weight of the fiber
- D.
All "ferruginous" bodies represent asbestos fibers
- E.
Patients need both tobacco exposure and asbestos exposure to develop mesothelioma
- 18.Of the following lung tumors which is MOST LIKELY to be associated with hypercalcemia?
- A.
Large cell undifferentiated carcinoma
- B.
Adenocarcinoma
- C.
Bronchioloalveolar carcinoma
- D.
Squamous cell carcinoma
- E.
Mesothelioma
- 19.
![A 64-year-old African American woman presents with complaints of shortness of breath and dry cough. These symptoms, per the patient's statement, had an insidious onset and have been present for the past few weeks. Her physical examination is unremarkable. Her pulse, BP and temperature are as follows: 80/min, 130/90 mm Hg and 98.9°F. The patient's lab results and lung biopsy are as follows
The next step in the patient's management entails:
- ProProfs]( "A 64-year-old African American woman presents with complaints of shortness of breath and dry cough. These symptoms, per the patient's statement, had an insidious onset and have been present for the past few weeks. Her physical examination is unremarkable. Her pulse, BP and temperature are as follows: 80/min, 130/90 mm Hg and 98.9°F. The patient's lab results and lung biopsy are as follows
The next step in the patient's management entails:")
A 64-year-old African American woman presents with complaints of shortness of breath and dry cough. These symptoms, per the patient's statement, had an insidious onset and have been present for the past few weeks. Her physical examination is unremarkable. Her pulse, BP and temperature are as follows: 80/min, 130/90 mm Hg and 98.9°F. The patient's lab results and lung biopsy are as follows The next step in the patient's management entails:- A.
Nothing, the disease has a self-limited course and will regress spontaneously
- B.
Performing acid-fast and silver stains on the biopsy
- C.
Treat the patient with antifungal drugs
- D.
Treat the patient with anti-tuberculous drugs
- E.
Treat the patient with steroids and immunosuppressive drugs
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