Pulmonary Path Dr Bellot Part 3

19 Questions | Total Attempts: 222

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Pulmonary Path Dr Bellot Part 3 - Quiz

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Questions and Answers
  • 1. 
    A 34‑year‑old man from Chicago presents to his family doctor with fever and chest pain with greeny‑yellow sputum. On examination of the chest, you hear a coarse rasping sound on deep inspiration at the left base, which does not disappear on coughing. The diagnosis is MOST LIKELY to be
    • A. 

      Carcinoma of bronchus

    • B. 

      Pericarditis

    • C. 

      Pleurisy

    • D. 

      Asthma

    • E. 

      Pneumothoroax

  • 2. 
    A 45‑year‑old farmer had been using paraquat for weed control. He suddenly became short of breath, was unresponsive to the usual supportive measures and died of respiratory failure. Sections of his lungs will probably demonstrate:  
    • A. 

      Lipid pneumonia

    • B. 

      Multiple abscesses

    • C. 

      Caseating graulomas

    • D. 

      Hyaline membranes

    • E. 

      Birefringent foreign bodies

  • 3. 
    A 35‑year‑old woman with a history of dyspnea and chest pain is shown by x‑ray to have right ventricular enlargement and is clinically going into right heart failure. Primary pulmonary hypertension is suspected. A pathologic characteristic of this disease is:
    • A. 

      Absence of pulmonary arterioles

    • B. 

      Plexogenic pulmonary arteriopathy

    • C. 

      Bullae formation

    • D. 

      Alveolar fibrosis

    • E. 

      Destruction of alveolar septa

  • 4. 
    Which is TRUE regarding Coal Workers Pneumoconiosis?
    • A. 

      The earliest stage, anthracosis, is not clinically significant

    • B. 

      Caplan's syndrome indicates a malignant complication

    • C. 

      Patients typically suffer obstructive lung disease

    • D. 

      Progressive massive fibrosis(PMP) is the usual outcome

    • E. 

      The lower lobes are usually most severely effected

  • 5. 
    A 21‑year‑old Black woman observes gradually worsening shortness of breath, night sweats and weight loss. Chest x‑ray reveals bilateral hilar adenopathy as well as early pulmonary interstitial fibrosis. Bronchial biopsy revealed many small "non­caseating granulomas". Her diagnosis MOST LIKELY is:
    • A. 

      Asbestosis

    • B. 

      Hypersensitivity pneumonitis

    • C. 

      Sarcoidosis

    • D. 

      Tuberculosis

    • E. 

      Atypical (viral) pneumonia

  • 6. 
    All of the following features may be associated with chronic bronchitis EXCEPT:
    • A. 

      Hypertrophy of mucus glands

    • B. 

      Chronic productive cough with excessive mucus secretion

    • C. 

      Epithelioid granulomas in the bronchial mucosa

    • D. 

      Increased resistance to air flow

    • E. 

      Squamous metaplasia of the respiratory epithelium

  • 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. The child is afebrile. A chest x‑ray reveals increased density of the right lower lobe, and slight shift of the mediastinum to the right. The child PROBABLY has:  
    • A. 

      Bacterial bronchopneumonia

    • B. 

      Bronchial asthma

    • C. 

      Hemorrhagic infarct of the lung

    • D. 

      Acute viral pneumonia

    • E. 

      Foreign body in the right lower lobe bronchus

  • 8. 
    An child with cystic fibrosis is at particular risk of developing which of the following?
    • A. 

      Bronchiectasis

    • B. 

      Pleural mesothelioma

    • C. 

      Bronchial asthma

    • D. 

      Hypersensitivity pneumonitis

    • E. 

      Panacinar emphysema

  • 9. 
    The major physiologic abnormality in emphysema is
    • A. 

      Decreased elastic recoil of lung

    • B. 

      Increased airway resistance

    • C. 

      Increased vital capacity

    • D. 

      Atelectasis

    • E. 

      Reduced total lung capacity

  • 10. 
    After 20 years as a rock crusher, a man has shortness of breath, conglomerate nodular shadows on chest x-ray, a restrictive ventilatory defect, and pleural nodules which show whorls of fibrous tissue containing birefringent particles. He has  
    • A. 

      Sarcoidosis

    • B. 

      Silicosis

    • C. 

      Asbestosis

    • D. 

      Bagassosis

    • E. 

      Tuberculosis

  • 11. 
    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

  • 12. 
    Cavitary disease at the apex of the lung suggests a diagnosis of
    • A. 

      Pneumococcal pneumonia

    • B. 

      Hypersensitivity pneumonia

    • C. 

      Secondary tuberculosis

    • D. 

      Pancoast tumor

    • E. 

      Sarcoidosis

  • 13. 
    A patient's chest radiograph shows diffuse interstitial disease and hilar adenopathy. Biopsy of a skin lesion and a lymph node show non-caseating granulomas with no necrosis. The BEST diagnosis is
    • A. 

      Sarcoidosis

    • B. 

      Silicosis

    • C. 

      Alveolar proteinosis

    • D. 

      Carcinomatosis

    • E. 

      Tuberculosis

  • 14. 
    A 30-year-old physician has a positive skin test for tuberculosis (PPD or purified protein derivative). Imaging studies of the chest are performed, and there is a 1.5 cm subpleural parenchymal lesion just above the interlobar fissure between the upper and lower lobes on the left and enlarged lymph nodes in the left hilum. This MOST LIKELY represents  
    • A. 

      Reactivation pulmonary tuberculosis

    • B. 

      Miliary tuberculosis

    • C. 

      Primary pulmonary tuberculosis

    • D. 

      Progressive pulmonary tuberculosis

    • E. 

      Tuberculous pneumonia

  • 15. 
    A 55-year-old man presents with malaise and right chest pain for the past two weeks. He has a long history of alcoholism, advanced dental caries, fever, and a cough producing foul, purulent sputum. A chest x-ray reveals a fluid-filled cavity in the upper right lobe. The MOST LIKELY diagnosis is
    • A. 

      Adenocarcinoma

    • B. 

      Bronchiectasis

    • C. 

      Infarct

    • D. 

      Abscess

    • E. 

      Mycoplasma pneumonia

  • 16. 
    A predominantly interstitial reaction in the lung is MOST LIKELY associated with
    • A. 

      Asbestosis

    • B. 

      Bronchopneumonia

    • C. 

      Lobar pneumonia

    • D. 

      Fungal infection

    • E. 

      Viral infection

  • 17. 
    Pulmonary embolism is MOST LIKELY to result in pulmonary infarction if the patient has
    • A. 

      Atrial fibrillation

    • B. 

      Multiple small emboli

    • C. 

      Large saddle embolus

    • D. 

      Pre-existing cardio-pulmonary disease

    • E. 

      Systemic hypertension

  • 18. 
    A 25-year-old man has bronchiectasis, sinusitis, situs inversus, and infertility. A defect in which of the following is MOST LIKELY responsible for his bronchiectasis?
    • A. 

      Alveolar macrophages

    • B. 

      Ciliary motility

    • C. 

      Pores of Kohn

    • D. 

      Alpha-1 antitrypsin

    • E. 

      Type II pneumocytes

  • 19. 
    You see a 48-year-old overweight woman who complains of a dry cough lasting 2 months. Physical examination, including chest x­-ray and sputum culture, is unrevealing. Your attending physician thinks there might be an iatrogenic cause for the cough. So you ask her about current treatment she might be receiving. What is the MOST LIKELY condition for which she might be receiving treatment? (Choose all that apply)
    • A. 

      Asthma

    • B. 

      Hypertension

    • C. 

      Gastroesophageal reflux disease

    • D. 

      Tuberculosis

    • E. 

      Arthritis

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