12. Pulmonary Path-6 Flashcards
A man with a 30 year pack smoking history is diagnosis with vasculitis of medium sized vessels. What else is characteristic of this disease?
A. No associated renal disease B.Anti a3 chain antibodies C. Linear deposits of IgG D. 3p deletions E. Anti-neutrophil antibodies
RFA
Ans. E. anti-neutrophil antibodies- this is also know as PR3-ACNA or C-ANCA the patient has Wegener’s which is a vasculitis linked with smoking and also has Renal issues.
A. Idiopathic pulmonary hemosiderosis- has no associated renal disease
B. Anti A3 chain antibodies- is Good pasture
C. Linear Deposits of IgG-is good pasture
D . 3p deletions is a common deletion in lung cancers
A 52 year old smoker found to have mutation of the glandular cells in his respiratory tract. Which mutation is most likely?
A. Myc amplification B. CDKN2a C. ALK D. p53 E. KRAS
RFA
Ans. E. the patient has Adenocarcinoma and is a smoker so most likely are KRAS or EGFT
A. Myc amplification- found in small cell
B. CDKN2a- found in non small cell but KRAS is more specific to Adenocarcinoma
C. ALK- is found in NON-smoker Adenocarcinoma
D. P53- small cell carcinoma
A 55 y/o male smoker complains of enophthalamos, ptosis, miosis, anhidrosis. Which of the following symptoms might also be present?
A. Hoarse voice B. Dysphagia C. Chylothorax D. Pallor E. Diarrhea
SZ
Ans. A, B, and C
The patient has a pancoast tumor which is causing sympathetic plexus damage and Horner syndrome.
The tumor can also compress the vagus nerve causing dysphagia and the recurrent laryngeal nerve causing a hoarse voice.
A 45 y/o woman presents to her PCP for chronic dry cough, SOB, hematuria, hemoptysis. A kidney biopsy shows IgG deposits in the basement membrane. Which of the following would be present on lung biopsy?
A. Eosinophils
B. Autoantibodies target alpha-3 collagen type IV
C. Dust laden macrophages
D. Autoantibodies targeting collagen type I
E. Nest of cells
SZ
Ans B. Autoantibodies target alpha-3 collagen type IV
The patient has Goodpasture syndrome
