5. Pulmonary Path.-3 Flashcards
A 17 year old child get 23 and me test done and come back that he has a polymorphism in his TGFB gene. If he developed obstructive lung disease what presentation would you expect to find?
A. Centrilobular B. Panlobular C. Distal Acinar D. Paracicatricial E. Microacinar
RFA
Ans. B- TGFB polymorphism would give him A1AT def. which would give a Panlobular presenation
A. Centrilobular- found in smokers
C. Distal Acinar(Septal)- is rare found in upper lobes and can lead to pneumothorax
D. Paraciatrical(irregular)- sounds a scar and is asymptomatic
A 13 year old boy goes into an asthma attack he is rushed to the hospital and he is given a bronchodilator and his serum is taken which is noted for eosinophils with an increase in IgE. How would you describe this episode?
A.Atopic Asthma B. Non-apotic C.Drug induced D. Occupational E. Eosinophilic Granuloma
Ans. A Atopic Asthma- the increase IgE and eosinophils points toward Atopic
B. Non-atopic- would have normal IgE
C. Drug induced-no history of Aspirin so no reason to think this
D.Occupational- nothing in history supports this
E.Eosinophilic Granuloma- would be noted by Birbeck granules with Langerhans being the culprit.
A 6 y/o boy presents with wheezing, SOB, and chest tightness. He diagnosed with atopic asthma. Which of the following would cause stimulation of mucus and IgE by B cells?
A. IL-4 B. IL-5 C. IL-13 D. IL-8 E. IL-10
SZ
Ans. C IL-13 is stimulates mucus production and IgE by B cells
IL-4 stimulates IgE
IL-5 activates eosinophils and B cells
IL-8 chemotactic for neutrophils
IL-10 inhibits Th1 and upregulates Th2
Which of the following is not a characteristic of chronic bronchitis?
A. Hyperplasia B. Hypertrophy C. Bronchiole metaplasia D. Fibrosis E. Increased Reid index F. A1AT deficiency
SZ
Ans. F A1AT deficiency is a characteristic of emphysema
A 48 y/o female presents to the emergency department with complaint of worsening of her chronic copious productive cough over the past 3 days which has made breathing acutely difficult. Her cough began 3 years ago, and has been continuous since. She is a lifelong smoker with a 30 year 1ppd history. Her FEV1/FVC ratio on spirometry was approximately R=0.4. The clinician references a textbook image to review the histological appearance of chronic bronchitis. Which of the following describes the morphological change? (MG)
A. Hemorrhage & exudate B. Mucinous cell hyperplasia C. Increased Elastin D. Hyalin membranes E. Atelactasis
B. Mucinous cell hyperplasia
Which biphasic process leads to bronchoconstriction, increased mucus, and activation of eosinophils, PMNs, and Tcells in atopic asthma? (MG)
A. IFNgamma release B. Mast cell degranulation C. Wheal and flare D. Smooth muscle proliferation E. Chemo-attractant growth factor release
B. Mast cell degranulation
