Chapter 15/16 Flashcards
1
Q
Lung cancers in smokers tend to have which mutations
A
TP53
2
Q
What tissue origin is sinonasal (schneiderian) papilloma
A
Respiratory mucosa lining the nasal cavity and paranasal sinuses
3
Q
What are the main causes for lung infections
A
- Loss of the cough reflex
- Injury to the mucociliary function
- Accumulation of secretions
- Interference with phagocytosis of immune cells (due to smoking)
- Pulmonary congestion and edema
4
Q
What are the stages of lobar pneumonia
A
1-Congestion (vascular enlargement)
2- Red hepatization (Red cells and inflammation)
3-Grey hepatization (Inflammation and debris)
4- Resolution (fibrosis, macro clean up)
5
Q
What conditions are associated with centralobular/acinar emphysema
A
COPD
6
Q
What is the clinical presentation of diptheria
A
- Pharyngeal or nasal infection, leading to grey pharyngeal membrane, damage to heart, nerves,
- Can produce a toxin and necrosis
- Formation of psuedomembranes from nonviable tissue
7
Q
INfection with which agent is associated with an increased risk of developing asthma
A
Rhinovirus C have 10-30x increased risk
8
Q
What are asteroid bodies in sarcoidosis composed of
A
Collagen
9
Q
What are the complications as a result of chronic bronchitis
A
- Cor pulmonale and heart failure
- Atypical metaplasia, dysplasia and carcinoma
- Bronchiectasis
10
Q
What are the testing findings in a patient with allergic bronchoaspergillosis (ABPA)
A
Increased IgE
Positive skin test
Thick mucus in bronchi
-Fungal hyphi from Aspergillus spp
11
Q
What are pleural empyemas and how do the form
A
- Inflammatory process with the accumulation of pus in the pleural spaces, usually due to a bacterial infection
- Create a loculation, which is a web like feature that traps fluid
12
Q
What is the lesion that arises in chronic otitis media
A
Cholesteatoma
13
Q
What is the difference in histology between bacterial and viral infections
A
-Bacterial infections are actually in the alveolar spaces while the viruses will be in the interstitial areas
14
Q
What are the histological findings in the cause of granulomatosis with polyangiitis (GPA)
A
Aka Wegener granulomatosis
- Granulomatous Inflammation/vasculitis
- “necrobiotic” necrosis (very blue color)
15
Q
What type of tumor is EBV related Extranodal NK/T cell lymphoma
A
Malignant
16
Q
What is the most common emphysema
A
-Centracinar (95% if cases)
17
Q
What is the prognosis of patients with sarcoidosis and progression to lung disease
A
65-70% recover normally
20% progress to lung disease
-Death from pulmonary, cardiac, or neurological involvement
18
Q
What is a Ranke complex and what infection is it indicative of
A
When a TB infection’s Ghon complex undergoes fibrosis and produces a calcification that can be seen on radiographs
19
Q
When are fat emboli commonly seen
A
Resulting from a trauma, whether a motor vehicle accident, or someone who has received CPR
20
Q
What portion of the lung is affected by panacinar/lobular emphysema
A
The whole lung, most severely in the base of the Lung
21
Q
What are the schaumann bodies seen in sarcoidosis composed of
A
Calcified concretions
22
Q
What is the clinical prevention of primary tuberculosis.
A
Usually no different than a bacterial pneumonia and is generally not an issue for immunocompetent individuals.
23
Q
IN the case of HIV patients, what is the likely pathogen causing pulmonary disease if the CD4 count is <200
A
-Pneumocystis jiroveci
24
Q
What are the conditions that can commonly lead to Bronchiectasis
A
Obstruction and infection are the major conditions associated, which are included by these conditions:
- Allergic bronchopulmonary aspergillosis
- Cystic fibrosis
- Primary ciliary dyskinesia (Kartegener syndrome)
25
In the cause of a hemothorax, how do you differentiate between trauma and other factors
Look at the hematocrit, with trauma being >50%, while the others are ,50%
26
What is the patients commonly seen to have langerhans cell histiocytosis (LCH)
Young smokers
27
What are the usual causes of sinusitis
Bacteria from the oral cavity
28
Which clinical presentation with patients with an increased risk for aspirin sensitive asthma
Samter’s triad which is:
- Nasal polyps
- Recurrent rhinitis
- Aspirin sensitive asthma
29
Laryngeal carcinomas are which type of neoplasm
-Malignant squamous cell carcinoma
30
What is the histological findings of NUT carcinoma
Small round blue cell tumor with squamous nests (small blue cells, with very very large clear looking cells in the middle)
31
What is the clinical pattern seen in sarcoidosis
-Bilateral hilar lymphadopathy or lung involvment in 90% or cases
32
Nasopharyngeal carcinomas can be seen histologically with which markers
EBER 1 or LMP1
33
Which blood related genetic factor has an increased risk for lung cancer
-individuals who show more chromosomal breakages in blood lymphcytes have a 10x higher risk
34
What is the prognosis and treatment of cryptogenic organizing pneumonia (COP)
Good prognosis and responds to steroids
35
Which from of nasopharyngeal carcinoma has the worst prognosis
Keratinizing squamous cell because it is least radiosenstive
36
What is the prognosis of a patient with idiopathic pulmonary fibrosis
Most die from respiratory disease 3-5 years
37
What are the methods/pathways that are targeted by adenocarcinomas
- EGFR
- ALK-1
- PD-1
- CTLA-4
38
What other conditions are usually seen in a pt with asthma
-Rhinitis and eczema
39
What are the findings in a patient with hangerhans cell histiocytosis
Progressive scarring that leads to the formation of irregular cystic spaces
40
What are the characteristics of Haemophilus influenza
Gram negative organism
41
What are the characteristics of pulmonary adenocarcinoma
- Shows malignant glands of different sizes.
| - May even look like there are “spaces” due to the production of mucus
42
Idiopathic pulmonary fibrosis is most often causes by which condition
Environmental factors, especially smoking
43
Which tumor tends to spread aerogenously
Mucinous adenocarcinomas
44
Which form of asbestos is more dangerous
Amphibole
*tends to be more linear, so able to get deep into the lungs, as well as being more soluble
45
What is the characteristics of sarcoidosis
Non-caseating (nonnecrotizing) granulomatous disease
46
What would be the clinical presentation of measles
- Koplic spots (ulcerated mucosal lesions in the oral cavity near the Stenson ducts
- Warthin-Finkeldey cells (randomly distributed multinucleated giant cells)
47
What upper airway complication can be seen with Kartegener syndrome
Chronic severe sinusitis
*Kartegener syndome= Bronchiectasis and sinusitis due to defective cilia
48
What are the characteristics of adenocarcinoma in situ (AIS)
- Large lesion (<3 cm)
| - dysplasia pneumocytes growing along preexisting alveolar septum(Basically covers all of the edges)
49
What are the complications seen with cholesteatoma
- Rupture leading to further inflammation
| - Errosion into the ossicles or labyrinth
50
Which patients are seen to have talc embolism
IV drug users
51
What are the general conditions that lead to restrictive lung disease
Chest wall disorders (obesity, poliomyelitis, pleural diseases, kyphoscoliosis)
Interstitial and infiltrative diseases (pneumoconioses and interstitial fibrosis)
52
What is the prognosis of pulmonary hypoplasia
High mortality, with immediate death if lungs <40% normal lung weight
53
What is the histological finding in the cause of ARDS and ALI
Diffuse alveolar damage (DAD)
54
What type of tumor is sinonasal (schneiderian) papilloma
Benign
55
If a chyloud milky fluid is pulled from a pleural effusion, what is the underlying cause
Obstruction of the thoracic duct
56
What type of tumor is olfactory neuroblastoma
Malignant
57
Which patient population is commonly seen to have inflammatory myofioblastic tumors
Children, although it is a rare tumor
58
What are the findings that are going to be seen on a cellular level in the case of atopic asthma
-Increased mucus
Increased TH2 and eosinophils
-Increased gland proliferation
59
Renal angiomyolipoma and lymphangioleiomyomosis is associated with a mutation in which component
mTOR
60
What are the characteristics of mycobacterium
Slender, aerobic rods in straight or branching chains
61
What are the usual clinical presentations of patients with sarcoidosis that requires treatment
Onset of respiration abnormalities (SOB,cough, chest pain)
62
Which predisposing conditions lead to an increased risk of contracting legionnaires disease
- Renal, cardiac, immunological, or hematologic disease
| - Transplant Patients
63
What type of neoplasm is laryngeal squamous papilloma
Benign squamous neosplasm
64
What are the morphological findings in cystic fibrosis leading to Bronchiectasis
Thickening of the mucus allows pooling, leading to bronchi dilation with the smaller bronchioles being obliterated due to fibrosis
65
What is Potters sequence
When there is not enough amniotic fluid to support the development of the fetal lungs
66
What conditions are associated with panacinar emphysema
Alpha1-antitrypsin deficiency
67
What condition is nasopharyngeal angiofibroma associated with
Familial adenomatous polyposis (FAP)
68
Which bacterial infection is commonly seen causing secondary pneumonia following the influenza infection
Staph aureus
69
What are the three contributing factors to nasopharyngeal carcinoma
- Hereditary
- Age
- EBV infection
70
What conditions are patients with silicosis at a higher risk for developing
- Cancer (2 fold increase)
| - TB
71
What are the characteristics of acute interstitial pneumoniae (AIP)
ARDS without a specific etiology
72
What are the morphological findings of the lung with a lymphangioleiomyomatosis
- Cystic
- emphysema-like dilation of terminal airspace’s
- Thickening of the interstitium
- obstruction of the lymphatic vessels
73
What is a complication of sinusitis
1) Obstruction of the outflow, leading to empyema
| 2) Accumulation of mucous leading to mucocele
74
Which complications are commonly seen to arise from mesothelioma
Extensive pleural effusions and invasion into thoracic structures
75
What are the common complications of the maxillary sinus
Osteomyelitis
| Mucocele
76
What is the common finding with nasopharyngeal angiofibroma
Recurrent nose bleeds
*Can be the first sign of a patient with FAP
77
What are nasopharyngeal carcinomas associated with
EBV
78
What is the prognosis in the case of a patient with Mucor caused sinusitis
Not good if left untreated, and required emergent IV Amphotericin B
-Mucor will erode through the bone, causing necrosis and into the brain
79
What are the characteristic histological findings in sarcoidosis
Granuloma with tight well defined border, nonnecrotizing, with multi nucleated cells and lymphocytes
80
What size of particle seems to be most detrimental to the lungs
1-5 micrometers, since they are small enough to get into the alveoli
81
What is the location of a branchial (cervical lymphoepithelial cyst)
From the second branchial arch and forms along the SCM
82
Which bacteria is the cause of “current red jelly sputum” and which patient population is it commonly seen in
Alcoholics
83
What is the cell infiltrate in the cause of allergic rhinitis (hay fever)
Leukocytic, with eosinophils dominating
84
If bloody fluid is pulled from a pleural effusion, what is the underlying cause
Metastatic
85
What is antigenic drift
Cause of the epidemic of influenza every year, as it undergoes minor changes. Individuals carry some immunity year to year
86
What are the common causes of pneumonia in neonates
- Group B strep
- gram negative bacilli
- Listeria (gram positive)
87
Olfactory neuroblastoma arises from which embryological tissue
Neuroectoderm
*member of the small round blue cell tumor, all of which are neuroectoderm
88
What is the patient seen to have Respiratory bronchiolitis- interstitial lung disease
30-40 year old smokers (virtually all who have the disease are smokers)
89
What is the cause of lung cancer Horner’s syndrome and what are the symptoms
Apical lung cancers in the superior pulmonary sulcus around the SNS cervical sympathetic plexus leading to:
- Severe pain in the ulnar nerve
- Enophthalmos (sunken eyeballs)
- Ptosis (drooping of eyelid)
- Miosis (persistent small pupil)
- Anhydrosis (no sweating on that side of the face)
*basically the tumor will cause pinching of the nerve and lack of SNS innervation
90
What are the malignancies that can cause pulmonary disease in HIV patients
- Kaposi sarcoma (purple skin lesions)
- Non-Hodgkin lymphoma
- lung cancer
91
Which conditions is characterized by infertility due to semen being retained in the epididymis and increased risk with Bronchiectasis
Young’s syndrome
92
Which tumor shows the highest association with smoking
Small cell carcinoma
93
What condition is present when there are a Velcro-like crackle on exam
Idiopathic pulmonary fibrosis
94
What is the difference between resolution and fibrosis following ARDS
Resolution results in normal cellular structure and function
Fibrosis results in distorted and changed shape, along with fibrosis and decreased function
95
What is occurring during resorption atelectasis
There is an obstruction in the airway that leads to gradual air resorption and lung collapse
96
What is occurring during acute Leung injury (ALI)
No cardiogenic Pulmonary edema that is characterized by abrupt hypoxemia and bilateral pulmonary infiltrates not caused by cardiac failure
97
What are the characteristics histological findings in Goodpasture syndrome
Linear deposits
98
What is the clinical presentation of pertussis
Whooping cough:
| -Acute violent coughing with an inspiratory whooping
99
What are the characteristics of Bronchiectasis
Necrotizing inflammatory response leading to permanent dilation of bronchi and bronchioles
100
What are the histological findings of diffuse alveolar damage
- Alveolar walls are lined with hyaline membranes
- fibrin fish edema fluid
- Cell debris
101
What is the histological findings on histoplasmosis
-Pumpkin seed morphology seen with a silver stain
102
What is the cause of the enlarged alveoli in emphysema
Small airway fibrosis results in airtrapping in the alveoli, resulting in the enlargement and wreaking of the walls
103
What is the presentation of cryptogenic organizing pneumonia (COP)
Pneumonia like presentation, not not induced by infection drugs or toxins. More a diagnosis by exclusion
104
What is the most common cause of death in a patients with influenza
Bacterial pneumonia
105
What is the prognosis and treatment of hypersensitivity pneumonitis
-Good prognosis as the treatment is removing the offending allergen
106
What is the location that thyroglossal duct cysts occur
IN the midline, along the path of the migration of the thyroid
107
Extranodal NK/T lymphomas are associated with which pathogen
EBV
108
What is the FEV1/FVC ratio in obstructive lung disease
Low, as the FVC does not change, but the FEV (forced expiration volume) decreases because the airways are obstructive, so the air can not be pushed out
109
What is the patients commonly seen to have desquamative interstitial pneumonia (DIP)
40-50 year old smokers (virtually all patients with this condition are smokers)
110
Small cell carcinoma has which histological features
- Nuclear molding
| - Tightly packed small blue cells (due to mostly nucleus and not cytoplasm)
111
What does carotid body tumors look like histologically
Zellballen, or nests of cells
112
Systemic sclerosis commonly shows which pattern of damage
Nonspecific interstitial pattern more often and usual
113
What are the immunological findings commonly seen in sarcoidosis
- Higher CD4 to CD8 ratio (5-15:1)
| - Increased TH1 activation and cytokines (TNF is a marker of disease activity)
114
If there is a trans usage fluid pulled from a pleural infusion, what is the normal underlying cause
Heart failure
115
What stain is used to visualize the carotid body tumors
S100 stain, which highlights the surrounding supporting cells
116
What is a gram positive rod that can cause illness in a neonate and what is the source
Listeria especially unpasteurized milk, deli meats, soft cheeses, refrigerated smoked fish
117
What are the characteristics of the cholesteatoma
Reactive process leading to Benign lesions lined with squamous epithelium with trapped keratin debris
118
What are the histological findings in grey hepatization in lung pneumonia
- Firm and grey lung with Fibrous pleurisy
- Macrophages
- Dense fibril material
119
Which patients are seen to have mycobacterium avium complex and what is it
Immunocompromised or elderly patients and will show as slender red forms on acid fast staining
120
What is the common morphological/histological finding in patients with chronic lung rejection
Bronchiolitis obliterans, which is partial or complete occlusion of small airways with fibrosis, with or without inflammation
121
Lung cancers that are in non smokers tend to have which mutations
-EGFR mutations, with almost never having KRAS
122
What morphological finding is associated with all cases of pulmonary hypertension
- Medial hypertrophy of the pulmonary muscular and elastic arteries
- Right ventricular hypertrophy
123
What is antigenic shift
The cause of pandemic, where the change in antigens is across species, so there is little to no immunity agains the new strain
124
Small cell neuroendocrine carcinomas are almost always associated with which conditions
Smoking
125
What type of tumors are the majority of the lung tumors
Carcinomas (90-95%)
126
What are the characteristics of atypical adenomatous hyperplasia (AAH)
- Small lesion (<5mm)
| - dysplasia pneumocytes present along alveoli with some interstitial fibrosis
127
What is the characteristic of the human metapneumonovirus
Paramyxoviridae
128
What is the most common cause of death in a patient with goodpasture syndrome
Uremia
129
Which patient populations are at a higher risk for developing COPD
Smokers, women, African Americans
130
Extralobar pulmonary sequestrations are commonly associated with which other conditions
Tracheoesophageal fistulas or cardia abnormalities
131
What is the effect of coal workers pneumoconiosis
Benign with little changes to lung function, and very small amount progresses to massive fibrosis
132
What are Pulmonary sequestration’s characterized by
- Lack of connection to the tracheobronchial tree
| - Independent arterial supply from the aorta or its branches
133
When do most post-transplant infections occur
3-12 months following the transplantation
134
What is the increased levels of leukotriences C4, D4, E5 resulting in the case of asthma
- Bronchoconstriction
- Increased mucus secretion
- Increased vascular permeability
135
Lobar pneumonia shows which disease pattern
Covers one whole lobe
136
What are the common gram negative bacteria causing nosocomial pneumonia
-Enterobacteria and pseudomonas
137
What is occurring during compression atelectasis
Accumulation of material, usually fluid or air, within the pleura that prevents the expansion of the lungs (pneumothorax, hemothorax)
138
What is laryngeal squamous papilloma associated with
HPV 6 and 11
139
What is the function of the type 2 pneumocytes
Produce surfactant
| Replace damaged Type 1 cells
140
What is the complication seen with chronic rhinitis
Bacterial infection, producing results such as deviated septum or nasal polyps, with the ability to spread into the sinuses
141
What are the components of hyaline membranes
-Edema, fibrin, and cell debris
142
What are the histological findings in idiopathic pulmonary fibrosis
Shows the finding of usual interstitial pneumonia (UIP)
“Looks like a combination pizza”
- Normal and fibrotic areas
-Peripheral honeycombing
*There is the typical wave of damage, watch doing more and more damage
143
What is the function of the Type 1 pneumocytes
Facilitate gas exchange
144
IN the cases where there is a familial link to pulmonary hypertension, what is the common gene found mutated
Germline mutations in BMPR2 (bone morphogenetic protein receptor type 2) linked to TGF-beta leading to dysfunction in vascular smooth muscle proliferation
145
Which gender has a higher propensity to lung cancer
Women more than men
146
What is the mechanism of action for aspirin sensitive asthma
- Blocks COX, leading do a Decreased production of Prostaglandin E2
- Increased production due to shunting of other half of the pathway, resulting in increased production of C4,D4,E4
147
What are the histological findings in patients with respiratory bronchiolitis- interstitial lung disease
- Stuffed “smokers” macrophages with brown pigmentation* in the 1st and second bronchioles
- Peribronchiolar metaplasia (abnormally located ciliated cells) and fibrosis
*Very similar to desquamative interstitial pneumonia (DIP) but less macrophage involvement
148
In general, what are the general causes of restrictive lung disease
-Chronic interstital lung disease, where there is thickening of the alveolar wall affecting gas exchange
149
What is occurring during allergic fungal sinusitis
-Aspergillus will colonize the sinus tract (does not invade), leading to a hypersensitivity reaction
150
What can a congential pulmonary adenoma malformation cause in a neonate
Mass occupying lesion in the thoracic cavity that can restrict the development of the lungs
151
What are the main conditions classified as obstructive diseases
- Asthma
- Emphysema
- Bronchiectasis
- Bronchic bronchitis
152
What is the function of neuraminidase in the influenza virus
Allows the release of the replicated viruses from the host cell
153
What are the steps involved in ALI/ARDS
1) Endothelial damage (TNF involvement)
2) Adhesion and extravasation of neutrophils (MIF involvement)
3) Accumulation of intralveolar fluid and formation of hyaline membranes
4) Resolution of injury (TGF beta, PDGF involvement)
154
What are the conditions that result of leaking out fluid into the alveolar spaces during pulmonary edema
- Hypoalbuminemia
- Nephrotic syndrome
- Liver disease
*All result in the decreased of proteins in the blood that keep the fluid from leaking out into the alveolar spaces
155
What are the findings in histology that can lead to the diagnosis of sarcoidosis
Asteroid body or Schaumann bodies as granuloma inclusions
156
What are the locations that can harbor legionella
Warm fresh water such as:
- Hot tubs
- Misters
- Hot tubs
157
What is the pathogenesis of group 3 pulmonary hypertension
Secondary to chronic pulmonary parenchymal disease or hypoxia
*i.e obliterative alveolar capillaries or sleep apnea
158
Branchial cysts most commonly arise from where
Second branchial arch
159
ARDS and poorer prognosis is associated with which factors
- Smokers
| - Chronic alcoholics
160
What are the histological findings of a inflammatory myofibroblastic tumor
-Proliferation of spindle shaped fibroblasts/myofibroblasts, lymphocytes, plasma cells, and fibrosis
161
Which form of asthma is most common
Atopic (extrinsic)
162
What is the histology of nonspecific interstitial pneumonia (NSIP)
Uniform infiltrates and fibrosis and interstitial thickening
163
What are the characteristics of Strep pneumoniae
Gram positive lancet shaped diplococci
164
What are the common causes of otitis media
Strep pneumoniae
Moraxella cararrhalis
Haemophilus influenza
165
What are the morphological findings in asbestos exposure
- Hyalinzed collagen (will appear very very pink)
| - “Candlewax drippings” on the pleura
166
What is congenital pulmonary adenomatoid malformation (CPAM)
Arrested development of pulmonary tissue with the formation of cystic masts. Can be at the stage of any portion of the respiratory tree
167
What are the complications seen with congentical pulmonary adenomatoid malformations (CPAM)
- Hydrops or pulmonary hypoplasia
| - Can get infected
168
Very generally, what are the histological findings of restrictive lung disease
Ground glass appearance due to the fibrosis of the interstitium
169
Small cell tumors of the lung arise from which tissue origin
Neuroendocrine cells
170
What are the characteristics of legionella pneumophila
Gram negative bacillus
171
Which treatment in the hospital are increasing at risk from nosocomial infections
-Mechanical ventilation devices
172
What are the common cause of diffuse infiltrates in immunocompromised hosts
CMV
Pneumocystis jiroveci
Drug reaction
173
What is the patient group seen to have NUT carcinoma
Aka midline carcinoma
Any age, but median age is 22 years old
174
What are the characteristics of pertussis
Gram negative coccobacilis
175
What type of pathogens are commonly causing the post transplantation infection
- Bacterial
| - Some fungal, usually candida and Aspergillus (usually involved the bronchial anastomotic sites and lung
176
What are the common causes of pneumonia in children older than one month
- Strep pneumoniae
- H influenza
- M catarrhalis
- Staph aureus
177
What are the immunological factors involved in hypersensitivity pneumonia
```
Proinflammtory chemokines (IL-8 and MIP)
Higher CD4 and CD8 cells
```
178
What are the cell types typically seen in non-atopic asthma
Normal IgE levels
| -Increased T lymphocytes and neutrophils
179
What location of invasion is commonly seen with P. Aeruginosa
Blood vessels with speed to lead to bacteriemia
180
What is the treatment for small cell carcinoma
- Surgical excision if it has not reach the LN
| - Responds very well to the specific chemotherapy, but there is a high rate of recurrence
181
What is the prognosis and treatment for desquamative interstial pneumonia
Good prognosis (>95% at 5 years), and treatment is smoking cessation and corticosteroids
182
What is the most common cause of communist acquired pneumoniae
Strep pneumonia
183
What is the complication seen with the sphenoid sinus
Mucocele
184
Carcinoid tumors histologically have which features
Uniform cells with visible nucleus
| Organoid arrangement
185
What is the common sinus that is the location of the mucocele
Frontal
186
What are the age groups that olfactory neuroblastomas are seen
- Adolescence
- Middle age
*bimodal distribution
187
What are the markers of an olfactory neuroblastoma
- Neuron specific enolase, synaptophysin
- CD56
- chromogranin
188
What will the fluid from an empyema contain
Thick, yellow fluid containing neutrophils and bacteria
189
What marker can be used to see Extranodal NK/T cell lymphomas
EBER1 because it is associated with EBV
190
Singer’s nodules are commonly due to which cause
Reactive swelling usually do to heavy use such as smoking or singers
191
Lung smoking caused emphysema tends to involved which portion of the lung
Upper lobes
192
What condition is associated with carotid body tumors
MEN 2
193
What is the common clinical presentation of polyangiitis with granulomatosis, aka Wegener
Hemoptysis
194
How does langerhans cell histiocytosis (LCH) patients normally first present with the disease
Unexplained Pneumothorax due to cyst rupture
195
What are the common conditions that will lead to pulmonary hypoplasia What
- Congential diaphragmatic hernia
| - Oligohydramnios (secondary to renal agenesis)
196
What is status asthmaticus
Unrelenting, potentially fatal asthma attack resulting in usual bronchial occlusion by thick mucus
197
What is the inheritance pattern of otosclerosis
Autosomal dominant
198
What the prognosis of mesothelioma
Grim, with most not living longer than 2 years
199
What are the common gram positive bacteria causing nosocomial pneumonia
Staph aureus and strep pneumonia
200
What is the cause of foregut cysts
Detachment of primitive foregut, usually in the hilum or middle mediastinum
201
Arising of which syndrome would lead to thought of which type of tumor
Carcinoid Syndrome induced by serotonin
- Flushing
- Diarrhea
- Cyanosis
202
What are the morphological and radiographic findings in histoplasma capsulatum
- Tree back appearance from granuloma formation from macrophages
- Calcification or coin lesions on chest X ray
203
What is the mechanism of damage in the case of chronic bronchitis
- Damaged cilia do to the underlying cause
- Mucus hypersecretion (earliest form) due to increased goblet cells proliferation (mucous gland hyperplasia)
- Inflammation
- Thickened smooth muscle decreases the size of the lumen
204
What is the end stage of any fibrotic lung disease
Honeycomb fibrosis
205
What are the histological findings in the red hepatization phase of lobar pneumonia
- Red and firm lung with serofibrinous pleurisy
| - Fibrin strands with numerous RBC and neutrophils
206
How does smoking increase the chances for pneumoconiosis
Smoking decreases the function of the cilia, so it has a decreased ability to keep particles from getting into the lungs
207
What is the end result of restrictive lung disease
Pulmonary hypertension and cor pulmonale
208
What are some of the factors that can increase the chances of emphysema
- Protease-antiprotease imbalance
- Oxidative strees
- Infection
- Inflammatory mediators
209
What are the locations that nasopharyngeal carcinomas are usually found
IN the nasopharynx, but more present in the neck because of the lymph node metastasis
210
What are the histological findings in hypersensitivity pneumonitis
- Noncaseating granulomas that are loosely formed
| - contain lymphocytes
211
What are the ways that autoimmune diseases can present
```
Interstitial lung diseases such as:
1-usual interstitial pneumonia (UIP)
2- Nonspecific interstitial pneumonia (NSIP)
3- Organizing pneumonia
4-Bronchiolitis
```
212
IN the case of HIV patients, what is the likely pathogen causing pulmonary disease if the CD4 count is <50
CMV, fungal, Mycobacterium Avium
213
What is the usual cause of nasopharyngeal carcinomas in patients with Chinese/southeast Asian adults
INgestion of smoked fish with nitrosamines or EBV
214
Branchial cysts most commonly show which histological finding
Simple cyst lined by stratified squamous or respiratory epithelium surround fibrous tissue
215
Which professions are associated with a higher risk of asbestos exposure
- Insulation workers
- Navy/shipyard workers
- Paper mill workers
- Oil or chemical refinery workers
216
What is the most common cause of bacterial acute exacerbation of COPD
H influenza
217
Indwelling central venous lines increase the risk for which complication
Right atrial thrombi formation
218
What is the histological findings for cryptogenic organizing pneumonia (COP)
-Masson bodies (polyploid plugs of loose connective tissue) in the alveoli, alveolar ducts, and. Bronchioles
219
What are Pulmonary sequestrations
Nonfunctioning lung tissue that forms from an accessory lung bud, typically in the left lower lobe
220
Coal miner lungs can lead to what end stage condition
Centrilobular emphysema
221
What is the prognosis of a patient with non-specific interstitial pneumonia (NSIP)
Much better prognosis that responds to steroids, because a uniform pattern of fibrosis.
-No heterogeneity, fibroblast foci, granulomatas
222
What are the characteristics of the morphology in silicosis
Progressing, modular fibrosis
-Lipoproteinaceous material in the alveoli
223
What are the complications that arise form emphysema
- Respiratory failure
- CAD
- Right sided heart failure
- Pneumothorax with lung collapse
224
What are the common causes of focal inflitrates in immunocompromised hosts
```
Malignancy
Aspergillus
Candida
Staph aureus
Gram neg bacteria
```
225
What is the prognosis of pulmonary harmatomas
Benign, usually found as a incidental finding
226
What are the results of diffuse alveolar damage
-Hyaline membranes result in decreased surfactant, leading to stiff lungs, along with ventilation perfusion mismatch
227
What is anthracosis
Coal induced pulmonary lesion in coal miners where there is pigmentation that is engulfed by alveolar macrophages
228
What are the findings in status asthmaticus
- Coiled mucus plugs known as “curschmann spirals”
| - Charcot Leyden crystals as a result of the eosinophilic degranulation
229
What is the gene involvement for mesothelioma
-CDKN2A/INK4
230
What is the grade and rate of mitosis in carcinoids
Grade 1 (low rate of metastasis) as well as low levels of mitosis
231
What is the mutations commonly associated with lymphangioleiomyomatosis
Loss of function in the tumor suppressor gene TSC2
| -Affects the mTOR pathway
232
What is the histological finding of olfactory neuroblastoma
Small blue cell carcinomas, with rosette looking areas intermixed
233
What is the FEV1/FVC ratio in restrictive lung disease
Normal, as both the values drop, but at the same rate
234
IN the case of HIV patients, what is the likely pathogen causing pulmonary disease if the CD4 count is >200
Bacterial or tubercular
235
What are the common causes of serious pulmonary disorders in patients with HIV
- S aureus
- Strep pneumoniae
- H influenza
- gram negative rods
*These pulmonary offenders tend to be more common, more severe, and associated with bacteremia than in healthy individuals
236
What is the most common location for metastatic neoplasms
THe lungs
237
What is the clinical definition of chronic bronchitis
Persistent cough with sputum for at least 3 months in the last consecutive years
238
Which factor tends to be expressed in pulmonary adenocarcinomas
-Thyroid transcription factor 1
239
What type of virus is the influenza virus
RNA virus
240
Panacinar emphysema tends to involved which portion of the lung
The basilar portion
241
What portion of the lung is affected in idiopathic pulmonary fibrotic lung disease
-Affects the whole lung
242
What are the characteristics of atopic asthma
-IgE mediated, TH2, typ1 hypersensitivity reaction to an environmental allergen
243
What are the complications seen with pulmonary sequestrations
Infection and abscess formation
244
What is a potential complication/ result from recurrent rhinitis
Nasal polyps, which are are edematous with a loose stroma. Is usually filled with a variety of inflammatory cells
245
Which patient population seems to be more susceptible to sarcoidosis
African Americans (10 times) younger than 40
246
What condition is being identified if it is positive for staining with S-100 and CD1a
Langerhans cell histiocytosis (LCH)
247
What are the common complications of the ethmoid sinus
- Mucoecele
- Subperiosteal abcess
- Preseptal cellulitis
- orbital abscess
- Orbital cellulitis
*Basically anything involving the orbit is related to the ethmoid sinus
248
Which patients are at a higher risk for silicosis
African Americans
249
What are the histological findings in the phase of lower pneumonia congestion
- Enlarged and heavy lung and mild pleurisy
- Widened septum
- Neutrophils and RBCs with fluid
250
What condition can be associated with larnyngeal squamous papilloma
Recurrent respiratory papillomatosis
251
In general, obstructive lung diseases as classified as disease of which area
The airways
252
What are the conditions that cause the pushing out of fluid into the alveolar spaces during pulmonary edema
- Left sided heart failure (most common)
- Volume overload
- Pulmonary vein obstruction
*All result in blood/fluid to not leave the lungs, therefore the forces puss them out into the alveoli
253
What is the most common origin of foregut cysts
Bronchogenic
254
What are the organisms that make up the atypical pathogens
Aka do not stain or grow on typical culture media
- Mycobacterium pneumoniae
- Chlamydphila pneumoniae
- Coxiella Burnetii
- viruses
255
What are the traits of atypical carcinoid tumors that differ from the typical from
- Increased mitotic activity
- Necrosis****
- Disordered Growth
- Increased rate of metastasis with lower rates of survival.
256
Singer’s nodules are from which tissue origin
Expansion of the soft tissue underlying the vocal fold (Rienke’s space)
257
Tuberous sclerosis complex can contain which components
-Hypomelanotic macules
-Facial angiofibromas
-cardiac rhabdo
Retinal hamartomas
-Shagreen Patch
258
What is the prognosis of NUT carcinoma
Very bad, with most dying within a year due to this aggressive metastatic tumor
259
What is the process and coloration of thelungs following a pulmonary infarct
1-Red infarct first and initially
2-White infarct as there is healing and scarring
*The lesions in the lungs following an infarct are wedge shaped
260
How do the locations of pulmonary squamous cell carcinomas and adenocarcinomas differ
Squamous cells tend to be more central while adenocarcinomas tend to be towards the periphery
261
What is the pathogenesis of group 2 pulmonary hypertension
- Secondary to left heart failure
| * i.e mitral stenosis
262
What is the embryological origin of carotid body tumors
Aka PNA paraganglioma
-Neuroectoderm from NC cells
263
Which environmental factor greatly increases the risk of lung carcinoma and mesothelioma
Smoking (55 fold increase)
264
Idiopathic pulmonary hypertension is most common in which group
Women from 20-40 yrs old
265
With regards to the the paraneoplasm condition of hypercalcemia (PTH related peptide), what is the underlying tumor
Squamous cell carcinoma
266
What is the histological findings of thyroglossal duct cysts
Thyroid follicles with respiratory lining
267
What type of tumor is NUT midline carcinomas
Malignant
268
Which portion of the lung is most commonly involved in blastomycosis
Upper lung
269
Which patient population is at high risk for infection with H influenza
-Causes virulent pneumonia in children
270
What are the histological findings during allergic fungal sinusitis
- Allergic mucin aka Charcot Leydig crystals, which are bright pink crystals from the eosinophilic degranulation
- Fungal hyphae
+/- mycetoma (aka fungal ball)
271
What are the histological and morphological findings in a harmatoma
Firm “coin like lesion or marble” with smooth edges composed of:
- Fibrous connective tissue
- Benign glandular respiratory epithelium around hyaline cartilage
272
Polymorphisms in which gene has the strongest and most consistent association with asthma or allergic disease
IL13 gene
273
What is the toxin of pseudomasa aeruginosa
-Exotoxins A inhibits protein synthesis and causes necrosis
274
What are the three components to asthma
- Recurrent airway obstructions that is reversible
- Airways hyper responsiveness
- Airway inflammation
275
What conditions commonly make an individual more prone to TB infections
```
HIV
DM
Hodgkin lymphoma
Chronic lung diseases (especially silicosis)
alcoholism
```
276
What are the findings in chronic bronchitis
Elevated hemoglobin
| Rhonchi and wheezing
277
What is the histological finding in blastocysts dermatitides
Broad based budding (upon budding, the two buds have a lot of wall contact still)
278
What are the 4 steps in the progression of adenocarcinomas of the lung
1-Normal tissue
2- Atypical adenomatous hyperplasia
3-Adenocarcinoma insitu
4-adenocarcinoma
279
What conditions in children are caused by H influenza
- acute purulent conjunctivitis
| - pneumonia (emergency)
280
Acute respiratory distress syndrome in neonates will have which neonate radiographic
Ground glass due to lack of surfactant
281
What are the common bacteria that cause superimposed infection in the upper airways
- Strep pneumoniae
| - Haemophilus influenza
282
What condition is present if there are “eggshell” findings on X-ray
Silicosis
283
Where in the lungs does asbestosis begin
Lower lungs and pleura
284
Which conditions is commonly seen in concurrence with a lymphangioleiomyomatosis
Angiolipomas of the kidney
285
Inflammatory myofibroblastic tumors are associated with which gene rearrangement
ALK gene
286
Which two factors are more commonly elevated in bacterial infections as opposed to viral infections
CRP and procalcitonin
287
What is the method that M. tuberculosis is able to evade the host immunity
1) Enters the macrophages via CR3 and MBL
| 2) Replicates in the macrophage and able to prevent the formation of the phagolysosome by inhibiting calcium signaling
288
What are the histological findings for pneumocystis jiroveci
Cup shaped fungus, usually in the diffuse form, but can be focal infiltrates
289
What can be a common presentation of lymphangioleiomyomatosis
-Spontaneous pneumothorax
290
What are the common products of the immune system that results in the affects seen during asthma
Leukotrience C4, D4,E4
291
Where do mesotheliomas arise from
Visceral or parietal pleura
292
Genetic defects in which portion of the innate immunity can lead to increased pulmonary infections
MyD88
293
What is the underlying pathogenesis in neonatal respiratory distress syndrome
Hyaline membrane disease, with the lack of surfactant production
*All due to the immaturity if the fetal lungs
294
Goodpasture sysndrome is caused by which factor
-Autoantibodies against the non collagenous domain of the alpha3 collagen 4
295
What is the gene and its location for alpha1 antitrypsin deficiency
-Pi (protein inhibitor gene) coded on chromosome 14
296
Patients with a pulmonary embolism are at an increased risk for developing which complication
A second PE
297
With regards to the the paraneoplasm condition of SIADH, what is the underlying causing tumor
small cell carcinoma
298
What are the complications of the frontal sinus
- Osteomyelitis
- Mucocele
- Meningitis
- Epidural and subdural abscess
- Brain abcess
*Basically anything related to the brain
299
Which patient population is commonly infected by P. Aeruginosa
-CF and immunocompromised individuals
300
Expression of which gene tends to lead to mire severe disease, airway remodeling, and decreased pulmonary function
YKL-40
301
What portion of the lung is affected in centriacinar/centrilobar emphysema
The proximal or central parts, with the distal portions being spared
302
What is the patient population seen to have Granulomatosis with polyangiitis
Aka Wegener granulomatosis
-Middle aged adults
303
What genetic polymorphism is commonly seen in patients with asthma
ADAM33, which is a metalloproteinase linked to increased proliferation of bronchial smooth muscle and fibroblasts
304
What is the process of pulmonary edema
Interstitial Fluid enters the alveolar spaces in the lungs and prevents gas exchange
305
What is the relation of lung cancer worldwide to diagnosis and deaths
Most frequently diagnosed and most come cause of cancer mortality
306
What are the cell type markers expressed by a lymphangioleiomyomatosis
- Smooth muscle cells
| - Melanocytes (HMB45)
307
What is the prognosis and treatment for respiratory bronchiolitis- Associated interstitial lung disease
Good prognosis if caught early, with treatment being smoking cessation
308
What are the three types of atelectasis
- Resorption
- Compression
- Contraction
309
What are patients with a pulmonary embolism usually presenting with
- Acute and instantaneous death
- May have electromechanical dissociation, meaning the heart is beating, but there are not pulses felt due to no blood entering the pulmonary circulation
310
How can honeycomb lung be diagnosed
Radiographic findings (CT)
311
What is the progressing sequence of changes leading to lung cancer
1-Basal cell hyperplasia
2- squamous metaplasia
3- Squamous dysplasia
4- carcinoma in situ
312
What is the type of sinonasal papillomas that can cause complications and what is the reason
Endophytic
*Although it is a benign tumor, it can be locally aggressive, growing down. It will grow into the stroma and of left excised, will invade the orbit or Cranial vault
313
How will a inflammatory myofibroblastic tumor appear on radiographs
-Single lesion, well defined, round, calcium deposit
314
WHat are the common causes of health care associated pneumonia
- MRSA
| - P aeruginosa
315
What is used to diagnose DIPNECH
High resolution CT scan
316
What are the histological findings of patients with deaquamative interstial pneumonia (DIP)
Stuffed “smokers” macrophages that contain large amounts of brown pigments
317
What is the patient population seen to have nasopharyngeal angiofibromas
Young men, usually fair skinned and red headed
318
ARDS is most commonly associated with which conditions
- Sepsis
- Diffuse Pulmonary Infections
- Gastric aspiration
- Mechanical or head trauma
319
Chronic uncontrolled asthma can lead to which conditions
Irreversible changes due to airway remodeling, such as fibrosis, smooth muscle hyperplasia, and increased goblet cells and glands, all of which are unresponsive to therapeutic agents
320
What is the usual cause of severe chronic sinusitis that is not of bacterial origin
Fungal, especially mucormycosis
321
What is the morphological finding in coccidiodes immitis infection
Spherules full of intact coccidiodes
322
Which patient population is highly susceptible to fungal caused sinusitis
Diabetic population and immunosuppressed patients (especially mucor invasion)
323
What are the characteristics of polyangiitis with granulomatosis
Capillaries and scattered poorly formed granulomas (as opposed to the well formed ones of sarcoidosis)
324
What is the function of hemagglutinin in influenza virus
Attaches to the cells
325
What is the cause of hypersensitivity pneumonitis
-Overreaction to prolonged exposure to inhaled organic antigens (pigeon breeders lung, farmer’s lung, humidifier lung)
326
Which form of silicon is the most detrimental
Crystalline from is more fibrogenic
*Includes quartz, tobalite, tridymite)
327
Death as a result of ARDS is commonly due to which cause
- Sepsis
- Multiorgan failure
- direct lung injury
328
Which conditions are asbestos exposure linked to
Mesothelioma
Pleural effusions
Lung cancer
329
What is the clinical presentation of a patient with idiopathic pulmonary hemosiderosis
Young children with symptoms similar to goodpasture, except there are no autoantibodies
330
Which population is at a higher risk of pneumonia caused by E. Coli
IV drug users
331
What is the common cause of chronic otitis media in diabetics
Pseudomonas aeuroginosa
332
What is the characteristic histological finding in asbestos exposure and what is the cause
Asbestos body, which has a linear and rounded portion:
- Linear portion is the asbestos
- Rounded portion and color is due to the engulfing attempt by macrophages
333
Emphysema and chronic bronchitis are normal grouped together as COPD because what reason
Most are caused by smoking and are commonly found together
334
What are the interstitial conditions that are directly causes by smoking
- Desquamative interstitial pneumonia (DIP)
- Respiratory bronchiollitis-interstial lung disease (RB-ILD)
- Langerhans cell histiocytosis (LCH)
335
What are patients with coal workers pneumoconiosis at increased risk for
TB
*Does not affect cancer rate
336
What is the common patient group to have sinonasal papillomas
-Middle aged man
337
What is the pathogensis of pulmonary alveolar proteinosis (PAP)
Defective metabolism and breakdown of surfactant due to lack of granulocyte macrophage colony stimulating factor (GM-CSF)
338
Which patient is commonly seen to have laryngeal carcinoma
Men >60 (because highest association with smoking and alcohol)
339
What is the difference between diffuse interstitial pulmonary neuroendocrine cell hyperplasia and carcinoid tumor
They are just differentiated by size
- DIPNECH (<5mm)
- Carcinoid (>5mm)
340
What is the patient group commonly seen to have lymphangioleiomyomatosis
Young women of childbearing age
341
What are the clinical presentations of secondary tuberculosis
Generally is the more dangerous form, as it is the reactivation of a dormant infection. Usually involves the upper lobes of the lung, producing cavitations that causes sputum containing bacteria
342
What are the complications of lobar pneumonia
Abscess
Empyema
Bacteremia
343
Which directions does the mediastinum shift during compression atelectasis
Away from the atelectasis lung
344
How does the influenza virus cause damage to the alveolar cells
Inhibits sodium channels and leads to electrolyte and water changes that cause fluid accumulation into the alveolar lumen
345
What is the imaging finding in carotid body tumors
The carotid bifurcation is pushed out
346
What is occurring during contraction atelectasis
Fibrotic or other restrictive processes restrict the lung expansion
347
What is the usual cause of nasopharyngeal carcinomas in young patients with African descent
EBV related
348
What is the treatment for idiopathic pulmonary hemosiderosis
Long term immunosuppression with prednisone and azathiprine
349
With regards to the the paraneoplasm condition of cushing syndrome (secretion of ACTH) what is the underlying tumor
Small cell carcinoma
350
Which lifestyle increases the chances for lung accesses
-alcoholism
351
What is the entire respiratory tree lined by
Pseudostratified, tall, columnar, ciliated epithelial cells
352
What type of tumor is EBV related nasopharyngeal carcinomas
Malignant
353
How does RSV cause illness
1-RSV adheres to the epithelial cells of the airways
2-Cells are sloughed off, which allows the traveling further into the lower respiratory tract
3- INflmmation ensues and there is an increased amount of mucus production that leads to blockage of the airways
354
Laryngeal carcinoma are strongly associated with which factors
- Smoking
- Alcohol
- HPV infection
355
What are the components and their cause in Kartegener syndrome
Ciliary dysfunction, leading to:
- Sinus inverses (ciliary needed to rotate organs)
- Infertility (nonmotile sperm)
- Recurrent sinusitis
- Bronchiectasis
356
What is the finding of olfactory neuroblastomas on CT
Dumbbell shape, where there is one portion in the upper respiratory tract, and then the other have in the anterior cranial fossa as it penetrates the cribriform plate
357
What is the characteristic lesion seen in pulmonary hypertension
-Plexiform lesion
358
Bronchopneumonia usually has what type of disease pattern
Pathcy, covering multiple lung lobes/area
359
Which patients tend to be prone allergic bronchopulmopnary aspergillosis
-Asthma and CF patients
360
What are the interstitial granulomatous diseases
- Sarcoidosis
| - Hypersensitivity pneumonia
361
What is the complication with otosclerosis
Conductive hearing loss due to the bony deposition at the stapedial endplate, leading to inabilty to transfer the sound wave
362
What are the types of mesotheliomas
- Epithelioid type (60%) being cuboidal, columnar or flattened cells resembling an adenocarcinoma
- Sarcomatoid type (20%) being spindle cell sarcoma, resembling a fibrosarcoma
- Mixed (20%)
363
What are the major causes of rhinitis
Adenovirus
Echovirus
Rhinovirus *
Coronavirus *
*Most common
364
What is the gene mutation involved with NUT carcinoma
NUT protein, which is a chromatin regulator protein, usually associated with BRD4
365
What is the gene associated with an increased risk of oxidative stress leading to emphysema
-NFR2 lacking or decreased amounts more susceptible to smoke and other factors causing oxidative stress
366
Which age population is commonly seen to have idiopathic pulmonary hemosiderosis
Young children
367
What is the cause of non-atopic asthma
Cold, exercise, infection (usually viral)
368
What is a spontaneous idiopathic pneumothorax
Rupture of a small apical subpleural bleb, usually in younger patients
369
Which direction does the mediastinum shift during resorption atelectasis
Shifts towards the atelectic lung
370
If there is a biopsy run on the neck, and it is found to be a squamous cell with squamous debris, how does the diagnosis differ by age
In infants and adolescents, it would be a branchial or thyroglossal cyst
In adults, it is a metastatic cystic carcinoma
371
What are the characteristics of Respiratory syncytial virus (RSV)
Paramyxovirus
372
What is the stain used to differentiate mesothelioma from other adenocarcinomas
Calretinin
*May even have ferruginous bodies present
373
What is the pathogensis of group 1 pulmonary hypertension
- Primary vascular disease leading to increased vascular resistance
* most common is autoimmune in the form of systemic sclerosis
374
Which pathogen can be found in patients with the endophytic or exophytic forms of sinonasal papillomas
DNA from HPV 6 and 11
*not found in the oncocytic/cylindrical form)
375
What type of cell type of cancer is nasopharyngeal carcinoma
Squamous
376
What is a characteristic of TB in patients with HIV
-Tend to be false negative- smear and PPD tests
377
What are the histological findings that can lead to a diagnosis of squamous cell pulmonary carcinoma
- Keratin pearls (very pink)
| - Orange cytoplasm
378
What are the factors/markers that are commonly seen in small cell carcinoma
-CD57, chromogranin, synaptophysin
379
IN those with GERD, what lung issues may arise
-Aspiration pneumonia leading to small, poorly formed nonnecrotizing granulomas with multinucleated foreign body giant cell reactions
380
What is the primary cause of the majority of pulmonary alveolar proteinosis
-Autoantibodies to GM-CSF (90% of cases)
381
Carcinoids have an association to occur with which genetic conditions
MEN1
382
What are the associations that lead to an increased risk for neonatal respiratory distress syndrome
- Male
- Maternal diabetes
- Cesarean delivery
383
What is the prognosis of Extranodal NK/T cell lymphomas
Not great, as very aggressive and commonly undergoes relapse and recurrence
384
Elevated levels of Angiotensin converting enzyme (ACE) is characteristic of which condition
Sarcoidosis
385
Which individuals have decreased alpha 1 antitrypsin
Z allele in the homozygous PiZZ individuals
386
What is the prognosis and treatment for langerhans cell histiocytosis
Good prognosis and >95% getting better with smoking cessation
387
What are the associations with recurrent respiratory papillomatosis
- Mothers <20
- Vaginal delivery
- First born
*all usually due to the HPV being transferred to the newborn
388
What is a gram positive rod that can cause disease of the upper respiratory tract
Diphtheria (club shaped)
389
What is the treatment for idiopathic pulmonary fibrosis (IPF)
- Tyrosine kinase inhibitors
- TGF beta inhibitors
*Lung transplant is the only therapy
390
What are the genetic factors involved in the case of idiopathic pulmonary fibrosis
Loss of function in:
- TERT and TERC coding for telomerase,
- MUC5B producing mucus
*These are making individuals more prone to toxins and factors
391
How does the combination of obstruction and infection lead to Bronchiectasis
- Obstruction or thickening mucus or ciliary dysfunction disrupts the normal clearing mechanism
- Infection than can not be cleared/prevented
392
What type of tumor is nasopharyngeal angiofibroma
Benign
393
What are the characteristics of coal nodules
Larger coal caused areas where there are carbon-ladened macrophages
394
What are the characteristics of coal macules
Small (1-2mm) ares of carbon-laden macrophages
395
What is a Ghon complex and which infection is it indicative of
When the TB infection is creating caseous lesions located in the lung parenchyma, as well as moving to the regional LNs and causing caseous lesions
396
What are the bacteria that can lead to lung abcess and necrotizing opneuomia
Staph aureus
Klebsiella
Strep pyogenes
Type 3 pneumococcus
-Anareobic bacteria
397
What is the propensity for small cell carcinoma to metastasize
Very high rate with a poor prognosis
398
What is the characteristic finding in emphysema
Irreversible enlargement of airspace distal to terminal bronchioles, along with damage such as fibrosis
399
Which type of tumors will grow in a contiguous manner
- Esophageal carcinomas
| - Mediastinal lymphomas
400
IN those with aspiration pneumoniae due to loss of gag reflex, what is the common complication
-Death due to necrotizing pneumonia, with Lung abscess formation in those few that survive
401
What is the pathogenesis of group 4 pulmonary hypertension
- Secondary to thromboembolitic pulmonary disease
| * Recurrent pulmonary emboli can decreased the cross sectional area of the capillaries
402
What condition will be positive for smooth muscle markers, as well as the melanoma markers (HMB45, Melan-A)
Renal cell tumors (lymphoangioleimyomatosis or angiomyolipoma)
403
What are the characteristics of the measles virus
RNA paramyxovirus
404
What is recurrent respiratory papillomatosis
Papillomas that not only affect the larynx, but are able to move down into the lungs
405
Which patients are most commonly affected by human metapneumonovirus
Immunocompromised individuals, younger and older populations
406
What are the histological findings of silicosis
Denise collagenous nodules
