Pathoma

Question 1

What are some common causes of nasal polyps?

Answer 1

• recurrent bouts of rhinitis
• CF
• aspirin-intolerant asthma

Question 2

What is the triad of aspirin-intolerant asthma?

Answer 2

• asthma
• aspirin induced bronchospasms
• nasal polyps

Question 3

Nasopharyngeal carcinoma is associated with what?

Answer 3

EBV

Question 4

What patients classically get nasopharyngeal carcinoma?

Answer 4

African children and chinese adults

Question 5

What type of H. flu is the most common cause of epiglottis?

Answer 5

B, especially in non immunized children

Question 6

What disease is associated with ‘seal-like barking’?

Answer 6

coupe (laryngotracheobronchitis)

Question 7

What viruses can cause laryngeal papilloma?

Answer 7

HPV 6 and 11 (single nodules in adults and multiple in children)

Question 8

What is pneumonia?

Answer 8

bacterial invasion of the parenchyma

Question 9

How does pneumonia present?

Answer 9

• fever and chills
• rusty (bloody) sputum
• pleuritic chest pain
• elevated WBC

Question 10

What are the patterns of pneumonia?

Answer 10

• bronchopneumonia
• lobar
• bronchial interstitial

Question 11

What are the gross phases of lobar pneumonia?

Answer 11

• congestion
• red hepatization
• grey hepatization
• Resolution

Question 12

What class makes up the most common cause of aspiration pneumonia?

Answer 12

gram negative enteric rods

Question 13

What are some gram negative enteric rods that commonly cause aspiration pneumonia?

Answer 13

• Baceroides

- Fusobacterium

Question 14

What are the abscess forming causative pneumonia bacteria?

Answer 14

• Klebsiella

- Staph aureus

Question 15

What are two common causes of pneumonia in COPD patients?

Answer 15

Haemophilus influenzae

Moxaxella catarrhalis

Question 16

What part of the lung does primary TB affect?

Answer 16

lower lobes and hillier lymph nodes

Question 17

How does primary TB present?

Answer 17

generally asymptomatic, but results in a positive PPD

Question 18

What is a Gohn complex?

Answer 18

• caseating necrosis

- hilar lymph nodes that undergoes fibrosis and calcification

Question 19

How does secondary TB present?

Answer 19

• fevers and night sweats
• cough with hemoptysis
• weight loss

Question 20

How does TLC change in obstructive disease?

Answer 20

increase due to air trapping

Question 21

What Reid index finding suggests chronic bronchitis?

Answer 21

50%+

Question 22

Smoking is a risk factor for _____ emphysema

Answer 22

centriacinar (upper lobes)

Question 23

Why is A1AT associated with liver cirrhosis?

Answer 23

Mutant A1AT accumulates in the ER of hepatocytes resulting in liver damage

Question 24

What would a biopsy of the liver show in panacinar emphysema?

Answer 24

PAS-positive globules

Question 25

Pathogenesis of asthma

Answer 25

Type I hypersensitivity- allergens induce TH2 phenotype in CD4+ T cells of genetically susceptible individuals

Question 26

What do these TH2 CD4+ T cells do?

Answer 26

TH2 secrete IL-4, IL-5, and IL-10

Question 27

What is a primary function of IL-4?

Answer 27

class switching to IgE

Question 28

What is a primary function of IL-5?

Answer 28

chemotractant of eosinophils

Question 29

What is a primary function of IL-10?

Answer 29

stimulates TH2 and inhibits TH1s

Question 30

What does re-exposure to allergen cause?

Answer 30

IgE mediated mast cell degranulation

Question 31

What causes bronchiestasis?

Answer 31

necrotizing inflammation with damage to airway walls that cause them to permanently dilate

Question 32

What are some common causes of bronchiectasis?

Answer 32

- CF - Kartagener syndrome - tumor - necrotizing infection

Question 33

What is Kartagener syndrome?

Answer 33

inherited defect of the dynein arm, which is needed for cilia movement

Question 34

What are the symptoms of Kartagener syndrome?

Answer 34

- bronchiectasis - sinusitis - infertility (sperm have no cilia) - situs inversus (organs misplaced)

Question 35

Restrictive diseases most commonly arise from what part of the lung?

Answer 35

the interstitium

Question 36

Type of restrictive disease?

Answer 36

- IDP - Pneumoconioses - Sarcoidosis - Hypersensitivity pneumonitis

Question 37

What is the likely cause of IPF?

Answer 37

cyclical lung injury which causes TGF-B release from injured pneumocytes and causes fibrosis

Question 38

What drugs have been known to cause IPF?

Answer 38

- Bleomycin | - Amiodarone

Question 39

What is Caplan syndrome?

Answer 39

association between R.A. and coal worker's pneumoconiosis

Question 40

Asbestosis is common in what population?

Answer 40

- construction workers - plumbers - shipyard workers

Question 41

What is the typically patient population for granulomas?

Answer 41

young AA females

Question 42

What are often seen in the granulomas of sarcoidosis patients?

Answer 42

asteroid bodies

Question 43

What are some things that might be elevated in sarcoidosis?

Answer 43

- serum ACE | - Hypercalcemia

Question 44

What is the normal PAP?

Answer 44

10 mm Hg

Question 45

What is the most basic result of ARDS?

Answer 45

diffuse damage of the alveolar-capillary interface

Question 46

What does diffuse damage of the alveolar-capillary interface cause in ARDS?

Answer 46

leakage of protein-rich exudate into the airways and the formation of hyaline membranes

Question 47

What is used to screen for lung maturity if the risk of NRDS is there?

Answer 47

lecithin (component of surfactant): sphingomyelin ratio lecithin levels increase as surfactant is produced, sphingomyelin ratio remains constant

Question 48

What is a sufficient L:S ratio?

Answer 48

2+

Question 49

What are the risk factors of NRDS?

Answer 49

- prematurity - C-section delivery - Maternal diabetes

Question 50

Why would maternal diabetes be a risk factor for NRDS?

Answer 50

Insulin reduces surfactant production

Question 51

Pleural involvement is classically seen in what lung malignancy?

Answer 51

adenocarcinoma

Question 52

What kind of pneumothorax shows deviation of the trachea to the side of the injury?

Answer 52

spontaneous (tension= away)