resp onc 4

Question 1

58 year old woman…. firm fixed non tender axillary lymph node
what are pathological findings on bopsy?

Answer 1

the breast has direct lymph drainage to axillary LN
most common invasive tumor is infiltrative ductal carcinoma
anastomosing sheets of pleomorphic cells that express HER 2

Question 2

clusters of small basophilic epithelial cells

Answer 2

small cell lung cancer

Question 3

large germinal centers with numerous mitotic figures and necrotic cells

Answer 3

lymphadenitis

Question 4

proliferation of intralobular stroma

Answer 4

fibroadenoma

Question 5

pt has central lung mass and high level of ACTH and cortisol
how to treat cerntipetal obesity?

Answer 5

ketoconazole

inhibits 11 B hydroxylase …. which reduces production of cortisol

Question 6

absent interleukin 12 means

Answer 6

no TH1 activation and finally no macrophage activation

IL12 is released by macrophags

Question 7

pt with a kidney transplant present with worsening cough , fever, malaise …. CT shows ground glass opacities

Answer 7

pneumocystis jorvecii

also consider ascomycetous fungi

Question 8

most common bacterial pneumonia assoc with VAP

Answer 8

pseudomonas

Question 9

NADPH oxidase uses which substrate to make what?

Answer 9

oxygen to make superoxide

catalase positive organisms will use this up and nothing will be left for phagocytosis to take place

Question 10

capsular polysaccharide cell wall by which bacteria

Answer 10

klebsiella

Question 11

relationship of arteries to other structures in bronchopumonary segment

Answer 11

arteries run with the airways in the center of segment

Question 12

each lung segment is supplied by?

Answer 12

tertiary bronchus and two arteries (pulmonary and bronchial)

Question 13

epithelium of bronchus and when does it change

Answer 13

pseudostratified squamous till beginning of terminal bronchiole and then transition to cuboidal

Question 14

airway smooth muscle cells extend to?

Answer 14

end of terminal bronchiole too

Question 15

inferior mesenteric lymphnodes receive drainage from

Answer 15

splenic flexure to upper rectum

Question 16

super mesenteric lymphnode

Answer 16

jeum, ileum, cecum, appendix. asc and transverse colon

Question 17

internal illiac

Answer 17

lower rectum to the anal canal (above the pectinate line), bladder, vagina (middle third), cervix, and prostate.

Question 18

superficial inguinal LN

Answer 18

anal canal (below the pectinate line), skin below the umbilicus (except the popliteal area), scrotum, and vulva

Question 19

extensive vascular and foamy cells found in cerebellum

Answer 19

hemangiomas

Question 20

cells with round central nucleus with a perinuclear halo (fried egg)

Answer 20

oligodendroglioma

Question 21

rod shape perinuclear inclusions that involve lining of ventricles

Answer 21

ependymomas

Question 22

erythema nodosum hypersensitivity

Answer 22

type 4

Question 23

late stage prostate cancer treatment

Answer 23

leuprolide

flutamide – nonsteroidal antiandorgenic

Question 24

painless hematuria smoking history and night sweats

Answer 24

TCC

Question 25

small cell carcinoma of bladder what is seen microscopically

Answer 25

neurosecretory dense core granules

Question 26

sensitized cd4 activation of macrophages means what In terms of hypersnstvty reactions

Answer 26

tpe 4

Question 27

pt dies after BCG vaccination whats the immunodef

Answer 27

il12 …. t cells required to fight of M TB