Respiratory

Question 1

Answer 1

Bronchiectasis:

Chronic necrotizing infection of bronchi leading to

Permanent dialation of the airways

blood and purulent sputum in cough

Seen in Patients with asthma or cystic fibrosis

associated with Kartagener’s syndrome, tumor/ foreign body, necrotizing infection

prone to Aspergillus infection

Question 2

Answer 2

Lobar Pneumonia:

Consolidation of entire Lobe of Lung

MCC by S. pneumoniae (95%) or Klebsiella pneumoniae (5%)

Question 3

Answer 3

Red Hepatisation of Lobar Pneumonia:

2nd Stage of LP.

Lungs get a solid and spongy consitency due to exudate, neutrophils, and hemorrhage filling the alveolar air spaces.

1. congestion, 2. Red Hepatisation, 3. Grey Hepatisation, 4. Resolution

Question 4

Answer 4

Normal Chest CT

Question 5

Answer 5

Emphysema:

typical of smokers or those with alpha-1-antitrypsin deficiency, dilated airspaces

macrophages and neutrophils release proteases (elastase)

Protease-antiprotease imbalance results in acinar wall destruction.

Question 6

Answer 6

Paraseptal Emphysema:

Associated with bullae that can rupture and lead to spontaenous pneumothorax in healthy males

Located adjacent to the pleura and spetal lines

Question 7

Answer 7

Curschmann spirals:

associated with asthma

Formed by shed epithelium from mucous plugs

“Desquamated epithelium casts in sputum”

Question 8

Answer 8

Egg shell calcifications:

Associated with Silicosis , founderies, sandblasting, and coal mines

Macrophages respond to silica
and release fibrogenic factors, leading to fibrosis.

Affects Upper Lobes

Impairs macrophages and increases suceptibility to TB

Question 9

Answer 9

Abestosis:

Suprdiaphragmatic Ivory White calcified Pleural plaques

Restrictive lung disease,

Ship builders/ Plumbers/ roofers

risk of bronchogenic carcinoma and mesothelioma

Affects lower lobes

Question 10

Answer 10

Ferrougenous (Asbestos) Body:

Golden brown fusiform rods resembling dumbbells found in macrophages.

Associated with asbestosis

Visualized by prussian blue

Question 11

Answer 11

Pulmonary “Coin” lesion:

Question 12

Answer 12

Large Cell carcinoma of the Lung:

Pleomorphic Giant cells

Highly anaplastic, undifferentiated tumor

Poor porognosis, less resopinsive to Chemotherapy, removed surgically

Question 13

Answer 13

Bronchial adenocarcinoma:

Formation of glands and mucin seen on histology,

Most common lung tumor in non-smokers and female smokers.

peripherally located

Clubbing of fingers is common

Question 14

Answer 14

Idiopathic pulmonary fibrosis:

reticular infiltrates with a honeycomb pattern most concentrated in the periphery

Progressive dyspnea and cough, fibrosis on lung CT

Treatment is lung transplantation

results in loss of type I pneymocytes and hyperplasia of type II pneumocytes

Question 15

Answer 15

non-caseating granuloma:

A central collection of tightly clustered epitheliod macrophages with abundant pink cytoplasm surrounded by a ring of mononuclear cells.

Multinucleated giant cells upon magnification.

involvement of IL-12, Th1, IL-2, Ifn-Gamma, TNF-alpha
(forms granuloma when activated my macrophages and T-cells)

Assoc with Sarcoidosis

Question 16

Answer 16

Hemosiderin Laden Macrophages:

“Heart failure cells”

When blood leaves a ruptured blood vessel, the red blood cell dies, and the hemoglobin of the cell is released into the extracellular space. Phagocytic cells called macrophages engulf the haemoglobin , producing hemosiderin and biliverdin.