Respiratory Pathology

Question 1

How many lobes are in the right lung and left lung?

Answer 1

3 lobes in the right lung, 2 lobes in the left lung

Question 2

Dark macrophages inside the bronchiole are indicative of?

Answer 2

Tar filled macrophages

Question 3

What is the surface area of the respiratory tract?

Answer 3

500 sq/m

Question 4

Bronchitis is usually caused by viruses such as?

Answer 4

RSV - respiratory syncytial virus

Question 5

Pneumonia is a form of which inflammation?

Answer 5

Alveolar inflammation leads to a large recruitment of neutrophils, lymphocytes and T cells.

Question 6

Pneumonia is usually where in the airways with the formation of what?

Answer 6

Distal airways and alveoli with formation of inflammatory exudate

Question 7

Pneumonia can be either colonisation of the bronchi or of the whole lobe, true or false?

Answer 7

True

Question 8

Bronchopneumonia is seen more often in which type of patients and is caused by which three types of virus/bacteria usually?

Answer 8

Affects the elderly, already sick, and infants.
Staph, Strep, H. Influenzae, Sars-CoV2

Question 9

Lobar pneumonia affects which type of patient cohort and is caused by which type of bacteria?

Answer 9

Healthy adults between 20-50 years, Streptococcus Pneumoniae

Question 10

SARS-Cov2 invades respiratory epithelium through which receptor?

Answer 10

ACE2 receptor

Question 11

Complications of SARS CoV2 are caused by what?

Answer 11

Cytokine storm

Question 12

What is the leading cause of death from any infectious agent?

Answer 12

M. tuberculosis

Question 13

What is the morphology evident in TB?

Answer 13

Granulomatous inflammation and caseation, pulmonary lesions of about 10mm in diameter.

Question 14

What is secondary TB?

Answer 14

This is where the infection lies dormant for many years.

Question 15

What is miliary TB?

Answer 15

This is where TB spreads systematically

Question 16

What is a yellow mass of caseous necrosis called in the case of TB?

Answer 16

Ghon complex

Question 17

If an enlarged caseous node drains into a pulmonary vein there is?

Answer 17

Systemic dissemination of organisms

Question 18

If drainage is into a pulmonary artery, military, what type of dissemination occurs in the lung?

Answer 18

Miliary dissemination

Question 19

Tuberculous granuloma tissue is evident as what on the lungs, caused by bloodstream spread?

Answer 19

Numerous tiny yellow-white dots

Question 20

Is obstructive airway disease reversible?

Answer 20

It is either reversible or irreversible as abnormalities in the small bronchi or bronchioles can limit airflow

Question 21

COPD is a combination of which two disorders?

Answer 21

Emphysema and chronic bronchitits

Question 22

What type of clinical manifestations are seen in COPD?

Answer 22

Mild chronic inflammation throughout the airways, parenchyma, pulmonary vasculature.
Macrophages, CD8+ T lymphocytes, neutrophils are increased in various parts of the lungs.

Question 23

What type of T lymphocytes are seen in COPD?

Answer 23

CD 8+ T lymphocytes

Question 24

What is chronic bronchitis defined as?

Answer 24

A productive cough on most days for at least 3 months/a year for at least 2 successive years.

Question 25

What is seen histologically in chronic bronchitis?

Answer 25

An infiltration of inflammatory cells in the submucosal region of the bronchioles

Question 26

What is emphysema characterised by?

Answer 26

It is a condition of the lung by which an abnormal permanent enlargement of the airspace distal to the terminal bronchiole, accompanied by destruction of their walls and without obvious fibrosis.

Question 27

What are the 3 main clinical manifestations evident with emphysema?

Answer 27

Dyspnea Cough/wheezing purulent cough

Question 28

What is COPD caused by at the cellular level?

Answer 28

It is caused by an imbalance between proteases released from neutrophils and macrophages and antiproteases leading to alveolar wall destruction (emphysema). The proteases also cause the release of mucous.

Question 29

What is asthma?

Answer 29

It is a chronic inflammatory disorder of the airways that causes recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and/or in the early morning.

Question 30

What are the two classifications of asthma?

Answer 30

Extrinsic or intrinsic

Question 31

Extrinsic asthma is usually caused by which type of hypersensitivity?

Answer 31

Type 1 hypersensitivity --> IgE mediated - childhood - family history of allergy or associated allergies - dust, pollen, food

Question 32

Intrinsic asthma is usually caused by which type of hypersensitivity?

Answer 32

Non-immune mechanisms - adults - no family history associated - respiratory tract infection - viruses

Question 33

Extrinsic asthma is a IgE mediated hypersensitivity reaction and is usually caused by the acute inflammatory phase of ?

Answer 33

IgE coated mast cells release of inflammatory mediators causing bronchospasm, oedema, mucous secretion and leucocyte recruitment

Question 34

Describe the late-phase reaction of extrinsic asthma.

Answer 34

Mediated by the recruitment of leukocytes; lymphocytes, eosinophils, neutrophils --> causes bronchospasm, inflammation and bronchial damage

Question 35

The degranulation of mast cells, seen in allergic asthma causes the release of which types of chemical mediators?

Answer 35

histamine SRS-A ECF-A PAF

Question 36

Bronchial asthma causes which 5 changes to the mucus membrane, BM and muscle?

Answer 36

- accumulation of mucus - smooth muscle hypertrophy - increase in goblet cells - thickening of the BM - chronic inflammation

Question 37

What types of lymphocytes are seen in bronchial asthma/extrinsic asthma?

Answer 37

CD4+ and TH2

Question 38

90% of lung tumours are?

Answer 38

Carcinomas - arising from epithelial cells

Question 39

What are the 3 types of lung tumour?

Answer 39

- squamous cell carcinoma - adenocarcinoma - small cell carcinoma/oat cell carcinoma

Question 40

Squamous cell carcinoma is the most common cancer of the?

Answer 40

Bronchus

Question 41

What is the main cause of squamous cell carcinoma?

Answer 41

Cigarette smoke

Question 42

Squamous cell carcinoma of the lung demonstrates a lot of which?

Answer 42

Keratin production

Question 43

What is the most common type of lung cancer in women and non-smokers?

Answer 43

Adenocarcinoma

Question 44

What is the most aggressive of lung carcinomas?

Answer 44

Small cell carcinoma - occurs in the major bronchi and the lung periphery. Metastasize is widely and virtually incurable by surgical means—a strong relationship to cigarette smoking.

Question 45

What type of differentiation is seen with small cell carcinoma of the lung?

Answer 45

Neuroendocrine differentiation.