Respiratory Pathology

Question 1

What parts of the lung are the conducting airways?

Answer 1

trachea, bronchi, segmental bronchi, terminal bronchioles

Question 2

What parts of the lung are the respiratory airways?

Answer 2

respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli

Question 3

What is the histology of the conducting airways?

Answer 3

pseudostratified ciliated columnar mucus secreting epitheliuem

Question 4

What is the histology of alveoli?

Answer 4

mostly flat Type I pneumocytes (gas exchanged) with a few rounded Type II pneumocytes

Question 5

What partial pressure is the cut off for respiratory failure?

Answer 5

PaO2

Question 6

What are the 3 general reasons for respiratory failure?

Answer 6

defective ventilation, perfusion or gas exchange

Question 7

What is the difference between Type I and Type II respiratory failures?

Answer 7

Type I - paCO23.6kPa (hypercapnic drive)

Question 8

Define sputum

Answer 8

mucoid, purulent, haemoptysis

Question 9

Define cough

Answer 9

reflex response to irritation

Question 10

What does stridor show?

Answer 10

proximal airway obstruction

Question 11

What would you suspect if you heard a wheeze?

Answer 11

distal airway obstruction

Question 12

When would you see dyspnoea?

Answer 12

in someone with impaired alveolar gas exchange

Question 13

If you heard crackles on auscultation, what does this mean?

Answer 13

resisted opening of small airways

Question 14

What does hyperesonant percussion suggest?

Answer 14

pneumothorax or emphysema

Question 15

What does dull percussion suggest?

Answer 15

lung consolidation or pleural effusion

Question 16

What is asbestos?

Answer 16

fibrous metal silicates

Question 17

How is the fibre burden related to incidence of lung cancers?

Answer 17

dose related

Question 18

What are carcinoid tumours of the lung?

Answer 18

low grade neuroendocrine epithelial tumours

Question 19

Which are more common, non-small cell carcinomas or small cell carcinomas?

Answer 19

non-small cell carcinomas (85%0

Question 20

In immunochemistry, what would you expect to find in lung non-mucinous adenocarcinoma and small cell?

Answer 20

cytokeratin and thyroid transcription factor positive

Question 21

in immunochemistry, when would you expect to find cytokeratin 7 negative and cytokeratin 20 positive?

Answer 21

colorectal cancer

Question 22

What would you expect to find in the immunochemistry of a melanoma?

Answer 22

S100, HMB45, MelanA positive and cytokeratin negative

Question 23

If you found cytokeratin 7 positive and cytokeratin 20 positive in immunochemistry, what would you suspect?

Answer 23

upper GI cancer

Question 24

Where would you expect to find an adenocarcinoma in the lung?

Answer 24

more peripherally

Question 25

Why do you get hypercalcaemia in squamous cell carcinoma?

Answer 25

due to parathyroid hormone related peptide

Question 26

Would you expect to find squamous cell carcinoma more centrally or peripherally?

Answer 26

central > peripheral

Question 27

What is expressed in many non-mucinous lung adenocarcinomas?

Answer 27

thyroid transcription factor (TTF)

Question 28

What does bronchioloalveolar carcinoma mimic?

Answer 28

pneumonia

Question 29

What is the neuroendocrine morphology of large cell neruoendrocrine carcinomas?

Answer 29

organoid architecure, eosinophilic granular cytoplasm, antigen expression

Question 30

If you found nodules in the same lobe as the tumour (but not others), what would you stage the cancer at? (TNM 7th edition)

Answer 30

T3

Question 31

How would you differentiate malignant mesothelioma from adenocarcinoma?

Answer 31

cellular antigent expression

Question 32

What is chronic bronchitis?

Answer 32

cough and sputum for 3 months in each of 2 consecutive years

Question 33

What is emphysema?

Answer 33

abnormal permanent dilation of airspcaes distal to the terminal bronchiole