Respiratory Pathology

Question 1

What type of epithelium lines the conducting airways?

Answer 1

Pseudostratified ciliated columnar mucus secreting epithelium

Question 2

What cells line the alveoli?

Answer 2

Type 1 pneumocytes (gas exchange)

Type 2 pneumocytes (surfactant production)

Question 3

When does respiratory failure occur?

Answer 3

When the PaO2 is less than 8Kpa

Question 4

What is Type 1 respiratory failure?

Answer 4

When there is a Hypoxic drive and the paCO2 is less than 6.3kPa

Question 5

What is Type 2 respiratory failure ?

Answer 5

Hypercapnic respiratory drive and the paCO2 is greater than 6.3kPa

Question 6

What are some of the signs and symptoms of respiratory conditions?

Answer 6

1) Sputum (mucoid, purulent, haemoptysis)
2) Cough
3) Stridor (proximal airway obstruction)
4) Wheeze (distal airway obstruction)
5) Pleuritic pain
6) Dyspnoea (SoB due to impaired alveolar gas exchange??)
7) Cyanosis (decreased oxygenation of haemoglobin)
8) Clubbing
9) Weight loss (tumour)

Question 7

What can be heard on auscultation?

Answer 7

1) Crackles (resisted opening of small airways)
2) Wheeze (narrowed small airways)
3) Bronchial breathing (sound conduction through solid lung)
4) Pleural rub (movement of inflamed visceral and parietal pleura)

Question 8

Why would we hear a dull or hyperesonant sound upon percussion?

Answer 8

Dull is due to lung consolidation or pleural effusion.

Hyperesonant is due to pneumothorax or emphysema.

Question 9

what is an adenochondroma?

Answer 9

It is a rare, benign primary lung tumour involving glandular and cartilagous tissue,

Question 10

What are the risk factors of lung carcinoma?

Answer 10

• cigarettes
• asbestos
• lung fibrosis
• radon
• chromates, nickel, tar, hematite, arsenic, mustard gas

Question 11

High levels of exposure to this substance leads to pulmonary instertitial fibrosis?

Answer 11

Asbestos

Question 12

What type of cancer is cytokeratin and thyroid transcription factor positive?

Answer 12

Lung non mucinous adenocarcinoma and small cell

Question 13

What type of cancer is cytokeratin 7 negative and cytokeratin 20 positive?

Answer 13

Colorectal and Upper GI tract

Question 14

What is the site of squamous lung carcinoma?

Answer 14

More central than peripheral

Question 15

What is the normal bronchus lined by?

Answer 15

Pseudostratified columnar epithelium with ciliated and mucus secreting cells

Question 16

What happens in squamous metaplasia?

Answer 16

The epithelium undergoes metaplastic changes from psuedostratifies columnar to stratified squamous epithelium.

Question 17

What is the process by which one cell undergoes irreversible genetic chances to produce the first neoplastic (cancerous) cell.

Answer 17

Dysplasia

Question 18

Is bronchioloalveolar carcinoma invasive or non invasive?

Answer 18

non invasive

Question 19

What neuroendocrine proteins are used as a marker for cancer and can be identified by immunocytochemistry?

Answer 19

1) Neural cell adhesion molecule (CD56)

2) Neurosecretory granule proteins (Chromogranin / Synaptophysin)

Question 20

what are Kulchitsky cells?

Answer 20

Kulchitsky cells are neuroendocrine cells that are found in normal mucosa

Question 21

EGFRs are transmembrane receptors present on cell membranes. They controll normal cell growth, apoptosis ect.
How do Tyrosine Kinase Inhibitors work as a cancer treatment in mutated EGFRs?

Answer 21

Mutations of EGFRs can activate receptors which lead to unregulated cell division.

Tyrosine Kinase inhibitors bind to the tyrosine kinase domain on the EGFR and stop it working.

Question 22

Pneumothorax

Answer 22

air in the pleural cavity

Question 23

Hydrothorax

Answer 23

transudate or exudate in the pleural cavity

Question 24

Haemothorax

Answer 24

blood in pleural caviy

Question 25

Chylothorax

Answer 25

lymph in pleural cavity

Question 26

pyothorax

Answer 26

pus in pleural cavity

Question 27

What causes lobar pneumonia in the elderly, diabetic and alcoholic?

Answer 27

Klebsiella pneumoniae

Question 28

what is a ghon complex?

Answer 28

Ghon’s complex is a lesion seen in the lung that is caused by tuberculosis. The lesions consist of a calcified focus of infection and an associated lymph node.

Question 29

where in the lung does tuberculosis usually reactivate?

Answer 29

apically

Question 30

permanent dilation of bronchi and bronchioles caused by destruction of the muscles and elastic tissue

Answer 30

Bronchiectasis

Question 31

give an example of an obstructive disease?

Answer 31

asthma

COPD

Question 32

what 2 diseases make COPD

Answer 32

chronic bronchitis

emphysema

Question 33

chronic inflammation of small airways of the lung causes wall weakness and destruction

Answer 33

chronic bronchitis

Question 34

Abnormal permanent dilation of airspaces distal to the terminal bronchioles, with destruction of airspace wall, without obvious fibrosis

Answer 34

Emphysema

Question 35

Is interstitial lung disease restrictive or obstructive?

Answer 35

restrictive

*increased tissue in the alveolar capillary walls along with inflammation and fibrosis decreases the lung compliance.

Question 36

What are the features of acute interstitial disease?

Answer 36

• diffuse alveolar damage.
  1) exudate and death of type 1 pneumocytes form hyaline membranes lineing alveoli.
  2) type 2 pneumoncyte hyperplasia

Question 37

What are the features of chronic interstitial lung disease?

Answer 37

• dyspnoea
• clubbing
• dry cough
• honeycomb lung

Question 38

Non caseating perilyphatic pulmonary granulomas then fibrosis

Answer 38

Sarcoidosis

Question 39

What are pneumoconioses also known as?

Answer 39

dust diseases

Question 40

what is silicoses?

Answer 40

Sand/stone dust causes fibrosis

Question 41

what is hypersensitivity pnumonitis?

Answer 41

extrinsix allergic alveolitis.

Type 3 hypersensitivity reaction to dust

Question 42

What disease is caused by a mutation in the 7q31.2 gene?

Answer 42

cystic fibrosis

7q31.2 encodes a chloride channel protein/