Respiratory Pathology

Question 1

Collateral connections between air spaces through which infections and neoplastic cells can spread

Answer 1

Pores of Kohn

Question 2

Most common cause of lung abscess

Answer 2

Aspiration

Question 3

Complications of lung abscess

Answer 3

• empyema
• pulmonary hemorrhage
• secondary amyloidosis

Question 4

Complications of atypical pneumonia

Answer 4

• superimposed bacterial infections

- Reye syndrome

Question 5

What is the Simon focus?

Answer 5

Granuloma at the lung apex in secondary pulmonary TB

Question 6

What is the Ghon complex?

Answer 6

• Ghon focus (subpleural caseous granuloma) + hilar lymph nodes with granulomas

Question 7

Which diseases may you suspect if you see an apical lung lesion at chest X-ray?

Answer 7

• secondary pulmonary TB
• fungus ball
• pan-host tumor: Horner syndrome

Question 8

Serum test to suspect sarcoidosis? Findings at chest x-rays?

Answer 8

• serum ACE

- bilateral hilar lymphadenopathy

Question 9

Which are the types of emphysema? Factor associated

Answer 9

• Centriacinar: smoke, pollution

- Panacinar: alfa-1 antitrypsin deficiency

Question 10

Twisted mucus plugs admixed with sloughed epithelium, in what pathology do you see it?

Answer 10

• Curschmann spirals

- asthma sputum cytology

Question 11

What are the Charcot-Leyden crystals?

Answer 11

Seen at sputum cytology in asthma, composed by eosinophil membrane protein

Question 12

Complications of oxygen treatment in respiratory distress syndrome of the newborn

Answer 12

• bronchopulmonary dysplasia

- retrolental fibroplasia (retinopathy of prematurity)

Question 13

Type of asbestos associated with mesothelioma

Answer 13

Amphibole asbestos

Question 14

Most common tumor in asbestos exposed individuals

Answer 14

Bronchogenic carcinoma

Question 15

Type of pneumoconiosis which pathology findings show noncaseating granulomas and fibrosis, hilar lymph node granulomas and systemic granulomas

Answer 15

Berylliosis

Question 16

Common genetic mutations in bronchogenic carcinoma

Answer 16

• L-myc: small cell carcinoma
• K-ras: adenocarcinoma
• p53 and retinoblastoma

Question 17

Uses of Erlotinib (Tarceva). Mechanism of action.

Answer 17

• Tx non-small cell lung cancer, pancreatic cancer, other types which prior chemotherapy failed
• tyrosine kinase inhibitor of EGFR (epidermal growth factor receptor)

Question 18

Paraneoplastic syndrome associated with squamous cell carcinoma

Answer 18

Hypercalcemia secondary to PTH secretion

Question 19

In case of peripheral mass in the lung (seen by chest x-ray or other) what entities you should think and how do you differentiate them?

Answer 19

• adenocarcinoma: Bx ▶️ EM: microvilli short and blunted

- mesothelioma: Bx ▶️ EM: microvilli long and thin

Question 20

Immunohistochemical stain for small-cell lung carcinoma

Answer 20

Chromogranin, neuron-specific enolase, synaptophysin

Question 21

Most common cause of elevated alkaline phosphatase in a asymptomatic individual older than 40

Answer 21

Paget disease

Question 22

Most common cause of congenital hypothyroidism

Answer 22

• structural lesions of the thyroid or pituitary
• hormone synthesis defects
• maternal intake of radioidine during pregnancy