Respiratory Pathology

Question 1

Hemoptysis in a 60 yr old patient who is a smoker is likely a symptom of…..

Answer 1

lung cancer

Question 2

What is the most common cause of bacterial sinusitis?

Answer 2

S. pneumoniae

Question 3

What is the most important pathogenic feature that causes sinusitis?

Answer 3

mucosal edema and block of mucous draining

Question 4

Pain over the cheek upon tapping is most likely a symptom of….

Answer 4

sinusitis

Question 5

Test to confirm strep throat

Answer 5

rapid strep test

Question 6

Most common cause of typical community acquired pneumonia

Answer 6

S. pneumoniae

Question 7

Where is inflammation most localized in typical community acquired pneumonia?

Answer 7

alveoli

Question 8

Where is inflammation most localized in atypical community acquired pneumonia?

Answer 8

interstitium

Question 9

Why does Mycobacterium live comfortably in macrophages?

Answer 9

inhibits fusion of phagosomes with lysosomes, preventing destruction by lysosomal enzymes

Question 10

Ghon Complex

Answer 10

caseous necrosis in periphery and hilar lymph nodes

in primary TB

Question 11

Difference b/t primary and secondary TB

Answer 11

1- airborne, resolves or remains latent

2- originates from a latent primary site

Question 12

How does TB affect the eye?

Answer 12

causes uveitis or retinitis

Question 13

What are symptoms of influenza?

Answer 13

high fever, runny nose, sore throat, muscle/ joint pain, headache, coughing, tired
pain with eye mvmt

Question 14

Who should get a flu vaccine?

Answer 14

everyone

mandatory after age 65 and in ppl with chronic illness

Question 15

COPD

Answer 15

progressive, irreversible obstruction to airflow out of lungs

Question 16

Main cause of COPD

Answer 16

smoking

Question 17

Mechanism of COPD

Answer 17

chronic inflammation leads to destruction of elastic fibers which keep airways open
bronchioles collapse during exhalation
increases pressure and destroys normal alveolar structure

Question 18

Asthma

Answer 18

episodic and reversible airway disease of bronchi

Question 19

Mechanism of Asthma

Answer 19

abnormal bronchiolar mm contraction as reaction to histamine
S1- inhaled allergens come in contact with lung macrophages which triggers IgE production
S2- second exposure IgE react w/ receptor on mastocyte that releases histamine

Question 20

Most common origin of emboli

Answer 20

deep veins of lower extremities and pelvis

Question 21

Difference between thrombus and embolus

Answer 21

embolus is a detached thrombus

Question 22

Pathogenesis of cor pulmonale

Answer 22

increased pressure in pulmonary arteries- increased pressure in R ventricle- ventricle hypertrophies- ventricle decompensates and dilates- R heart failure

Question 23

Difference between hydrostatic and oncotic pressure

Answer 23

H- pressure blood exerts on blood vessel walls. determined by work of heart and vessel tone
O- pressure plasma proteins create

Question 24

Where does plasma that leaks through walls of pulmonary capillaries end up?

Answer 24

alveoli- drowning

Question 25

What causes interstitial fibrosis?

Answer 25

Chronic inflammation

Question 26

Result of insterstitial fibrosis

Answer 26

lung cannot expand fully

difficulties and decreased breathing

Question 27

How do pulmonary vessels react to hypoventilation?

Answer 27

contract

Question 28

Result of hypoventilation

Answer 28

pulmonary hypertension- cor pulmonale- right heart failure

Question 29

What diagnosis would you expect in a 35 yr old AA woman with uveitis, mild dyspnea, redish skin nodules?

Answer 29

sarcoidosis

Question 30

What are the earliest symptoms of lung cancer?

Answer 30

cough
weight loss
hemoptysis

Question 31

What types of lung cancers are there? Which are strongly connected with smoking?

Answer 31

Smoking- small cell carcinoma, squamous cell

non- adenocarcinoma

Question 32

Oncogene

Answer 32

mutated genes that normally determine cell survival and division
determine uncontrolled cellular division which can cause tumor cells

Question 33

Suppressor Gene

Answer 33

normally triggers apoptosis

mutation causes cell to become “immortal”- tumor

Question 34

Horner’s Syndrome

Answer 34

ptosis, miosis, anhydrosis
compression and destruction of symp nerves innervating eye
norm from tumor originating from apex of lung

Question 35

What causes ptosis in Horner’s Syndrome?

Answer 35

Mueller’s Muscle in upper lid is innervated by symp fibers