Revision Questions

Question 1

Why is smoking a risk factor for pneumonia?

Answer 1

Reduces mucociliary clearance and pulmonary macrophage function

Question 2

Why is alcohol a risk factor for pneumonia?

Answer 2

Reduces neutrophil function, cough and epiglottic reflexes

Question 3

What changes are seen in the pleural fluid in empyema?

Answer 3

Exudative with neutrophils
Acidic
Low glucose

Question 4

What kind of necrosis creates lung abscesses?

Answer 4

Suppurative

Question 5

What is centriacinar emphysema?

Answer 5

Bronchioles are affected and alveoli are spared
More commonly in upper lobes
Cigarette smokers

Question 6

What is panacinar emphysema?

Answer 6

Acini are uniformly enlarged
Lower lobes
a-1-AT deficiency

Question 7

What is distal acinar emphysema?

Answer 7

Only alveoli are enlarged

Most associated with pneumothorax

Question 8

What is irregular emphysema?

Answer 8

Acinus is irregularly involved
Associated with scarring
Most common but also most are asymptomatic

Question 9

What are the causes of death in COPD?

Answer 9

Respiratory failure
Cor pulmonale
Pneumothorax

Question 10

What effect can the chronic inflammation of the bronchi do to the airway epithelium?

Answer 10

Can cause squamous metaplasia

Question 11

What system is used to stage COPD?

Answer 11

GOLD initiate

Question 12

What are the signs of CO2 retention in COPD?

Answer 12

Warm sweaty palms with dilated veins
Bounding pulse
Chemosis (eye irritation)
Asterixis

Question 13

What are the signs of hyperinflation in COPD?

Answer 13

Barrel shaped chest
Decreased cricosternal distance
Reduced chest expansion
Impalpable apex beat
Hyper-resonant on percussion
Absent cardiac dullness
Liver pushed down

Question 14

Which paraneoplastic syndromes are associated with small cell carcinomas?

Answer 14

Cushing’s; ACTH
Hyponatraemia; SIADH
Cerebellar syndrome
Myasthenic syndrome

Question 15

What paraneoplastic syndrome is associated with squamous cell carcinomas?

Answer 15

Hypercalcaemia; PTHRP, TGFa, IL-1

Question 16

What paraneoplastic syndrome is associated with adenocarcinoma?

Answer 16

Hypertrophic osteoarthropathy

Question 17

What is the treatment for small cell carcinomas?

Answer 17

Chemotherapy and prophylactic cranial irradiation

Question 18

What type of carcinoma can arise near scar tissue?

Answer 18

Adenocarcinoma

Question 19

Where in the lung does adenocarcinoma usually arise?

Answer 19

Peripheral

Question 20

What are the steps in the growth of an adenocarcinoma?

Answer 20

Typical adenomatous hyperplasia
Adenocarcinoma in situ
Invasive adenocarcinoma

Question 21

How does an adenocarcinoma in situ appear on a CT?

Answer 21

Ground glass opacity

Question 22

What marker is an adenocarcinoma positive for?

Answer 22

TTF-1

Question 23

What is an intracellular bridge?

Answer 23

Area of cytoplasm connected to another cell via a desmosome when the cells shrink

Question 24

What are the steps in squamous cell carcinoma?

Answer 24

Squamous metaplasia
Dysplasia
Carcinoma in situ
Invasive squamous cell carcinoma

Question 25

What IHC markers is a squamous cell carcinoma positive for?

Answer 25

CK5/6 and p63

Question 26

What mutations are present in adenocarcinoma?

Answer 26

``` EGFR ALK ROS-1 RET B-RAF ```

Question 27

What are the histiological features of small cell carcinomas?

Answer 27

Scant cytoplasm | Necrosis and mitosis

Question 28

What are the treatments for non-small cell carcinomas?

Answer 28

Surgery Chemo Radio

Question 29

What methods are used to stage non small cell carcinomas?

Answer 29

PET CT | EBUS TBNA

Question 30

What is the ECOG status?

Answer 30

Evaluates how well a patient will withstand treatment

Question 31

What are the signs of SVC obstruction?

Answer 31

Dilated anterior chest veins Distended jugular veins Hoarseness Pemberton's sign

Question 32

What is the name of a paraneoplastic syndrome that can appear in the skin?

Answer 32

Acanthosis nigricans

Question 33

What causes hoarseness in lung cancer?

Answer 33

Laryngeal nerve palsy

Question 34

What are the signs of IPF?

Answer 34

Tachypnoea Finger clubbing Reduced expansion Fine end inspiratory bibasal creps

Question 35

Mikulicz syndrome

Answer 35

Combined inflammation of uvea and paratid gland

Question 36

Lofgren's syndrome

Answer 36

Fever Erythema nodosum Polyarthritis Bihilar lymphadenopathy

Question 37

Upper zone fibrosis

Answer 37

``` Coal workers Histiocytosis Hypersensitivity Ankylating spondylitis Radiation TB Silicosis ```

Question 38

Lower zone fibrosis

Answer 38

``` RA Asbestosis IPF Drugs Scleroderma ```