Robbins Lungs

Question 1

6. Figure shows red infarct typical of

Answer 1

pulmonary thromboembolism, usually with pelvic or leg veins affected by phlebothrombosis being the source; bronchial artery supply of blood can produce HEMORRHAGE, but not enough for infarction, hence the RED INFARCT!!

Question 2

8. Solitary fibrous tumor is

Answer 2

localized benign mesothelioma; in pleura, it’s a rare neoplasm appearing as a pedunculated mass that has no relationship to asbestos exposure or other environmental pathogens

Question 3

13. Pulmonary alveolar proteinosis (PAP) with

Answer 3

autoantibodies against granulocyte-macrophage CSF; impaired surfactant clearance by alveolar macrophages in this case

Question 4

15. ARDS characterized by

Answer 4

diffuse alveolar damage, which is initiated in most cases by injury to capillary endothelium by neutrophils and macrophages; leukocytes aggregate in alveolar capillaries and release toxic oxygen metabolites, cytokines, and eicosanoids; damage to the capillary endothelium allows leakage of protein-rich fluids

Question 5

16. Goodpasture syndrome shows

Answer 5

renal and pulmonary lesions produced by Ab directed against Ag common to basement membrane in alveolus and glomerulus

Question 6

20. This patient has

Answer 6

“farmer’s lung,” a form of hypersens pneumonitis caused by inhalation of actinomycete spores; spores contain the Ag that incites the hypersens reaction, and disease abates when the patient is no longer exposed to the Ag

Question 7

21. Distal acinar (paraseptal) emphysema is

Answer 7

localized, beneath pleura typically in an upper lung lobe, and may occur in an area of fibrosis or scar formation; they are prone to rupture with minor trauma, leading to pneumothorax (can cause spontaneous pneumothorax in young adults)

Question 8

22. Localized atelectasis can result from

Answer 8

complete obstruction of a bronchus, and this leads to resorption of air as well

Question 9

23. Most paraneoplastic syndromes involve ____ carcinomas, but

Answer 9

small-cell anaplastic carcinomas; hypercalcemia is an excpetion and is caused by squamous cell carcinoma

Question 10

24. Patient with a small cell anaplastic (oat cell) carcinoma of lung, producing

Answer 10

a paraneoplastic syndrome with syndrome of inappropriate secretion of ADH (masses tend to be central and associated strongly with smoking)

Question 11

30. Changes associated with pulmonary HTN characteristic of

Answer 11

restrictive and obstructive lung diseases; explains occurrence of cor pulmonale and right CHF in patients with COPD or pneumoconiosis; pulmonary vascular bed reduced to increase pulmonary arterial pressure

Question 12

31. In bronchiectasis,

Answer 12

irreversible dilation of bronchi results from inflamm and destruction of bronchial walls after prolonged infections or obstruction; serious bouts of pneumonia can predispose to bronchiectasis

Question 13

32. Resorption atelectasis most often the result of; compression (relaxation) atelectasis is; microatelectasis is;; contraction atelectasis is

Answer 13

mucous or mucopurulent plug obstructing a bronchus (can occur postop or complicate bronchial asthma);
accumulation of air or fluid in pleural cavity (pneumothorax);
post-op, DAD, respiratory distress of newborn from loss of surfactant;
fibrous scar tissue surrounding the lung

Question 14

33. Chylothorax can emerge as a result of

Answer 14

1. disruption of the thoracic duct in the posterior chest

2. malignant neoplasm (high-grade non-Hodgkin lymphoma)

Question 15

39. Centrilobular emphysema results from

Answer 15

damage to central or proximal part of the lung acinus, with dilation that primarily affects the respiratory bronchioles; relative sparing of the DISTAL acinar structures (like alveolar ducts and alveolar sacs)

Question 16

42. The progressive pulmonary interstitial fibrosis of a _______ like pneumoconiosis can lead to

Answer 16

restrictive lung disease;

dilation of remaining airspaces, giving a honeycome appaerance

Question 17

48. Asbestosis gives rise to

Answer 17

pleural fibrosis and interstitial lung disease, similar to other pneumoconioses; seen grossly as a DENSE PLEURAL PLAQUE, which is often calcified

Question 18

58. Patient has hypersens pneumonitis, characterized by

Answer 18

interstitial mononuclear infiltrates; can be “farmer’s lung” with inhalation of actinomycetes in moldy hay, and it’s mainly a type III hypersens reaction;
in the long run, could get type IV hypersens with granulomatous inflamm

Question 19

60. Patient with SARS, caused by a strain of

Answer 19

coronavirus!!

Question 20

61. Idiopathic pulmonary fibrosis leads to

Answer 20

progressive restrictive lung disease; an unknown Ag incites the TH2 inflamm process with activated macrophage release of cytokines like FGF and TGF-beta1

Question 21

63. Desquamative interstitial pneumonitis

Answer 21

is one form of smoking-related interstitial lung disease; most cases abate with cessation of smoking and corticosteroid therapy