Uworld Path/pathophysio Pulm

Question 1

Because sound vibrations travel faster and more efficiently through liquids than through gases, alveolar filling processes such as lobar consolidation (alveoli filled with pus) and pulmonary edema (alveoli filled with transudate) create increased breath sound intensity and ——- tactile fremitus

Answer 1

increased

Question 2

Fluid in the pleural space acts to insulate sound vibrations that originate in the airways; therefore, pleural effusion causes —— tactile fremitus and —— intensity of breath sounds. The high density of pleural fluid compared to normal lung tissue also causes dullness to percussion.

Answer 2

decreased

Question 3

Prone positioning may be used to improve arterial oxygenation in patients with severe acute respiratory distress syndrome. The improvement likely results from reduced compression of the —-lung segments, where the majority of alveoli are located. This leads to more evenly distributed ventilation throughout the lungs with reduced intrapulmonary shunting and improved ventilation-perfusion matching.

Answer 3

posterior

Question 4

Pneumothorax is recognized on chest x-ray by a continuous line without lung markings peripheral to it. —– tactile fremitus, —– breath sound intensity, and hyperresonance to percussion are expected on physical examination.

Answer 4

Decreased

Question 5

Hereditary —– presents with mucocutaneous telangiectasias, epistaxis, and visceral arteriovenous malformations (AVMs) (eg, liver, lung, brain). Lung involvement includes pulmonary AVMs (eg, digital clubbing, platypnea) and pulmonary hypertension (eg, a loud P2) due to high-output heart failure from underlying systemic AVMs.

Answer 5

hemorrhagic telangiectasia

Question 6

Hypersensitivity —–involves an exaggerated immunologic response to an inhaled antigen and can have an acute or chronic presentation. Chronic disease presents with gradually progressive cough, dyspnea, fatigue, and weight loss, and lung biopsy reveals lymphocytic infiltrate, poorly formed noncaseating granulomas, and septal fibrosis.

Answer 6

pneumonitis

Question 7

62yr old patient with chronic progressive dyspnea, nonproductive cough, digital clubbing, and inspiratory crackles are concerning for interstitial lung disease. CT reveals peripheral reticular infiltrates (ie, thickened, linear interstitial markings) with subpleural honeycombing (ie, multiple cystic spaces with irregularly thickened walls), which strongly suggests idiopathic pulmonary fibrosis (IPF). IPF is a chronic, fibrosing interstitial pneumonia that is histologically defined by foci of fibroblast proliferation and dense collagen deposition intermixed with unaffected lung (ie, usual interstitial pneumonia pattern)

BM abnormal

type 1 pnumocytes, type 2. are increased or decreased

Answer 7

ecreased type 1

increased type 2

Question 8

The lungs are supplied by dual circulation from both the pulmonary and bronchial arteries. This —- circulation can help protect against lung infarction due to pulmonary artery occlusion (ie, pulmonary embolism), as the bronchial circulation can continue to provide blood to the lung parenchyma.

Answer 8

collateral

Question 9

Chronic rejection is a major problem in lung transplant recipients; it affects small airways, causing bronchiolitis obliterans. It is characterized by —– inflammation, fibrosis, and, ultimately, destruction of the bronchioles.

Answer 9

lymphocytic

Question 10

Infection is a leading cause of death in lung transplant recipients. —–virus causes the most significant opportunistic infection in transplant recipients. Infected cells have a characteristic intranuclear inclusion surrounded by a clear halo (owl’s eye inclusion).

Answer 10

Cytomegalovirus

Question 11

——- carcinoma is the most common malignancy associated with asbestos exposure

Answer 11

Bronchogenic