Week 4

Question 1

Which of the following is likely the least contributive cause of airflow obstruction in COPD?

1. Loss of tethering of airways due to emphysema
2. Remodeling of the small airways increasing their tendency to collapse
3. Increased mucus secretion which decreases the internal airway caliber and causes plugging
4. Noxious stimuli from cigarette smoke

Answer 1

SM 182a: COPD - #2. Describe the development of COPD

D – Most heavy smokers do not develop clinically apparent COPD (rather publicize that 1 in 3 heavy smokers die from their habit!). Why? The answer is not known, but a leading hypothesis is that patients who develop COPD do so because of a genetic predisposition. And so you need the noxious stimulus and a susceptible host to get the disease.

Question 2

Which of the following describes primary TB?

1. Lower lobe infiltrate
2. More common in adolescents
3. Fever, night sweats, and weight loss
4. Cavitary lesion on chest X-ray

Answer 2

SM 183a: Tuberculosis - #2. Distinguish the clinical and radiographic features of primary and reactivation pulmonary tuberculosis

A - Primary: more common in young children, elderly, and immunosuppressed hosts; presents as lower or middle lobe infiltrates, often with hilar or mediastinal adenopathy

Reactivation: typical in adolescents and adults; presents with several weeks of malaise, fever, sweats, weight loss, cough; chest x-ray shows apical posterior infiltrates – often cavitary.

Question 3

Skin abscesses are caused by which of the following mycobacterial species?

1. M. avium
2. M. kansasii
3. M. marinum
4. M. tuberculosis

Answer 3

SM 183a: Nontuberculous Mycobacterial and Fungal Pneumonias – #4. Explain the potential for extra-pulmonary infection with NTM, in particular, disseminated M. avium complex infection in the setting of advanced HIV/AIDS and cutaneous infection with M. marinum, M. chelonae-abscessus, and M. fortuitum

C

Question 4

An infant presents to you with a few days of wheezing, cough, and fever. The baby’s mother brings her in because her diaper was stained red. The likely cause of this baby’s condition is:

1. Influenza
2. Adenovirus
3. Respiratory Syncytial Virus
4. Coronavirus

Answer 4

SM 184a: Respiratory Viral Infections - #3. Describe the clinical manifestation of disease caused by viral respiratory pathogens

B – hemorrhagic cystitis with viral respiratory symptoms = adenovirus

Question 5

Which interleukin plays a critical role in promoting host defense against TB?

1. IL-10
2. IL-4
3. IL-12
4. IL-1

Answer 5

SM 185a: Advances in screening tests for TB - #1. Explain the importance of the IL12-IFNgamma axis in controlling mycobacterial infections

C - Interferon-Gamma Release Assays (IGRA): The IL12-IFNγ signaling axis (which regulates the CD4-Th1 response) plays a critical role in promoting host defense against mycobacterial infections. Consequently, patients with molecular defects affecting this signaling pathway display enhanced susceptibility to mycobacterial infections [Mendelian Susceptibility to Mycobacterial Diseases (MSMD)]. This fact also guides the conceptual framework underpinning the development of the IGRA

Question 6

Epiglottitis should indicate what bacterial etiology?

1. S. pyogenes
2. S. pneumonia
3. H. influenza
4. C. diphtheriae

Answer 6

SM 186a: Respiratory Bacterial Pathogens - #3. Describe the disease manifestations caused by bacteria that cause respiratory infections as well as tests and therapies used to diagnose and treat them

C – S. pyogenes = Pharyngitis, S. pneumonia = otitis media, acute sinusitis, acute bronchitis, C. diphtheriae = pharyngitis

Question 7

Non-small cell lung cancer is characterized by being:

1. Found in smokers
2. Central
3. The most common
4. Neuroendocrine

Answer 7

SM 187a: Lung Cancer - #2. Understand key differences in biology and pathology for Non-small Cell Lung Cancer (NSCLC) versus Small Cell Lung Cancer (SCLC). Cell features and clinical presentations

C – all the rest describe small cell

Question 8

The more severe symptoms of allergic rhinitis are best treated with?

1. OTC antihistamines
2. Subcutaneous immunotherapy
3. Intranasal steroids
4. Sublingual immunotherapy

Answer 8

SM 188a: Allergic Rhinitis Sinusitis - #3. Explain the treatment for allergic rhinitis

C – intranasal steroids. OTC antihistamines for less severe rhinitis. Subcutaneous and sublingual immunotherapies are for reducing sensitivity to specific aeroallergens but are not the best treatment for presenting allergic rhinitis.