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Medical Boards February 2013 > XIII - The Lung > Flashcards

XIII - The Lung Flashcards

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USMLE® Step 1 flashcards
1
Q

Loss of lung volume cause by inadequate expansion of airspaces, resulting in shunting of inadequately oxygenated blood from pulmonary arteries into veins.

A

Atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480

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2
Q

Atelectasis which occurs when an obstruction prevents air from reaching distal airways.

A

Resorption atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 480

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3
Q

Atelectasis usually associated with accumulation of fluid, blood, or air within the pleural cavity, which mechanically collapse the adjacent lung.

A

Compression atelectasis (aka passive or relaxation atelectasis)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481

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4
Q

Atelectasis which occurs when either local or generalized fibrotic changes in the lung or pleura hamper expansion and increase elastic recoil during expiration.

A

Contraction or cicatricial atelectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 481

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5
Q

Lungs are dark red, firm, airless and heavy. There is capillary congestion, necrosis of alveolar epithelial cells, interstitial and intra-alveolar edema and hemorrhage and neutrophils in capillaries. Hyaline membrane is also characteristic, lining the alveolar ducts.

A

Acute Respiratory Distress Syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 482

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6
Q

Diffuse pulmonary disease characterized by limitation of airflow, usually resulting from an increase in resistance caused by partial or complete obstruction atvany level.

A

Obstructive pulmonary disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483

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7
Q

Diffuse pulmonary disease characterized by reduced expansion of lung parenchyma accompanied by decreased total lung capacity.

A

Restrictive lung disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483

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8
Q

Lung volumes in obstructive lung disease:FEV1FVCFEV1:FVC ratio

A

FEV1 - decreasedFVC - normal / increasedFEV1:FVC ratio - decreased(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483

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9
Q

Lung volumes in restrictive lung diseaseFEV1FVCFEV1:FVC ratio

A

FEV1 - normal/decreasedFVC - decreasedFEV1:FVC ratio - near normal(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 483

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10
Q

Characterized by abnormal permanent enlargement of the airspaces distal to the terminal bronchioles accompanied by destruction of their walls without obvious fibrosis. There is thinning oof the alveolar walls and loss of elastic tissue.

A

Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485

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11
Q

Type of emphysema involving the central or proximal parts of the acini, formed by respiratory bronchioles, while distal parts are spared. Lungs deep pink and less voluminous, affecting the upper 2/3 of the lungs. Occurs in smokers.

A

Centriacinar (centrilobular) Emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485

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12
Q

Type of emphysema wherein the acini are uniformly enlarged from the level of the respiratory bronchiole to the terminal alveoli. Occurs more commonly in the lower lung zones. Occurs in a-antitrypsin deficiency.

A

Panacinar (panlobular) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 485

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13
Q

Type of emphysema wherein only the distal part is primarily involved. Lesion is adjacent to the pleura along the lobular connective tissue septa and at the lobe margins. More severe at the upper half of the lungs, forming bullae.

A

Distal acinar (paraseptal) emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 486

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14
Q

Barrel-chested, dyspneic, prolonged expiration, sits forward in a hunched-over position, adequate oxygenation of oxygen. “Pink puffers”.

A

COPD predominantly emphysema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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15
Q

History of recurrent infections with purulent sputum, less prominent dyspnea and respiratory drive, becomes hypoxic and are pften cyanotic and obese. “Blue bloaters”.

A

COPD predominantly chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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16
Q

Defined as persistent productive cough for at least 3 consecutive months in at least 2 consecutive years.

A

Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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17
Q

Mucosal lining of the larger airways is usually hyperemic and swollen with edema fluid, often covered by a layer of mucinous or mucopurulent secretions. Trachea and bronchi have enlarged mucus-secreting glands.

A

Chronic bronchitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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18
Q

Characterized by goblet cell metaplasia, mucus plugging, inflammation and fibrosis, and sometimes complete obliteration of the lumen due to fibrosis.

A

Chronic bronchiolitis (small airway disease)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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19
Q

Most important underlying risk factor for chronic bronchitis.

A

Cigarette smoking(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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20
Q

Triad of 1.intermittent and reversible airway obstruction2.chronic bronchial inflammation with eosinophils3.bronchial smooth muscle cell hypertrophy and hyperreactivity

A

Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 489

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21
Q

Collections of crystalloids made up of eosinophil proteins.

A

Charcot-Leyden crystals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492

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22
Q

Whorls of shed epithelium found in mucus plugs.

A

Curschmann spirals(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492

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23
Q

Curshmann spirals and Charcot-Leyden crystals are found histologically in this disease.

A

Asthma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 492

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24
Q

Permanent dilation of bronchi and bronchioles caused by destruction of theuscle and elastic supporting tissue, resulting from chronic necrotizing infections.

A

Bronchiectasis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493

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25
Q

An autosomal recessive disorder frequently associated with bronchiectasis and sterility in males.

A

Kartagener syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 493

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26
Q

Refers to a pulmonary disorder of unknown etiology characterized patchy interstitial fibrosis. Grossly, pleural surfaces of the lung have the appearance of cobblestones because of retraction scars along the interlobular septa.

A

Idiopathic Pulmonary Fibrosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 495

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27
Q

A thrombus that lodges astride a pulmonary artery bifurcation, which causes pulmonary hypertension, which can lead to hypoxia and cor pulmonale.

A

Saddle embolus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 505

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28
Q

Most common symptom of pulmonary embolism.

A

None, asymptomatic 60-80% of the time.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506

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29
Q

Mean pulmonary pressures reach one-fourth or more of systemic pressures.

A

Pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506

30
Q

Encountered in young persons, more commonly in women, marked by fatigue, syncope, dyspnea on exertion, and sometimes chest pain. Cause of increased pulmonary pressures is unknown.

A

Primary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 506

31
Q

Clinical features of this disease reflect the underlying disease, with accentuation of respiratory insufficiency and right-sided heart strain.

A

Secondary pulmonary hypertension(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 507

32
Q

Pneumonia with a patchy distribution of inflammation involving more than one lobe.

A

Bronchopneumonia(TOPNOTCH)

33
Q

Pneumonia with a patchy distribution of inflammation involving more than one lobe.

A

Bronchopneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 509

34
Q

Four stages of pneumococcal pneumonia.

A

Congestion, red hepatization, gray hepatization, resolution(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 510

35
Q

Affected areas are red-blue, congested and subcrepitant. Inflammatory reaction is largely confined within the walls of the alveoli. Septa widened and edematous, with mononuclear infiltrates of lymphocytes, histiocytes and plasma cells. Alveolar spaces are free of cellular exudate.

A

Atypical pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 513

36
Q

A localized area of suppurative necrosis within the pulmonary parenchyma, resulting in the formation of one or more large cavities.

A

Lung abscess(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515

37
Q

Pulmonary abscess resulting from aspiration of infective material are much more common on the left or right side?

A

Right side since it’s shorter and more vertical.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 515

38
Q

Form of tuberculosis that develops in a previously unexposed, unsensitized person.

A

Primary tuberculosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518

39
Q

Implantation of the inhaled M. tuberculosis bacilli in the distal airspaces of the lungs, causes the formation of this 1 - 1.5 cm area of gray-white inflammatory consolidation.

A

Ghon focus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518

40
Q

Ghon focus + nodal involvement = ________

A

Ghon complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518

41
Q

Radiographically detectable calcified Ghon complex.

A

Ranke complex(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 518

42
Q

Pattern of disease that arises in previously sensitized host to M. tuberculosis.

A

Secondary or reactivation TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520

43
Q

Occurs when TB bacilli drain through the lymphtics into lymphatic ducts, which eventually empty into the rightside of the heart and into pulmonary circulation. Individual lesions are small, visible foci of yellow-white consolidation scattered through the parenchyma.

A

Miliary TB(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 520

44
Q

The most frequent form of extrapulmonary TB.

A

TB Lymphadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521

45
Q

TB lymphadenitis of the cervical LN.

A

Scrofula(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 521

46
Q

Round to oval small yeast forms measuring 2-5 um in diameter.

A

Histoplasma capsulatum(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523

47
Q

Thick walled non-budding spherules 20-60 um diameter, often filled with small endospores.

A

Coccidiodomycosis immitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523

48
Q

Round to oval and larger fungi, which reproduce by broad-based budding.

A

Blastomycosis dermatitidis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 523

49
Q

Cells infected by this virus exhibit gigantism of the cell and nucleus. An enlarged inclusion surrounded by a clear halo “owl’s eye” is seen. It is the most common opportunistic viral pathogen in AIDS.

A

Cytomegalovirus (CMV)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 524

50
Q

Opportunistic infection of the lungs having a characteristic intra-alveolar foamy, pink-staining exudate “cotton candy exudate”, with thickened septa and mononuclear infiltrate.

A

Pneumocystis carinii pneumonia(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526

51
Q

Most frequent disease-causing fungus.

A

Candida albicans(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 526

52
Q

The fungus is a 5-10 um yeast, has a thick, gelatinous capsule and reproduces by budding. Most likely acquired through bird droppings. Visualized by India ink or Giemsa stain.

A

Cryptococcus neoformans(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 527

53
Q

Which type of lung cancer is treated by chemotherapy only? Why?

A

Small cell lung carcinomaIt is an aggressive tumor which usually have metastasized at the time of diagnosis.(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 529

54
Q

Lung carcinoma best treated with surgery since they respond poorly to chemotherapy.

A

Non-small cell lung carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 529

55
Q

Types of lung cancer with strongest association with tobacco exposure.

A

Squamous cell carcinomaSmall-cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 530

56
Q

Lung cancer which are peripherally located, most common type of lung cancer in women and nonsmokers. Grows slowly and metastasize early. Assumes a variety of forms, incliding acinar, papillary and solid types.

A

Adenocarcinoma(TOPNOTCH)

57
Q

Lung cancer which are peripherally located, most common type of lung cancer in women and nonsmokers. Grows slowly and metastasize early. Assumes a variety of forms, incliding acinar, papillary and solid types.

A

Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 531

58
Q

Lung carcinoma which typically have large, prominent nucleoli, and a moderate amount of cytoplasm, with minimal glandular or squamous differentiation.

A

Large-cell carcinoma(TOPNOTCH)

59
Q

Lung carcinoma which typically have large, prominent nucleoli, and a moderate amount of cytoplasm, with minimal glandular or squamous differentiation.

A

Large-cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 531

60
Q

Lung carcinoma which appear as pale gray, centrally located masses. Nests and cords of polygonal cells with scant cytoplasm, granular chromatin and inconspicuous nuclei. FNAB shows nuclear molding of adjacent cells. Associated with several paraneoplastic syndromes.

A

Small cell lung carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532

61
Q

Other name for small cell lung carcinoma.

A

Oat cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532

62
Q

Paraneoplastic syndromes associated with oat cell carcinoma.

A

Cushing syndromeSIADH Lambert-Eaton myasthenic syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532

63
Q

Hypercalcemia due to excessive production of PTH related protein is usually seen in patients with this type of lung carcinoma.

A

Squamous cell carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 532

64
Q

Form of lung cancer that is thought to arise from neuroendocrine cells, called Kulchitsky cells, that line the bronchial mucosa and resemble intestinal carcinoids. Nests of small, rounded, uniform cells with “salt and pepper” chromatin.

A

Bronchial carcinoids(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 534

65
Q

Presence of fluid in the pleural space.

A

Pleural effusion(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535

66
Q

Air or other gas in the pleural sac.

A

Pneumothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535

67
Q

A collection of whole blood in the pleural cavity.

A

Hemothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535

68
Q

A pleural collection of a milky lymphatic fluid containing microglobules of lipid.

A

Chylothorax(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 535

69
Q

A rare cancer seen in patients who work in shipyards, miners and insulators. Lesion is preceeded by extensive pleural fibrosis and plaque formation. May be epithelial, sarcomatoid or biphasic in morphology.

A

Malignant mesothelioma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 536

70
Q

Rare neoplasm with strong links to EBV and high frequency among the Chinese population. Characterized by large epithelial cells having indistinct borders (syncitial growth) and prominent eosinophilic nucleoli.

A

Nasopharyngeal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537

71
Q

Smoothe, hemispherical protrusions located on the true vocal cords, composed of fibrous tissue and covered by stratified squamous mucosa.

A

Vocal cord nodules(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537

72
Q

A benign neoplasm usually on the true vocal cords that forms a soft, raspberry-like excresence rarely more then 1 cm in diameter. Consists of multiple, slender, finger-like projections.

A

Laryngeal papilloma(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 537

Medical Boards February 2013 (24 decks)

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