Pulmonary Pathology 10/31/08
Leah Olsen is 29 y.o. today - prime
1. This type of cell is rounded, granular and secretes surfactant. a. Type I pneumocytes which cover over 90% of the alveolar surface b. Type II pneumocytes which multiply when there’s tissue damage c. Type I pneumocytes which get bigger when there’s tissue damage d. Mast cells which are present with macrophages at all times 2. This condition is most often secondary to space occupying lesions in the uterus: a. COPD b. Pulmonary hypoplasia c. Congenital tracheal stenosis d. Neonatal Respiratory Distress Syndrome 3. The most common cause of NRDS is: a. Head injury during delivery b. Excessive studying c. Hyaline membrane disease d. Over-sedation of the mother 4. A deficiency of pulmonary surfactant will cause: a. ARDS b. Asthma c. Emphysema d. Pneumoconiosis 5. Noncardiogenic pulmonary edema is due to: a. Cor pulmonale b. Strep pneumonea c. Orthopenia d. Injury to the parenchyma 6. Failure of this will lead to acute pulmonary edema: a. Kidney b. Liver c. Left ventricle d. Lymphatics 7. Which of the following does not cause pulmonary edema? a. Streptococcal erysipelas b. Climbing up a mountain c. Having a seizure and aspirating gastric contents d. Inhaling smoke
8. When pulmonary edema goes on for a long time, a. Hyaline cartilage lines the alveoli b. Macrophages phagositize iron c. Alveolar walls increase elasticity as they begin breaking down d. Both b and c 9. A detached mass that’s floating this way and that in the blood stream is a(n): a. Embolism b. Amniotic fluid bolus c. Scab d. All of the above 10. Most thromboemboli: a. Get stuck in the large and intermediate pulmonary veins b. Are in the lower lobes c. Prevent ventilation d. All of the above 11. Virchow’s Triad: a. Is the relationship between asthma, allergies and eczema b. Includes the presence of Leiden V Factor c. Includes 3 factors predisposing a person to COPD d. Will often follow an augmented fifth 12. Which of the following is a cause for hypercoagulability, which could result in pulmonary emboli? a. Polycythemia vera b. Pyelonephritis c. Oral contraceptives d. All of the above 13. If you have an embolism and a pre-existing heart condition, you are most likely not to have a good day. a. True b. False 14. What is a saddle embolus? a. A fatty embolus found in the bronchial tree b. A breeding ground for anaerobic organisms c. A clot from the femoral artery d. A large clot that straddles the bifurcation of the pulmonary arteries. 15. Billy Bob, breaks his leg. You get out your magnifying glass and see that he: a. Is at risk for a fatty embolism b. Is at risk for ARDS c. Is at risk for an enema
d. Both a and b 16. Most pulmonary emboli will end in pulmonary infarction: a. True b. False 17. Late one night you stay at the office to inspect your extra organs. You find a lung with a pie shaped black section on the lower lobe. You suspect: a. Popcorn pneumoconiosis b. Pneumocystis pneumonia c. Coal worker’s pneumoconiosis d. Pulmonary infarction 18. Adult Respiratory Distress Syndrome: a. Can happen as a result of a grown up getting hit in the chest from a flying chicken going 30 mph. b. Is a result of a genetic defect that finally overcomes the body’s natural defenses. c. Is caused by damage to the Type II cells preventing alveoli from opening d. Both a and c 19. Which of the following is a reversible disorder? a. Silicosis b. Atelectasis c. COPD d. IPF
20. Primary pulmonary hypertension: a. Creates cellular damage that encourages migration of smooth muscle to the large and medium pulmonary arteries. b. Encourage NO production c. Can encourage enlargement of the left ventricle d. Can lead to ARDS 21. Smokers cough in the morning is attributed to: a. Macrophages within the alveoli release cytokines with the cortisol spike b. Cilia are regaining function after not smoking all night c. Chronic pneumonitis d. Pneumocystitis carinii 22. Your patient comes in with a fever, cough, stabbing chest pain and green-yellow sputum. Your diagnosis would be: a. A viral infection due to the sputum color b. A bacterial infection due to the sputum color c. A viral infection due to the fever and chest pain
d. I can’t tell – it’s just pneumonia for God’s sake. 23. ( lobar pneumonia / bronchopneumonia) has 4 stages and they go in this order: a. Congestion, grey hepatization, black hepatization, death b. Congestion, red hepatization, grey hepatization, resolution c. Congestion, grey hepatization, red hepatization, resolution d. Infection, fibrinous and suppurative exudates, neutrophils and fibrin filling, resolution Bug & Pneumonia matching: 24. Bacterial 25. Community-acquired atypical 26. Viral Adults 27. Most Kids Pneumonia 28. Nosocomial 29. Aspiration 30. Immunocompromised a. b. c. d. e. f. g. h. Gram – Rods; Klebsiella, Pseudomonas, Ecoli and staph Staph, strep H influenza and anaerobes like Bacteriodes ssp. Respiratory syncytial virus Pneumocytstis carinii, Coccidiomycosis H. influenzae, Legionella, Klebsiella, Strep. Pneumo Mycoplasma pneumoniae, Chlamydia Gonorrhea Influenza A and Chicken pox
31. Onion skinned granulomas in the upper lobes could be due to: a. RSV b. Histoplasmosis c. Sarcoidosis d. emphysema 32. The most common cause of pneumonia is: a. TB b. Strep. pneumoniae c. Staph. Aureas d. Pseudomonas Aeruginosa
33. Honeycomb auto immune disorder: _______________________
1. This type of cell is rounded, granular and secretes surfactant. a. Type I pneumocytes which cover over 90% of the alveolar surface b. Type II pneumocytes which multiply when there’s tissue damage c. Type I pneumocytes which get bigger when there’s tissue damage d. Mast cells which are present with macrophages at all times 2. This condition is most often secondary to space occupying lesions in the uterus: a. COPD b. Pulmonary hypoplasia c. Congenital tracheal stenosis d. Neonatal Respiratory Distress Syndrome 3. The most common cause of NRDS is: a. Head injury during delivery b. Excessive studying c. Hyaline membrane disease d. Over-sedation of the mother 4. A deficiency of pulmonary surfactant will cause: a. ARDS b. Asthma c. Emphysema d. Pneumoconiosis 5. Noncardiogenic pulmonary edema is due to: a. Cor pulmonale b. Strep pneumonea c. Orthopenia d. Injury to the parenchyma 6. Failure of this will lead to acute pulmonary edema: a. Kidney b. Liver c. Left ventricle d. Lymphatics 7. Which of the following does not cause pulmonary edema? a. Streptococcal erysipelas b. Climbing up a mountain c. Having a seizure and aspirating gastric contents d. Inhaling smoke 8. When pulmonary edema goes on for a long time, a. Hyaline cartilage lines the alveoli b. Macrophages phagositize iron
c. Alveolar walls increase elasticity as they begin breaking down d. Both b and c 9. A detached mass that’s floating this way and that in the blood stream is a(n): a. Embolism b. Amniotic fluid bolus c. Scab d. All of the above 10. Most thromboemboli: a. Get stuck in the large and intermediate pulmonary veins b. Are in the lower lobes c. Prevent ventilation d. All of the above 11. Virchow’s Triad: a. Is the relationship between asthma, allergies and eczema b. Includes the presence of Leiden V Factor c. Includes 3 factors predisposing a person to COPD d. Will often follow an augmented fifth 12. Which of the following is a cause for hypercoagulability, which could result in pulmonary emboli? a. Polycythemia vera b. Pyelonephritis c. Oral contraceptives d. All of the above 13. If you have an embolism and a pre-existing heart condition, you are most likely not to have a good day. a. True b. False 14. What is a saddle embolus? a. A fatty embolus found in the bronchial tree b. A breeding ground for anaerobic organisms c. A clot from the femoral artery d. A large clot that straddles the bifurcation of the pulmonary arteries. 15. Billy Bob, breaks his leg. You get out your magnifying glass and see that he: a. Is at risk for a fatty embolism b. Is at risk for ARDS c. Is at risk for an enema d. Both a and b 16. Most pulmonary emboli will end in pulmonary infarction:
a. True b. False 17. Late one night you stay at the office to inspect your extra organs. You find a lung with a pie shaped black section on the lower lobe. You suspect: a. Popcorn pneumoconiosis b. Pneumocystis pneumonia c. Coal worker’s pneumoconiosis d. Pulmonary infarction 18. Adult Respiratory Distress Syndrome: a. Can happen as a result of a grown up getting hit in the chest from a flying chicken going 30 mph. b. Is a result of a genetic defect that finally overcomes the body’s natural defenses. c. Is caused by damage to the Type II cells preventing alveoli from opening d. Both a and c 19. Which of the following is a reversible disorder? a. Silicosis b. Atelectasis c. COPD d. IPF 20. Primary pulmonary hypertension: a. Creates cellular damage that encourages migration of smooth muscle to the large and medium pulmonary arteries. b. Encourage NO production c. Can encourage enlargement of the left ventricle d. Can lead to ARDS 21. Smokers cough in the morning is attributed to: a. Macrophages within the alveoli release cytokines with the cortisol spike b. Cilia are regaining function after not smoking all night c. Chronic pneumonitis d. Pneumocystitis carinii 22. Your patient comes in with a fever, cough, stabbing chest pain and green-yellow sputum. Your diagnosis would be: a. A viral infection due to the sputum color b. A bacterial infection due to the sputum color c. A viral infection due to the fever and chest pain d. I can’t tell – it’s just pneumonia for God’s sake. 23. ( lobar pneumonia / bronchopneumonia) has 4 stages and they go in this order: a. Congestion, grey hepatization, black hepatization, death
b. Congestion, red hepatization, grey hepatization, resolution c. Congestion, grey hepatization, red hepatization, resolution d. Infection, fibrinous and suppurative exudates, neutrophils and fibrin filling, resolution Bug & Pneumonia matching: 24. 25. 26. 27. 28. 29. 30. Bacterial Community-acquired atypical Viral Adults Most Kids Pneumonia Nosocomial Aspiration Immunocompromised a. b. c. d. e. f. g. h. Gram – Rods; Klebsiella, Pseudomonas, Ecoli and staph Staph, strep H influenza and anaerobes like Bacteriodes ssp. Respiratory syncytial virus Pneumocytstis carinii, Coccidiomycosis H. influenzae, Legionella, Klebsiella, Strep. Pneumo Mycoplasma pneumoniae, Chlamydia Gonorrhea Influenza A and Chicken pox
31. Onion skinned granulomas in the upper lobes could be due to: a. RSV b. Histoplasmosis c. Sarcoidosis d. emphysema 32. The most common cause of pneumonia is: a. TB b. Strep. pneumoniae c. Staph. Aureas d. Pseudomonas Aeruginosa
33. Honeycomb auto-immune disorder: _______________________
Heart failure cells – hemosiderin laden macrophages in pulmonary edema & heart failure ARDS – diffuse infiltrates on x ray`