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Pulmonary Pathology
Exam III
61
Pathology
Professional
03/15/2013

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Term
a patient presents with coryza "runny nose", sneezing, nasal congestion, and mild sore throat, diagnoses with common cold, which of the following associate with?
Definition
Adenoviruses
Term
Patient presents with allergic rhinitis, which of the following associate with symptom?
Definition
IgE type I immune reaction involving mucosal and submucosal mast cells and characterized by increased eosinophils in peripheral blood and nasal discharge
Term
Patients present with fever, allergic rhinitis, and injury to mucosal cilia, diagnosis with acute rhinitis, which of the organism is associate with the problem?
Definition
Strept, staph, Haemophilus Influenzae
Term
Which of the disorder associate with inflammation of the paranasal sinuses often caused by extension of nasal cavity or dental infection, or results in obstructed drainage outlets from the sinuses, leading to an accumulaton of mucoid secretions or exudate?
Definition
Sinusitis
Term
WHich of the following disorders associate with acute inflammation characterized by inflammation and edema of the vocal cords, with resultant hoarseness?
Definition
Laryngitis
Term
Which of the organism associate with acute epiglosttis and may be life threatening in young children?
Definition
H. influenza
Term
Which of the following associate with acute laryngotracheobronchitis, mostly is life-threatening in infants?
Definition
most often caused by viral infeciton
Harch cough and inspiratory stridor
Term
Which of the following associate with nasopharyngeal carcinoma?
Definition
most common in Southeast Asia and East Africa
Caused by the Epstein-Barr virus
Term
Which of the following associate with squamous cell carcinoma?
Definition
the most frequently occuring malignant nasal tumor
Term
Which of the following associate with Singer's nodule?
Definition
a small, benign laryngeal polyp, usually induced by chronic irritation, such as excessive use of the voice, and is associated most commonly with heavy cigarette smoking
usually localized to the true local cords.
Term
Which of the following associate with Laryngeal papilloma?
Definition
a benign neoplasm usually located on the true vocal cords
occurs singly and sometimes undergoes malignant change
In children caused by papillomavirus.
Benign but often recur after resection
Term
Which of the following associate with squamous cell carcinoma?
Definition
most common malignant laryngeal tumor
seen in men older than 40 years old
often associated with the combination of cigarette smoking and alcoholism
Persistent hoarsness
Term
Which of the following associate with glottic carcinoma?
Definition
malignant-arises from the true vocal cords, the most common laryngeal carcinoma and has the best prognosis
Term
WHich of the following associate with supraglottic and subglottic carcinoma?
Definition
are less common and have a poorer prognosis
Term
Which of the following associate with acquired atelectasis?
Definition
alveolar collapse caused by bronchial obstruction or external compression of lung parenchymal by tumors or by fleural accumulation of fluid
Term
which of the following associate with primary atelectasis neonatorum?
Definition
Associated with prematurity and intrauturine fetal anoxia
Term
Which of the following associate with secondary atelectasis?
Definition
Collapse of previously aerated bronchi
Term
Which of the following associate with Diffuse Alveolar Damage (DAD)?
Definition
cause by severe hypovolemic shock
inhalation of toxic gases, including oxygen therapy
sepsis (gm-)
acute pancreatitis, fat membolism, DIC
Acute diffuse alveolar damage: necrosis of type I pneumocytes
Exudation of protein rich fluid into the alveoli;pulmonary edema, hemorrhage, and hyaline membranes
Recovery associate with hyperplasia of type II pneumocytes and interstitial fibrosis
Term
What associate with Chronic obstructive pulmonary disease?
Definition
airflow obstruction
Increased compliance; Decreased elastic recoil
Lead to decrease FEV1 and increase FVC, lead to decrease FEV1/FVC
Term
What associate with Restrictive Lung Disease?
Definition
Decreased Compliance, increased elastic recoil
Lead to FEV1 and FVC are both decreased, resulting in normal FEV1:FVC ration
Term
Which of the following associate Bronchial Asthma (COPD) extrinsic?
Definition
Type I hypersensitivity response involving IgE bound to mast cells
begins in childhood, usually in patients with a family history of allergy
Term
WHich of the following associate with COPD bronchial asthma intrinsic?
Definition
associated with chronic bronchitis results from exercise or cold-induced asthma

not associated with a history of allergy
Term
What are the characteristics of Bronchial Asthma?
Definition
manifest morphologically by:
bronchial smooth muscle hypertrophy
hyperplasia of goblet cells
thickening and hyalinizaiton of basement membranes

Proliferation of eosinophils
Whorl-like cells: Curschmann spirals
Crystalloids of eosinophi-derived proteins Charcot-leyden crytals
Term
What are the complications of Asthma?
Definition
May Lead to Status asthmaticus, a prolonged about bronchial asthma that can result in death
Term
Which of the following associate with Chronic Bronchitis?
Definition
Clinically defined as a productive cough occuring during at least 3 consecutinve months over at least 2 consecutive years
Linked to cigarette smoking
Characterized by Hypersecretion of mucus due to marked hyperplasia of mucus-secreting submucosal glands
May lead to cor pulmonale (R-sided heart failure)
Term
WHich of the following associate with COPD Emphysema?
Definition
Dilation of air spaces with destruction of alveolar walls and lack of elastic recoil
Associated with Cigarette smoking, increased anteroposterior diameter of the chest, "Barrel Chest"
Term
Which of the following associate with Centriacinar Emphysema?
Definition
Dilation of the respiratory bronchioles
Upper part of the pulmonary lobes
Term
Which of the following associate with Panacinar Emphysema?
Definition
Associated with loss of elasticity and sometimes with genetically determined deficiency of alpha1-antitrypsin
Term
Which of the following are the complicaitons of Emphysema?
Definition
Pneumothorax
Term
Which of the following are the pathogenesis of Emphysema?
Definition
May result from Proteolytic enzyme such as elastase on the alveolar wall.
Elastase can induce destruction of elastin unless neutralized by the antiproteinase-antielastase activities of alpha1-antitrypsin
Term
Which of the following are the pathogenesis of Emphysema?
Definition
Centriacinar emphysema
Attracts neutrophils and macrophages, sources of elastase
Inactivates alpha1-antitrypsin
Cigarette smoking
Term
Which of the following are the pathogenesis of Emphysema?
Definition
The piZ allele codes for a structural alteration in the protein that interferes with its hepatic secretion
The homozygous state (piZZ) is associated with greatly decreased activity in alpha1-antitrypsin, panacinar emphysema, and often hepatic cirrhosis
Term
Which of the following associate with Bronchiectasis?
Definition
Permenant abnormal bronchial dilation caused by chronic infection, with inflammation and necrosis of the bronchial wall
predisposed by bronchial obstruction, most often by tumor

Irreversible dilation-Kartagener's syndrome
Term
Which of the following associate with ARDS?
Definition
Produced by diffuse alveolar damage with resultant increase in alveolar capillary permeability, causing leakage of protein-rich fluid into alveoli

Marked by the formation of an intra-alveolar hyaline membrane composed of fibrin and cellular debris

Results in severe impairment of respiratory gas exchange with consequent severe hypoxia
Term
What are ARDS Pathogenesis?
Definition
neutrophil release substances toxic of the alveolar wall
Activation of the coagulaiton cascade is suggested by the presence of microemboli
Oxygen toxicity is mediated by the formation of oxygen-derived free radicals
Term
What assciate with Neonatal respiratory distress syndrome (hyaline membrane disease)?
Definition
Hyaline membrane disease
Role of surfactant reduces surface tension within the lung, facilitating expansion during inspiration and preventing atelectasis during expiration

Measure Ratio of surfactant lecithin to sphingomyelin in the amniotic fluid
Lecithin:sphingomyelin ratio of 2:1 or greater indicates pulmonary maturity
Term
What are the etiology of hyaline membrane disease?
Definition
Prematurity
Maternal diabetes mellitus
Birth by caesarean section
Term
What associate with anthracosis?
Definition
Carbon dust, it is endemic in urban areas and causes no harm
Term
What associate with Coal workers pneumoconiosis?
Definition
Carbon and silica
Progressive massive fibrosis is marked by fibrotic nodules with necrotic black fluid
Term
What associate with Silicosis?
Definition
Free silica dust
Silicotic nodules
Silicotuberculosis
Term
What associate with Asbestosis?
Definition
Ferruginous bodies by Prussian blue+
Uncoated Asbestos fibers are not visible
Term
what are the complications of asbestosis?
Definition
Bronchogenic carcinoma: most common neoplasm, cigarrette smoling has additive effect

Malignant mesothelioma: not the most common but the most specific:

100% mortality rate, 90% dead within 2 years
Term
What are sarcoidosis associate with?
Definition
Noncaseating granulomas
Definitive diagnosis requires biopsy
Term
What are the idiopathic pulmonary fibrosis?
Definition
Chronic inflammation and fibrosis of the alveolar wall
Honeycomb lung
Death within 5 years
Term
What associate with Eosinophilic granuloma?
Definition
Localized proliferation of histocytic cells
Birkbeck Granules
Term
What associate with Pulmonary Embolism?
Definition
Term
What associate with primary pulmonary hypertension?
Definition
unknown
Term
What associate with secondary pulmonary hypertension?
Definition
Most caused by COPD
Increased pulmonary blood flow as in congenital left-to-right shunt;
Increased resistance
Often lead to right ventricular hypertrophy
Term
Which of the following associate with pulmonary edema?
Definition
Increased hydrostatic pressure
Increased alveolar capillary permeability
Term
Which associate with pulmonary edema?
Definition
increased alveolar pressure
Pulmonary edema fluid is a transudate: low protein, low specific gravity, noninflammatory, no alteration of endothelium
Term
Which of the following associate with pneumonia bacterial infection?
Definition
see neutrophilic leukocytosis with an increase in band neutrophils (shift to the left)
Term
What are the complication of pneumonia?
Definition
abscess formaiton
scar
bacteremic dissemination other organs
Term
Which of the following associate with acute lobar pneumonia?
Definition
sharp demarcation
>90% S. pneumoniae
Klebsiella affects elderly, diabetics and alcoholics
Bronchi not affected; alveolar wall congested but not destroyed
Term
What associate with lobar pneumonia?
Definition
Alveolar exudates only
No abscess formaiton

Acute congestion and edema (1st-2nd days)
Red hepatization (2nd-4th days)
Gray hepatization (4th-8th days)
Resolution
Term
What associate with Bronchopneumonia?
Definition
Extending from the bronchioles into the adjacent alveoli
Abscess formaiton
Term
What associate with interstitial (primary atypical) pneumonia?
Definition
Mycoplasma pneumoniae or viruses
Localized to interstitial areas
No exdudate in alveolar spaces, intraalveolar hyaline membranes
May be associated with nonspecific cold agglutinins reactive to red cells
Term
What associate with interstitial (primary atypical) viral pneumonia?
Definition
most common types of pneumonia in childhood
Caused by influenza viruses, adenoviruses, rhinovirus, and respiratory syncytial virus, rarely CMV

May also arise after childhood exanthem such as rubeola (measles) or varicella (chickenpox)
Term
Which of the following associate with Cytomegalovirus?
Definition
common in AIDS
Term
Which of the following associate with respiratory syncytial virus?
Definition
Yound children
Fall and winter
Bronchiolitis with necrosis of epithelium
Term
Which of the following associate with Influenza Pneumonia
Definition
Destruction of ciliated respiratory epithelium; predisposes to superimposed bacterial pneumonia

No inclusions; necrosis and sloughing of the alveolar lining cells, interstitial pneumonitis
Term
Which of the following associate with pneumocystis carinii pneumonia?
Definition
most common opportunistic infection in AIDS patients
P. Carinii is protozoan
Diagnosed by morphologic demonstration of the organism in biopsy or bronchial washing specimens.
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