Deck 12: Respiratory System

Question 1

The accompanying photomicrograph shows a section of lung that had been resected from the right upper lobe of a 73 year old male who had smoked two packs of cigarettes a day since the age of 18.The inherent danger of bullae formation (B)in emphysema is the distinct possibility of which one of the following pathophysiologic events?

A)Aspergillus infection
B)Heart failure
C)Lung cancer
D)Pneumothorax
E)Tuberculosis

Answer 1

Pneumothorax

Question 2

A 54 year old male with a long history of congestive heart failure due to coronary artery disease brought about by smoking presented at the Emergency Department in acute respiratory distress.He was coughing up copious amounts of pink,frothy fluid.Unfortunately,he died,and the family requested an autopsy.A representative section of his lung is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma of the lung
B)Pulmonary oedema
C)Pulmonary embolism
D)Pulmonary fibrosis
E)Pulmonary infarct

Answer 2

Pulmonary oedema

Question 3

At autopsy of a 69 year old man,the lungs had the appearance shown in the accompanying photomicrographs.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Asbestosis
C)Chronic bronchitis
D)Emphysema
E)Silicosis

Answer 3

Asbestosis

Question 4

A 53 year old woman with a 40 pack year smoking history consulted her physician for a chronic cough.A chest x-ray disclosed an infiltrate in the right middle lobe.She was treated with two courses of antibiotics,but six weeks later,the infiltrate had not improved.A bronchoscopic biopsy was performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Bronchioloalveolar carcinoma
C)Carcinoid tumour
D)Large cell undifferentiated carcinoma
E)Small cell carcinoma
F)Squamous cell carcinoma

Question 5

The accompanying photomicrograph compares normal bronchial mucosa (left)with abnormal mucosa (right).The magnification is approximately the same.Which one of the following is the best diagnosis for the tissue depicted on the right?

A)Chronic bronchitis
B)Emphysema
C)Neoplasia (cancer)
D)Pneumonia
E)Tuberculosis

Question 6

A 58-year-old white male with a 40 pack year smoking history presented to his local physician complaining of hoarseness for over one month.Laryngoscopy revealed an invasive tumour.A total laryngectomy was then performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Condyloma acuminatum
C)Squamous cell carcinoma
D)Squamous papilloma
E)Transitional cell carcinoma

Question 7

A 23 year old woman was seen by her primary care physician for a nasal obstruction.A polyp was seen and removed.A representative section is shown in the accompanying photomicrograph.From the histological appearance,which one of the following aetiological events is likely in this case?

A)Allergic sinusitis
B)Bacterial sinusitis
C)Neoplasm due to smoking
D)Parasitic infection
E)Viral sinusitis

Question 8

A 65 year old woman with a long history of smoking was found dead at home.An autopsy was requested by the family.They reported that she had recently been experiencing increasing breathlessness.A representative section from her lung is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma of the lung
B)Pulmonary oedema
C)Pulmonary embolism
D)Pulmonary fibrosis
E)Pulmonary infarct

Question 9

A 64 year old man with a 60 pack year smoking history was seen by his local physician for fatigue.He also reported having lost 20 pounds over the previous two months,while eating his normal diet.Chest x-ray disclosed a 4 cm mass near the left lung hilum.An endoscopic biopsy was performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Bronchioloalveolar carcinoma
C)Carcinoid tumour
D)Large cell undifferentiated carcinoma
E)Small cell carcinoma
F)Squamous cell carcinoma

Question 10

A 54 year old woman consulted her physician for a chronic,non-productive cough and fatigue.She had smoked approximately two packs of cigarettes a day for 35 years.A chest x-ray revealed a 6 cm hilar mass compressing the right main bronchus.An endoscopic biopsy was performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Adenocarcinoma
B)Bronchioloalveolar carcinoma
C)Carcinoid tumour
D)Large cell undifferentiated carcinoma
E)Small cell carcinoma
F)Squamous cell carcinoma

Question 11

An otherwise well 68 year old woman presents at the Emergency Department with fever and shortness of breath.A chest-x-ray shows patchy lung infiltrates bilaterally.A pneumonologist is consulted,who then performs a bronchoscopic biopsy,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis?

A)Aspergillus pneumonia
B)Bronchopneumonia
C)CMV pneumonitis
D)Lobar pneumonia
E)Pneumocystis jirovecii pneumonia