Interstitial lung diseases

Interstitial lung diseases US Medical PG Question 1: A 61-year-old male presents to your office with fever and dyspnea on exertion. He has been suffering from chronic, non-productive cough for 1 year. You note late inspiratory crackles on auscultation. Pulmonary function tests reveal an FEV1/FVC ratio of 90% and an FVC that is 50% of the predicted value. Which of the following would you most likely see on a biopsy of this patient's lung?

• A. Arteriovenous malformations
• B. Hyaline membranes
• C. Charcot-Leyden crystals
• D. Subpleural cystic enlargement (Correct Answer)
• E. Linear immunofluorescence along alveolar basement membranes

Interstitial lung diseases Explanation: ***Subpleural cystic enlargement*** - The patient's presentation with **dyspnea, non-productive cough, late inspiratory crackles**, and **restrictive lung disease** (normal FEV1/FVC ratio of 90% with reduced FVC of 50%) is highly suggestive of **pulmonary fibrosis**. - **Subpleural cystic enlargement** (honeycombing) is the characteristic histological finding in advanced pulmonary fibrosis, particularly in the **usual interstitial pneumonia (UIP)** pattern seen in **idiopathic pulmonary fibrosis (IPF)**. - The chronic, progressive nature (1-year history) and the restrictive PFT pattern make this the most likely biopsy finding. *Arteriovenous malformations* - These are abnormal vascular connections between arteries and veins that can cause **hypoxemia** and are typically associated with **hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease)**. - They do not explain the restrictive PFT pattern or the typical presentation of chronic progressive fibrosis with late inspiratory crackles. *Linear immunofluorescence along alveolar basement membranes* - This finding on **direct immunofluorescence** with **IgG deposition** is characteristic of **Goodpasture syndrome** (anti-GBM disease), which causes pulmonary hemorrhage and rapidly progressive glomerulonephritis. - This condition presents with **hemoptysis** and **acute renal failure**, not chronic non-productive cough, and would show an obstructive or mixed pattern if hemorrhage were present. *Hyaline membranes* - **Hyaline membranes** are proteinaceous material lining alveoli seen in **acute respiratory distress syndrome (ARDS)** or **diffuse alveolar damage (DAD)**. - The patient's **chronic 1-year symptoms** and restrictive PFTs indicate chronic interstitial lung disease, not acute lung injury. *Charcot-Leyden crystals* - **Charcot-Leyden crystals** are formed from breakdown of **eosinophils** and are found in conditions with eosinophilic inflammation, such as **asthma** or **eosinophilic pneumonia**. - While these conditions can cause cough and dyspnea, they would typically show an **obstructive pattern** (reduced FEV1/FVC) in asthma, not the restrictive pattern seen here.

Interstitial lung diseases US Medical PG Question 2: A 68-year-old man presents to the office with progressive shortness of breath and cough. A chest X-ray shows prominent hilar lymph nodes and scattered nodular infiltrates. Biopsy of the latter reveals noncaseating granulomas. This patient most likely has a history of exposure to which of the following?

• A. Asbestos
• B. Silica
• C. Coal dust
• D. Beryllium (Correct Answer)
• E. Organic dust

Interstitial lung diseases Explanation: ***Beryllium*** - **Chronic beryllium disease** (CBD) is characterized by **noncaseating granulomas** in the lungs, similar to sarcoidosis, and is associated with occupational exposure to beryllium. - Exposure typically occurs in workers involved in aerospace, ceramics, and electronics manufacturing. *Asbestos* - Exposure to **asbestos** is primarily associated with **asbestosis**, which features diffuse interstitial fibrosis, and an increased risk of mesothelioma and lung cancer. - While it causes lung disease, it does not typically present with noncaseating granulomas as the primary pathological finding. *Silica* - **Silicosis** results from inhaling **crystalline silica** and is characterized by nodular opacities, often with “egg-shell” calcifications in hilar lymph nodes, and fibrotic nodules, but not noncaseating granulomas. - The granulomas in silicosis are typically fibrotic and hyalinized, lacking the noncaseating appearance. *Coal dust* - Inhalation of **coal dust** leads to **coal worker's pneumoconiosis** (CWP), which can range from simple CWP with small nodular opacities to progressive massive fibrosis (PMF). - The pathology involves **macrophage accumulation** laden with coal dust, leading to fibrosis, rather than forming noncaseating granulomas. *Organic dust* - Exposure to **organic dusts** (e.g., from molds, animal proteins, cotton) can lead to **hypersensitivity pneumonitis**, characterized by diffuse inflammation of the lung interstitium and airways. - While granulomas can sometimes be seen in hypersensitivity pneumonitis, they are often poorly formed and are not the defining feature of the occupational lung disease that aligns with the described clinical picture with prominent nodular infiltrates and noncaseating granulomas, which is more characteristic of beryllium.

Interstitial lung diseases US Medical PG Question 3: A 35-year-old female comes to the physician because of a 2-year history of progressive fatigue and joint pain. She has a 1-year history of skin problems and a 4-month history of episodic pallor of her fingers. She reports that the skin of her face, neck, and hands is always dry and itchy; there are also numerous “red spots” on her face. She has become more “clumsy” and often drops objects. She has gastroesophageal reflux disease treated with lansoprazole. She does not smoke. She occasionally drinks a beer or a glass of wine. Her temperature is 36.5°C (97.7°F), blood pressure is 154/98 mm Hg, and pulse is 75/min. Examination shows hardening and thickening of the skin of face, neck, and hands. There are small dilated blood vessels around her mouth and on her oral mucosa. Mouth opening is reduced. Active and passive range of motion of the proximal and distal interphalangeal joints is limited. Cardiopulmonary examination shows no abnormalities. Her creatinine is 1.4 mg/dL. The patient is at increased risk for which of the following complications?

• A. Digital ulcers (Correct Answer)
• B. Scleroderma renal crisis
• C. Pulmonary arterial hypertension
• D. Gastrointestinal dysmotility
• E. Interstitial lung disease

Interstitial lung diseases Explanation: ***Digital ulcers*** - The patient exhibits several features of **systemic sclerosis (scleroderma)**, including **active Raynaud phenomenon** (**episodic pallor of fingers**), skin thickening, and telangiectasias (**red spots**). **Digital ulcers are the most immediate complication** given the active vascular symptoms. - Raynaud phenomenon causes repeated ischemia-reperfusion injury to the digits, and **up to 50% of patients with systemic sclerosis and Raynaud develop digital ulcers**, making this the highest near-term risk among the options. - The patient's **reduced mouth opening** and **limited range of motion in interphalangeal joints** are consistent with skin changes and joint involvement in scleroderma, further supporting the diagnosis and vascular complications. *Scleroderma renal crisis* - While **hypertension** is present (154/98 mm Hg) and **creatinine is elevated** (1.4 mg/dL), these findings are relatively mild and do not meet criteria for **scleroderma renal crisis**, which typically presents with **acute malignant hypertension** (>180/100 mmHg), rapidly progressive renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. - Renal crisis tends to occur earlier in the disease course (within first 4-5 years) and is more common with diffuse cutaneous scleroderma and recent corticosteroid use. This patient's presentation suggests limited cutaneous involvement (face, neck, hands - consistent with CREST/limited variant). *Pulmonary arterial hypertension* - **Pulmonary arterial hypertension (PAH)** is a serious late complication of systemic sclerosis, particularly in limited cutaneous disease, but there are **no current signs or symptoms** on cardiopulmonary examination. - While this remains a long-term risk requiring screening, it is not the most immediate complication. PAH typically develops years after disease onset and would present with dyspnea, fatigue, and signs of right heart dysfunction. *Gastrointestinal dysmotility* - The patient **already has** **gastroesophageal reflux disease (GERD)**, which is a manifestation of gastrointestinal dysmotility in systemic sclerosis due to esophageal smooth muscle involvement. - Since the patient already has this complication (not "at risk for" a future complication), this is not the best answer. Further GI complications could occur, but digital ulcers represent a more immediate risk. *Interstitial lung disease* - **Interstitial lung disease (ILD)** is a common and severe complication of systemic sclerosis, particularly in the diffuse cutaneous form, and is a leading cause of mortality. - However, the patient's **cardiopulmonary examination is noted as normal**, which does not suggest active or clinically apparent ILD at this time. While this remains a long-term risk requiring monitoring (with pulmonary function tests and HRCT), it is not the most immediate complication given the active Raynaud phenomenon.

Interstitial lung diseases US Medical PG Question 4: A 37-year-old woman comes to the physician because of a 10-month history of excessive daytime sleepiness and fatigue. She says she has difficulty concentrating and has fallen asleep at work on numerous occasions. She also reports having frequent headaches during the day. She has no difficulty falling asleep at night, but wakes up gasping for breath at least once. She has always snored loudly and began using an oral device to decrease her snoring a year ago. She has occasional lower back pain, for which she takes tramadol tablets 1–2 times per week. She also began taking one rabeprazole tablet daily 3 weeks ago. She does not smoke. She is 175 cm (5 ft 7 in) tall and weighs 119 kg (262 lb); BMI is 38.8 kg/m2. Her vital signs are within normal limits. Physical and neurologic examinations show no other abnormalities. Arterial blood gas analysis on room air shows: pH 7.35 PCO2 51 mm Hg PO2 64 mm Hg HCO3- 29 mEq/L O2 saturation 92% An x-ray of the chest and ECG show no abnormalities. Which of the following is the most likely cause of this patient's condition?

• A. Chronic inflammatory airflow limitation
• B. Thickening of alveolar membranes
• C. Drug-induced respiratory depression
• D. Diurnal alveolar hypoventilation
• E. Apneic episodes with obstructed upper airways (Correct Answer)

Interstitial lung diseases Explanation: **Apneic episodes with obstructed upper airways** - This patient has classic **obstructive sleep apnea (OSA)**, characterized by **loud snoring**, **waking up gasping for breath** (witnessed apneas), and **excessive daytime sleepiness**. - Her **obesity (BMI 38.8)** is a major risk factor for OSA, as excess soft tissue in the upper airway predisposes to collapse during sleep. - The ABG shows **compensated respiratory acidosis (pH 7.35, PCO2 51, HCO3- 29)** and **hypoxemia (PO2 64, O2 sat 92%)**, indicating chronic hypoventilation from recurrent apneic episodes. - OSA is the **underlying cause** of her condition; the oral device she uses is typically employed to treat OSA by repositioning the jaw to maintain airway patency. - The question asks for the **cause** of her condition, which is the **obstructed upper airways** leading to apneic episodes during sleep. *Diurnal alveolar hypoventilation* - While this patient does have daytime (diurnal) hypoventilation as evidenced by the elevated PCO2, this is a **consequence** of severe OSA, not the primary cause. - This describes **Obesity Hypoventilation Syndrome (OHS)**, which overlaps with OSA but refers specifically to the chronic hypoventilation state. - The **obstructed airways causing apneic episodes** are the underlying pathophysiology that leads to the chronic hypoventilation. *Chronic inflammatory airflow limitation* - This refers to **COPD**, which typically presents with **dyspnea, chronic cough, and wheezing**. - The patient is a **non-smoker**, has a **normal chest x-ray**, and lacks respiratory symptoms typical of COPD. - The clinical picture is classic for OSA, not obstructive lung disease. *Thickening of alveolar membranes* - This describes **interstitial lung diseases (ILD)**, which present with **progressive dyspnea, restrictive physiology**, and often **interstitial infiltrates on imaging**. - The patient's **normal chest x-ray** and lack of exertional dyspnea make ILD unlikely. - Her symptoms are related to sleep-disordered breathing, not parenchymal lung disease. *Drug-induced respiratory depression* - **Tramadol** (an opioid) can cause respiratory depression, but she takes it only **1-2 times per week** for back pain. - The ABG shows **compensated** respiratory acidosis with elevated bicarbonate, indicating a **chronic process** lasting weeks to months, not acute drug effect. - Her symptoms (snoring, gasping, daytime sleepiness) and obesity clearly point to OSA as the cause.

Interstitial lung diseases US Medical PG Question 5: A 49-year-old woman comes to the physician because of a 4-month history of a dry cough and shortness of breath on exertion. She also reports recurrent episodes of pain, stiffness, and swelling in her wrist and her left knee over the past 6 months. She had two miscarriages at age 24 and 28. Physical examination shows pallor, ulcerations on the palate, and annular hyperpigmented plaques on the arms and neck. Fine inspiratory crackles are heard over bilateral lower lung fields on auscultation. Which of the following additional findings is most likely in this patient?

• A. Increased airway resistance
• B. Decreased A-a gradient
• C. Decreased right atrial pressure
• D. Decreased diffusing capacity (Correct Answer)
• E. Increased lung compliance

Interstitial lung diseases Explanation: ***Decreased diffusing capacity*** - This patient presents with symptoms highly suggestive of **systemic lupus erythematosus (SLE)**, including recurrent miscarriages, joint pain, oral ulcers, skin lesions (annular hyperpigmented plaques), and pulmonary involvement (dry cough, dyspnea, crackles). - **Interstitial lung disease (ILD)**, a common pulmonary manifestation of SLE, leads to **fibrosis** of the alveolar-capillary membrane, thereby **decreasing the diffusing capacity of the lung for carbon monoxide (DLCO)**. *Increased airway resistance* - Increased airway resistance is characteristic of **obstructive lung diseases** like asthma or COPD, which primarily involve narrowing of the airways. - The patient's presentation with **inspiratory crackles** and symptoms of restrictive disease (shortness of breath on exertion, dry cough) is not consistent with increased airway resistance. *Decreased A-a gradient* - A **decreased alveolar-arterial (A-a) gradient** indicates efficient gas exchange and is typically seen in healthy individuals or in conditions causing hypoventilation without intrinsic lung disease. - In conditions like pulmonary fibrosis or ILD, there is impaired gas exchange leading to an **increased A-a gradient**. *Decreased right atrial pressure* - **Decreased right atrial pressure** would typically signify reduced venous return or normal cardiac function. - Given the patient's respiratory symptoms and potential for pulmonary hypertension secondary to ILD, an **increased right atrial pressure** would be more likely due to increased pulmonary vascular resistance. *Increased lung compliance* - **Increased lung compliance** is seen in conditions where the lung tissue becomes more distensible, such as **emphysema**, due to destruction of elastic fibers. - **Interstitial lung disease** and pulmonary fibrosis, as suggested by the patient's symptoms and signs, lead to **decreased lung compliance** due to stiffening of the lung tissue.

Interstitial lung diseases US Medical PG Question 6: A 62-year-old man presents to the emergency department for evaluation of a 2-year history of increasing shortness of breath. He also has an occasional nonproductive cough. The symptoms get worse with exertion. The medical history is significant for hypertension and he takes chlorthalidone. He is a smoker with a 40-pack-year smoking history. On physical examination, the patient is afebrile; the vital signs include: blood pressure 125/78 mm Hg, pulse 90/min, and respiratory rate 18/min. The body mass index (BMI) is 31 kg/m2. The oxygen saturation is 94% at rest on room air. A pulmonary examination reveals decreased breath sounds bilaterally, but is otherwise normal with no wheezes or crackles. The remainder of the examination is unremarkable. A chest radiograph shows hyperinflation of both lungs with mildly increased lung markings, but no focal findings. Based on this clinical presentation, which of the following is most likely?

• A. Decreased total lung capacity
• B. Increased DLCO
• C. Metabolic acidosis
• D. FEV1/FVC of 80% with an FEV1 of 82%
• E. FEV1/FVC of 65% (Correct Answer)

Interstitial lung diseases Explanation: ***FEV1/FVC of 65%*** - This patient's symptoms (shortness of breath, nonproductive cough, worsening with exertion), significant smoking history (40-pack-years), and chest X-ray findings (**hyperinflation**, mildly increased lung markings) are highly suggestive of **Chronic Obstructive Pulmonary Disease (COPD)**, particularly **emphysema** given the hyperinflation and decreased breath sounds. - COPD is characterized by **airflow limitation** that is not fully reversible, which is reflected by a **reduced FEV1/FVC ratio** (typically < 0.7 or < 70%). *Decreased total lung capacity* - **Decreased total lung capacity (TLC)** is characteristic of **restrictive lung diseases**, where lung expansion is limited (e.g., pulmonary fibrosis, interstitial lung disease). - COPD, and especially emphysema, typically presents with **increased TLC** due to air trapping and hyperinflation, not decreased TLC. *Increased DLCO* - **Increased DLCO** (diffusing capacity of the lung for carbon monoxide) can be seen in conditions like **pulmonary hemorrhage** or **asthma**. - In COPD, particularly emphysema, there is destruction of alveolar-capillary membranes, leading to a **decreased DLCO** due to impaired gas exchange. *Metabolic acidosis* - **Metabolic acidosis** is not a primary or direct feature of uncomplicated COPD. While severe respiratory failure in later stages might lead to some acid-base disturbances, directly attributing metabolic acidosis as a defining characteristic is incorrect. - COPD primarily causes **respiratory acidosis** due to CO2 retention in advanced stages. *FEV1/FVC of 80% with an FEV1 of 82%* - An **FEV1/FVC ratio of 80%** (or 0.8) and an **FEV1 of 82%** of predicted values are within the normal range and indicate **normal spirometry**. - This would rule out significant airflow obstruction, which is central to the diagnosis of COPD.

Interstitial lung diseases US Medical PG Question 7: A 31 year-old African-American female presents with painful shin nodules, uveitis, and calcified hilar lymph nodes. A transbronchial biopsy of the lung would most likely show which of the following histologies?

• A. Golden-brown fusiform rods
• B. Inflammation, fibrosis and cyst formation that is most prominent in subpleural regions
• C. Non-caseating granulomas (Correct Answer)
• D. Silica particles (birefringent) surrounded by collagen
• E. Patchy interstitial lymphoid infiltrate into walls of alveolar units

Interstitial lung diseases Explanation: ***Non-caseating granulomas*** - The constellation of **erythema nodosum** (painful shin nodules), **uveitis**, and **hilar lymphadenopathy** in an African-American female is highly characteristic of **sarcoidosis**. - **Sarcoidosis** is pathologically defined by the presence of **non-caseating granulomas** in affected tissues, which would be visible on a transbronchial biopsy. *Golden-brown fusiform rods* - These are **ferruginous bodies**, characteristic of **asbestosis**, which is not supported by the patient's presentation. - Asbestosis would typically involve a history of **asbestos exposure** and present with **pleural plaques** or **interstitial fibrosis**. *Inflammation, fibrosis and cyst formation that is most prominent in subpleural regions* - This description is more indicative of **pulmonary Langerhans cell histiocytosis**, a rare disease usually associated with **smoking**. - It does not align with the patient's specific systemic manifestations like uveitis or erythema nodosum. *Silica particles (birefringent) surrounded by collagen* - This describes the histological findings of **silicosis**, an occupational lung disease resulting from exposure to **silica dust**. - Silicosis is not typically associated with uveitis or erythema nodosum. *Patchy interstitial lymphoid infiltrate into walls of alveolar units* - This pattern can be seen in various interstitial lung diseases, but it is not specific for sarcoidosis. - It could be found in conditions like **lymphoid interstitial pneumonia**, which does not fit the overall clinical picture.

Interstitial lung diseases US Medical PG Question 8: A 68-year-old male smoker dies suddenly in a car accident. He had smoked 2 packs per day for 40 years. His past medical history is notable for a frequent, very productive cough, recurrent respiratory infections and occasional wheezing. He had no other medical problems. At autopsy, which of the following is most likely to be found in this patient?

• A. Increased number and activity of goblet cells (Correct Answer)
• B. Ferruginous bodies
• C. Mucous gland atrophy
• D. Interstitial fibrosis of the lung
• E. Pleural plaques

Interstitial lung diseases Explanation: ***Increased number and activity of goblet cells*** - The patient's history of a **productive cough**, **recurrent respiratory infections**, and **wheezing** in a chronic smoker strongly indicates **chronic bronchitis**. - **Chronic bronchitis** is pathologically characterized by **hypertrophy of mucous glands** and an **increase in goblet cell number and activity**, leading to excessive mucus production. *Ferruginous bodies* - **Ferruginous bodies** are typically found in **asbestosis**, a lung disease caused by asbestos exposure. - While asbestos exposure can cause respiratory symptoms, the sudden death and clinical picture without specific exposure history do not point to asbestosis as the primary diagnosis. *Mucous gland atrophy* - **Mucous gland atrophy** is generally not associated with chronic smoking and the symptoms described. - In conditions like chronic bronchitis, there is actually **hypertrophy** and **hyperplasia** of the mucous glands, leading to increased mucus production. *Interstitial fibrosis of the lung* - **Interstitial fibrosis** is characteristic of conditions like **idiopathic pulmonary fibrosis** or other **interstitial lung diseases**. - While smoking is a risk factor for some forms of fibrosis, the predominant symptoms of a productive cough and recurrent infections are more indicative of chronic bronchitis rather than diffuse interstitial fibrosis. *Pleural plaques* - **Pleural plaques** are **fibrous thickenings of the pleura**, almost exclusively associated with **asbestos exposure**. - They are usually asymptomatic and do not directly explain the productive cough, recurrent infections, and wheezing presented in this patient's history.

Interstitial lung diseases US Medical PG Question 9: A 44-year-old man comes to the physician because of a 5-month history of persistent cough productive of thick, yellow sputum and worsening shortness of breath. One year ago, he had similar symptoms that lasted 4 months. He has smoked two packs of cigarettes daily for the past 20 years. Physical examination shows scattered expiratory wheezing and rhonchi throughout both lung fields. Microscopic examination of a lung biopsy specimen is most likely to show which of the following findings?

• A. Decreased smooth muscle cells
• B. Decreased alveolar macrophages
• C. Increased ciliated epithelial cells
• D. Increased goblet cells (Correct Answer)
• E. Increased club cells

Interstitial lung diseases Explanation: **Increased goblet cells** - This patient's presentation of persistent cough with thick, yellow sputum, worsening shortness of breath, and a history of heavy smoking points towards **chronic bronchitis**. - **Chronic bronchitis** is pathologically defined by **mucus gland hyperplasia** and **goblet cell hypertrophy** in the bronchial airways, leading to excessive mucus production. *Decreased smooth muscle cells* - Airway smooth muscle can undergo **hyperplasia** and **hypertrophy** in chronic obstructive pulmonary diseases (COPD) like chronic bronchitis, rather than a decrease. - A decrease in smooth muscle cells is not a characteristic pathological finding in chronic bronchitis. *Decreased alveolar macrophages* - **Alveolar macrophages** are crucial for clearing inhaled particles and pathogens and are typically **increased** or functionally altered in chronic inflammatory lung conditions. - A decrease in these immune cells would not be a typical finding in chronic bronchitis and would likely lead to increased susceptibility to infections. *Increased ciliated epithelial cells* - In chronic bronchitis, there is often a **loss of ciliated epithelial cells** as they are replaced by **goblet cells** and undergo **squamous metaplasia** due to chronic irritation. - The remaining ciliated cells may be dysfunctional, impairing mucociliary clearance. *Increased club cells* - **Club cells** (formerly Clara cells) are non-ciliated, secretory cells found in the small airways that protect the bronchiolar epithelium. - While they play a role in airway defense, their significant increase is not a primary or characteristic pathological feature of chronic bronchitis.

Interstitial lung diseases Flashcard 1 of 10

Question: A Ghon complex is composed of a _____ and _____.

Answer: Ghon focus

Interstitial lung diseases Flashcard 2 of 10

Question: _____ is characterized by macrophages laden with carbon, causing inflammation and fibrosis

Answer: Coal workers' pneumoconiosis

Extra Information:   Watch Pneumoconioses [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-restrictive-lung-disease-pneumoconioses?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/pulmonology/videos/restrictive-lung-disease?index=6] https://onlinemeded.org/spa/pulmonary/restrictive-lung-disease/acquire?ref=anki 

Interstitial lung diseases Flashcard 3 of 10

Question: One complication associated with lung cancer is _____ due to compression of the recurrent laryngeal nerve

Answer: hoarseness

Extra Information:   Watch Lung Carcinoma [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-lung-cancer-lung-carcinoma?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/pulmonology/videos/lung-cancer?index=2] https://onlinemeded.org/spa/pulmonology/lung-cancer/acquire?ref=anki 

Interstitial lung diseases Flashcard 4 of 10

Question: Which two pneumoconioses increase the risk for cor pulmonale? _____

Answer: Berylliosis and Silicosis

Extra Information:  Watch Pneumoconioses [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-restrictive-lung-disease-pneumoconioses?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/pulmonary/restrictive-lung-disease/acquire?ref=anki 

Interstitial lung diseases Flashcard 5 of 10

Question: In conditions that cause destruction of the _____, hemosiderin laden macrophages may be seen in the alveoli

Answer: pulmonary vasculature

Extra Information:  https://onlinemeded.org/spa/pulmonology?ref=anki 

Interstitial lung diseases Flashcard 6 of 10

Question: Which pneomoconioses may produce centriacinar emphysema predominently in the upper lobes of the lung? _____

Answer: Simple coal worker's pneumoconiosis

Extra Information:  Watch Pneumoconioses [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-restrictive-lung-disease-pneumoconioses?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/pulmonary/restrictive-lung-disease/acquire?ref=anki 

Interstitial lung diseases Flashcard 7 of 10

Question: Lung carcinoma is classically divided into two categories: _____ (15%) and _____ (85%)

Answer: small cell carcinoma

Extra Information:  Watch Lung Carcinoma [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-lung-cancer-lung-carcinoma?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical]Watch associated Bootcamp video [https://app.bootcamp.com/med-school/pulmonology/videos/lung-cancer?index=2] https://onlinemeded.org/spa/pulmonology/lung-cancer/acquire?ref=anki 

Interstitial lung diseases Flashcard 8 of 10

Question: Pulmonary hypertension is characterized by _____ of the pulmonary trunk

Answer: atherosclerosis

Extra Information: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/pulmonology/videos/lung-pathology-special-topics?index=4] https://onlinemeded.org/spa/pulmonary/pulmonary-hypertension/acquire?ref=anki 

Interstitial lung diseases Flashcard 9 of 10

Question: Large cell carcinoma of the lung may present histologically with pleomorphic _____ cells

Answer: giant

Extra Information:   Watch Lung Carcinoma [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-lung-cancer-lung-carcinoma?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/pulmonology/lung-cancer/acquire?ref=anki 

Interstitial lung diseases Flashcard 10 of 10

Question: Large cell carcinoma of the lung may secrete the hormone _____

Answer: β-hCG

Extra Information:   Watch Lung Carcinoma [https://dashboard.sketchy.com/study/medical/courses/medical-pathophysiology/units/medical-pathophysiology-pulmonary/videos/medical-pathophysiology-pulmonary-lung-cancer-lung-carcinoma?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/pulmonology/lung-cancer/acquire?ref=anki