Respiratory Pathology Practice Questions

Q: What is the most common type of lung carcinoma in women and children?

Adenocarcinoma. **Explanation:** **Adenocarcinoma** is currently the most common histological subtype of lung cancer overall. It is specifically the most frequent type found in **women, non-smokers, and children**. Unlike other lung cancers, it typically arises in the **periphery** of the lung [1] and is associated with mutations in the **EGFR** gene (especially in non-smoking Asian women) or **ALK** rearrangements. In children, while primary lung epithelial tumors are rare, adenocarcinoma remains the most frequently reported subtype when they do occur. **Analysis of Incorrect Options:** * **Small Cell Carcinoma (SCLC):** This is a high-grade neuroendocrine tumor strongly associated with heavy smoking. It is usually central in location and is the most common type associated with paraneoplastic syndromes like SIADH or ACTH production. * **Squamous Cell Carcinoma (SCC):** Historically the most common type in men, it is characterized by "the 4 Cs": **C**entral location, **C**igarette smoking, **C**avitary lesions, and hyper**C**alcemia (due to PTHrP). * **Large Cell Carcinoma:** This is a diagnosis of exclusion (undifferentiated). It is less common and typically presents as a large peripheral mass with a poor prognosis. **NEET-PG High-Yield Pearls:** * **Most common lung cancer overall:** Adenocarcinoma. * **Most common lung cancer in non-smokers:** Adenocarcinoma. * **Scar Carcinoma:** Adenocarcinoma often arises in areas of previous lung scarring [1] (e.g., old TB foci). * **Driver Mutations:** EGFR (most common), KRAS (associated with smoking), and ALK are key targets for biological therapy in Adenocarcinoma [1]. * **Precursor lesion:** Atypical Adenomatous Hyperplasia (AAH) leads to Adenocarcinoma *in situ* (formerly Bronchioloalveolar carcinoma) [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 335-336.

Q: Bronchogenic cysts occur commonly in which location?

Carina. **Explanation:** **Bronchogenic cysts** are congenital anomalies arising from abnormal budding of the primitive foregut during embryonic development. **Why Carina is the correct answer:** The most common location for bronchogenic cysts is the **middle mediastinum**, specifically near the **tracheal bifurcation (carina)** or the paratracheal region. Because they originate from the ventral foregut (which forms the respiratory tree), they are typically found in close proximity to the major airways. While they can occur within the lung parenchyma, the subcarinal location is the classic and most frequent site. **Analysis of Incorrect Options:** * **Posterior mediastinum:** This is the characteristic location for **neurogenic tumors** (e.g., Schwannomas, Neuroblastomas). Bronchogenic cysts are rarely found here. * **Superior mediastinum:** While the upper paratracheal region is possible, the subcarinal area (middle mediastinum) is statistically more common. The superior mediastinum is more frequently associated with thymic or thyroid masses. * **Periphery of lung:** Intrapulmonary bronchogenic cysts do occur (usually in the lower lobes), but they are less common than the mediastinal variety. Peripheral cystic lesions are more often associated with Congenital Pulmonary Airway Malformations (CPAM). **High-Yield Clinical Pearls for NEET-PG:** * **Histology:** They are lined by **ciliated pseudostratified columnar epithelium** (respiratory epithelium) and often contain cartilage, smooth muscle, and mucous glands in the wall. * **Clinical Presentation:** Often asymptomatic in children but can cause compression of the airway or esophagus, leading to dyspnea, cough, or dysphagia. * **Imaging:** On CT, they appear as well-circumscribed, fluid-filled masses. They do not typically communicate with the tracheobronchial tree unless infected.

Question 1

What is the most common type of lung carcinoma in women and children?

Accepted Answer

Adenocarcinoma

Answer

Small cell carcinoma

Answer

Squamous cell carcinoma

Answer

Large cell carcinoma

Question 2

Which condition is associated with thymoma?

Accepted Answer

Myasthenia gravis

Answer

Polycythemia

Answer

Ectopic ACTH

Answer

Polyarteritis nodosa

Question 3

Which type of lung cancer is associated with neuromuscular disorders?

Accepted Answer

Small cell carcinoma

Answer

Adenocarcinoma

Answer

Squamous cell carcinoma

Answer

Bronchoalveolar carcinoma

Question 4

Which of the following lung cancers is associated with the worst prognosis?

Accepted Answer

Small cell carcinoma

Answer

Adenocarcinoma

Answer

Squamous cell carcinoma

Answer

Oat cell carcinoma

Question 5

What is the predominant constituent of a hyaline membrane?

Accepted Answer

Fibrin-rich exudates

Answer

Albumin

Answer

Anthracotic pigment

Answer

None of the above

Question 6

All of the following are seen in asbestosis except?

Accepted Answer

Diffuse alveolar damage

Answer

Calcified pleural plaques

Answer

Diffuse pulmonary interstitial fibrosis

Answer

Mesotheliomas

Question 7

A 40-year-old man presents with a two-week history of increasing cough and hemoptysis. He has no smoking history and is in good health. Physical examination reveals a temperature of 38.2°C. A chest radiograph shows consolidation in the right upper lobe. Despite antibiotic therapy, his cough and hemoptysis persist for an additional two weeks. A subsequent chest CT scan reveals right upper lobe atelectasis. Bronchoscopic examination demonstrates a tan, circumscribed obstructive mass filling a right upper lobe bronchus. Which of the following neoplasms is most likely to produce these findings?

Accepted Answer

Carcinoid tumor

Answer

Adenocarcinoma

Answer

Hamartoma

Answer

Kaposi sarcoma

Question 8

Which lung disease is associated with mesothelioma?

Accepted Answer

Asbestosis

Answer

Silicosis

Answer

Bagassosis

Answer

Anthracosis

Question 9

Bronchogenic cysts occur commonly in which location?

Accepted Answer

Carina

Answer

Posterior mediastinum

Answer

Superior mediastinum

Answer

Periphery of lung

Question 10

A 45-year-old man with cirrhosis due to alpha-1-antitrypsin deficiency receives a liver transplant. He is at increased risk of developing which of the following types of emphysema?

Accepted Answer

Panacinar

Answer

Centriacinar

Answer

Paraseptal

Answer

Compensatory

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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