Respiratory Pathology Practice Questions

Q: Chronic passive congestion of the lungs is most often secondary to which of the following conditions?

Corpulmonale. **Explanation:** **Chronic Passive Congestion (CPC) of the Lungs** occurs when there is a persistent backup of blood in the pulmonary vasculature due to an inability of the heart to pump blood effectively into the systemic circulation [1]. **Why Option C is Correct:** **Cor pulmonale** refers to right-sided heart failure resulting from primary pulmonary hypertension or chronic lung diseases (like COPD). In the context of "Chronic Passive Congestion of the Lungs," the term is traditionally associated with **Left-Sided Heart Failure** [1]. However, in many standardized examinations, if "Left Heart Failure" is not an option, **Cor pulmonale** (or chronic heart disease) is selected as it represents the hemodynamic failure of the cardiopulmonary circuit. *Note: In clinical practice, CPC of the lungs is caused by Left Heart Failure, while Cor pulmonale causes CPC of the Liver (Nutmeg liver).* **Why the other options are incorrect:** * **A & B (Malnutrition & Massive Hemorrhage):** These conditions lead to hypovolemia or decreased oncotic pressure, which results in reduced venous return rather than congestion. * **D (Atherosclerotic Heart Disease):** While this can lead to heart failure, it is a broad etiology. Cor pulmonale specifically describes the structural/functional failure directly linked to the pulmonary-cardiac interface. **High-Yield NEET-PG Pearls:** 1. **Gross Appearance:** The lungs become heavy, firm, and brown—a condition known as **Brown Induration**. 2. **Microscopic Hallmark:** The presence of **Heart Failure Cells** (hemosiderin-laden macrophages) in the alveolar spaces, resulting from the breakdown of extravasated red blood cells. 3. **Sequence:** Increased pulmonary venous pressure → Capillary congestion → Micro-hemorrhages → Phagocytosis by macrophages → Fibrosis and Brown Induration. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Heart, pp. 536-538.

Q: Bronchial adenoma commonly presents as:

Recurrent hemoptysis. **Explanation:** **Bronchial adenoma** is an older, clinical term primarily used to describe **Bronchial Carcinoids** (accounting for 80-90% of cases), as well as adenoid cystic carcinomas and mucoepidermoid carcinomas. **Why Recurrent Hemoptysis is the correct answer:** Bronchial carcinoids are typically **centrally located** (endobronchial) and are characterized by extreme **vascularity**. Because these tumors grow within the lumen of large bronchi and are covered by a highly vascularized intact mucosa [1], they are prone to surface erosion. This leads to **recurrent, painless episodes of hemoptysis**, which is the most classic and common presenting symptom. **Analysis of Incorrect Options:** * **B. Cough:** While cough can occur due to endobronchial irritation, it is non-specific and often secondary to the obstructive effects or associated infection. * **C. Dyspnea:** This occurs only if the tumor is large enough to cause significant airway obstruction or collapse of a lung lobe (atelectasis). * **D. Chest pain:** This is rare and usually indicates pleural involvement or secondary pneumonia, which is less common in the early stages of bronchial adenoma compared to hemoptysis. **High-Yield Pearls for NEET-PG:** * **Histology:** Carcinoid tumors show a characteristic **"Organoid pattern"** with uniform polygonal cells, salt-and-pepper chromatin [1], and are positive for neuroendocrine markers like **Chromogranin A, Synaptophysin, and CD56.** * **Location:** Most are central (perihilar). * **Carcinoid Syndrome:** Rare in bronchial carcinoids (only 1-2%) unless liver metastases are present. * **Radiology:** May present as a "check-valve" obstruction leading to obstructive emphysema or a "Golden S sign" if causing lobar collapse. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 727.

Question 1

Chronic passive congestion of the lungs is most often secondary to which of the following conditions?

Accepted Answer

Corpulmonale

Answer

Malnutrition

Answer

Massive hemorrhage

Answer

Atherosclerotic heart disease

Question 2

Which organ is primarily involved in Good-pasture syndrome?

Accepted Answer

Kidney

Answer

Liver

Answer

Adrenals

Answer

Brain

Question 3

Masson bodies are seen in which of the following conditions?

Accepted Answer

Cryptogenic Organizing Pneumonia

Answer

Usual interstitial pneumonia

Answer

Non-specific interstitial pneumonia

Answer

Hyaline membrane disease

Question 4

Which of the following inhaled occupational pollutants produces extensive nodular pulmonary fibrosis?

Accepted Answer

Silica

Answer

Asbestos

Answer

Wood dust

Answer

Carbon

Question 5

What is the commonest type of emphysema?

Accepted Answer

Irregular

Answer

Centriacinar

Answer

Obstructed

Answer

Panacinar

Question 6

Which of the following statements is false?

Accepted Answer

Assman's focus is supraclavicular in location

Answer

Primary tuberculosis is more common in children

Answer

Miliary TB is a type of secondary TB

Answer

Simmond's focus is seen in the liver

Question 7

A 56-year-old man undergoing chemotherapy for leukemia develops fever, nonproductive cough, dyspnea, pleuritic chest pain, and hemoptysis over one week. A chest CT scan shows multiple 1- to 4-cm nodular densities with surrounding ground-glass infiltrate (halo sign). Bronchoalveolar lavage fluid microscopy reveals narrow branching septate hyphae. His CBC shows Hgb, 13 g/dL; Hct, 38.7%; WBC count, 2000/mL; and platelet count, 200,100/mL. Which of the following organisms is the most likely cause of this infection?

Accepted Answer

Aspergillus fumigatus

Answer

Candida albicans

Answer

Cryptococcus neoformans

Answer

Moraxella catarrhalis

Question 8

What does the cut surface of lungs show in Silicosis?

Accepted Answer

All of the above

Answer

Pleural thickening

Answer

Hard collagenous scars

Answer

Nodules

Question 9

A 37-year-old man is admitted to the hospital with shortness of breath, cyanosis, and fever. Chest X-ray films reveal consolidation of the right lower lobe with relative sparing of the remaining lobes. A clinical diagnosis of lobar pneumonia is made and supported by the results of sputum cultures. Which of the following is the genus of the bacterium most likely to be isolated from this patient's sputum?

Accepted Answer

Streptococcus, alpha-hemolytic

Answer

Haemophilus

Answer

Klebsiella

Answer

Streptococcus, beta-hemolytic

Question 10

Bronchial adenoma commonly presents as:

Accepted Answer

Recurrent hemoptysis

Answer

Cough

Answer

Dyspnea

Answer

Chest pain

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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