Respiratory Pathology Practice Questions

Q: Which of the following findings is not typically seen in a patient with bronchial asthma?

Smooth muscle atrophy. **Explanation:** Bronchial asthma is a chronic inflammatory disorder of the airways characterized by reversible bronchoconstriction and **airway remodeling** [1]. The correct answer is **Smooth muscle atrophy** because, in asthma, the airway smooth muscle actually undergoes **hypertrophy and hyperplasia** due to chronic inflammation and repeated bronchospasm, leading to thickened airway walls. **Analysis of Options:** * **Smooth muscle atrophy (Correct):** This is incorrect for asthma. The hallmark of airway remodeling is the *increase* in smooth muscle mass, not its wasting. * **Charcot-Leyden crystals:** These are high-yield microscopic findings in the sputum of asthmatics. They are composed of **galectin-10** (eosinophil protein) and represent the breakdown products of eosinophils. * **Hyperplasia of submucosal glands:** Chronic irritation leads to an increase in the size and number of mucus-secreting glands and goblet cell metaplasia, contributing to excessive mucus production [1]. * **Viscid mucous plug:** Asthmatic airways often contain thick, tenacious mucus plugs that can lead to distal atelectasis [1]. These plugs may contain **Curschmann spirals** (whorls of shed epithelium). **NEET-PG High-Yield Pearls:** 1. **Airway Remodeling:** Includes subepithelial fibrosis (thickening of the basement membrane), increased vascularity, and smooth muscle hypertrophy. 2. **Microscopic Triad:** Look for Curschmann spirals, Charcot-Leyden crystals, and Creola bodies (clusters of exfoliated bronchial epithelial cells). 3. **Cytokine Profile:** Asthma is primarily a **Type 2 Helper T-cell (Th2)** mediated response involving IL-4, IL-5 (recruits eosinophils), and IL-13 [2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 328-329. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 688-689.

Question 1

Which is the most common site for extrathoracic metastases in patients with lung carcinoma?

Accepted Answer

Adrenal glands

Answer

Kidneys

Answer

Liver

Answer

Vertebral body

Question 2

Which of the following findings is not typically seen in a patient with bronchial asthma?

Accepted Answer

Smooth muscle atrophy

Answer

Charcot-Leyden crystals in the sputum

Answer

Hyperplasia of submucosal glands

Answer

Viscid mucous plug

Question 3

A 55-year-old patient presents with chronic cough. A chest x-ray film demonstrates a circular lesion near the apex of the lung. CT-guided biopsy of the lesion demonstrates a malignant tumor arising in an area of scarred lung. Which of the following types of cancer is MOST likely to be present?

Accepted Answer

Adenocarcinoma

Answer

Bronchioloalveolar carcinoma

Answer

Large cell carcinoma

Answer

Oat cell carcinoma

Question 4

Pancoast tumor is defined as which of the following?

Accepted Answer

Superior sulcus tumor

Answer

Inferior sulcus tumor

Answer

Median sulcus tumor

Answer

None of the above

Question 5

Which of the following conditions can lead to end-stage lung disease?

Accepted Answer

Sarcoidosis, Interstitial lung disease, Langerhans cell histiocytosis, Asbestosis

Answer

Interstitial lung disease, Langerhans cell histiocytosis, Aspergillosis, Asbestosis

Answer

Sarcoidosis, Interstitial lung disease, Aspergillosis, Asbestosis

Answer

Sarcoidosis, Interstitial lung disease, Langerhans cell histiocytosis, Aspergillosis

Question 6

Which of the following conditions is associated with hypersensitive pneumonitis?

Accepted Answer

Byssinosis

Answer

Silicosis

Answer

Asbestosis

Answer

Berylliosis

Question 7

Which of the following is a clinical manifestation of acute silicosis?

Accepted Answer

Pulmonary alveolar proteinosis

Answer

Hypersensitivity pneumonitis

Answer

Hypersensitivity pneumonia

Answer

Formation of nodules and pneumoconiosis

Question 8

What is the most common type of lung cancer observed in individuals with asbestos-related lung disease?

Accepted Answer

Adenocarcinoma of lung

Answer

Mesothelioma

Answer

Large cell carcinoma

Answer

Small cell carcinoma

Question 9

Sections of the lung from a patient with Wegener's granulomatosis who presents clinically with hemoptysis are most likely to show what pathological findings?

Accepted Answer

Large, serpiginous necrosis with peripheral, palisading macrophages

Answer

Atypical lymphocytes invading blood vessels

Answer

Granulomatous inflammation of blood vessels with numerous eosinophils

Answer

Granulomatous inflammation of bronchi with Aspergillus

Question 10

Bronchoalveolar carcinoma most commonly presents as which of the following?

Accepted Answer

Collapse

Answer

Hemoptysis

Answer

Effusion

Answer

All of the above

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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