Respiratory Pathology Practice Questions

Q: Secondary pulmonary tuberculosis usually involves which part of the lungs?

Apex of lungs. **Explanation:** Secondary (reactivation) pulmonary tuberculosis typically involves the **apex of the lungs** (specifically the apical and posterior segments of the upper lobes) [1]. **Why the Apex?** The primary reason is the **high oxygen tension ($PO_2$)** found in the lung apices. *Mycobacterium tuberculosis* is an obligate aerobe that thrives in oxygen-rich environments. Due to the effects of gravity on pulmonary blood flow, the ventilation-perfusion ($V/Q$) ratio is highest at the apex, leading to higher alveolar oxygen concentrations compared to the bases. Additionally, lymphatic drainage is less efficient in the apices, allowing the bacilli to proliferate more easily. **Analysis of Incorrect Options:** * **Base of lungs & Lower lobes (Options A & D):** These areas are the characteristic sites for **Primary Tuberculosis**. Primary TB typically presents as a subpleural lesion in the lower part of the upper lobe or upper part of the lower lobe (the **Ghon focus**). * **Middle lobes (Option C):** While TB can spread anywhere, the middle lobe is not the classic site for secondary reactivation. Isolated middle lobe involvement is more commonly associated with "Middle Lobe Syndrome" due to extrinsic compression of the bronchus by enlarged lymph nodes. **High-Yield Clinical Pearls for NEET-PG:** * **Ghon Complex:** Consists of a parenchymal lesion (Ghon focus) + lymphangitis + hilar lymphadenopathy. * **Ranke Complex:** A healed, calcified Ghon complex visible on X-ray. * **Assmann Focus:** The specific infraclavicular lesion seen in secondary TB. * **Pathology:** Secondary TB is characterized by **caseous necrosis** and **cavitation** [1], which can lead to erosion into airways (causing hemoptysis) or blood vessels (leading to miliary TB). **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 320-321.

Question 1

Secondary pulmonary tuberculosis usually involves which part of the lungs?

Accepted Answer

Apex of lungs

Answer

Base of lungs

Answer

Middle lobes

Answer

Lower lobes

Question 2

Uremic lung most often results due to what?

Accepted Answer

Pulmonary edema

Answer

Fibrosis

Answer

Alveolar injury

Answer

CVC liver

Question 3

In small cell carcinoma of the lung, which of the following is not typically seen?

Accepted Answer

Watery diarrhea

Answer

Hypercalcemia

Answer

Hyponatremia

Answer

Hypokalemia

Question 4

What is true about small cell lung cancer?

Accepted Answer

Destruction of alveolar cells occurs

Answer

Bone marrow involvement is uncommon

Answer

It is typically peripheral in location

Answer

All of the above are true

Question 5

Which of the following statements is NOT related to the pathogenesis of idiopathic pulmonary fibrosis?

Accepted Answer

Age less than 20 years

Answer

Smoking

Answer

Loss of function mutation in TERT and TERC gene

Answer

Mutations in genes encoding components of surfactant

Question 6

Hyaline membrane is seen in all of the following conditions, EXCEPT:

Accepted Answer

Staphylococcal bronchopneumonia

Answer

Radiation pneumonitis

Answer

Viral pneumonitis

Answer

Uremic pneumonitis

Question 7

A patient with long-standing, progressive congestive heart failure dies in respiratory distress. The lungs at autopsy are 3 times their normal weight. Histologically, the alveoli show a proteinaceous granular precipitate, enlarged alveolar capillaries, and hemosiderin-laden macrophages. Other inflammatory cells are inapparent. Which of the following is the most likely diagnosis?

Accepted Answer

Pulmonary edema

Answer

Candida pneumonia

Answer

Pneumococcal pneumonia

Answer

Pneumocystis pneumonia

Question 8

Which of the following does not occur with asbestosis?

Accepted Answer

Methaemoglobinemia

Answer

Pneumoconiosis

Answer

Pleural mesothelioma

Answer

Pleural calcification

Question 9

What are heart failure cells seen in?

Accepted Answer

Pulmonary edema

Answer

Pulmonary infarction

Answer

Pneumonia

Answer

Pulmonary embolism

Question 10

Which of the following is NOT seen with uremic lung?

Accepted Answer

Interstitial fibrosis

Answer

Alveolar injury

Answer

Pulmonary edema

Answer

Fibrinous exudate in alveoli

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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