Respiratory Pathology Practice Questions

Q: In a patient of mesothelioma, what is often found?

All of the above. **Explanation:** Malignant Mesothelioma is a rare neoplasm of the mesothelial cells, most commonly involving the pleura [2]. The correct answer is **"All of the above"** due to the following clinico-pathological features: 1. **Association with Asbestosis (Option B):** Asbestos exposure is the primary risk factor, present in up to 90% of cases [2]. While it is linked to asbestos exposure, it is important to note that unlike bronchogenic carcinoma, smoking does *not* increase the risk of mesothelioma. 2. **Haemorrhagic Pleural Effusion (Option C):** This is the most common clinical presentation. The tumor spreads widely over the pleural surface, often encasing the lung in a thick "rind" of tumor tissue. This leads to the accumulation of bloody (haemorrhagic) fluid in the pleural space [1]. 3. **Hypoglycaemia (Option A):** This is a recognized **paraneoplastic syndrome** associated with large mesenchymal tumors and mesotheliomas. It is caused by the secretion of **IGF-2 (Insulin-like Growth Factor 2)**, also known as "Non-Islet Cell Tumor Hypoglycemia" (NICTH). **High-Yield Facts for NEET-PG:** * **Latent Period:** Long interval (25–40 years) between asbestos exposure and tumor development [2]. * **Gross Appearance:** Diffuse pleural thickening forming a firm, grayish-white "rind." * **Microscopy:** Can be Epithelioid (most common), Sarcomatoid, or Biphasic. * **Immunohistochemistry (IHC):** Positive for **Calretinin** (most specific), WT-1, and Cytokeratin 5/6. It is negative for CEA (which helps differentiate it from Adenocarcinoma). * **Electron Microscopy:** Characterized by **long, slender microvilli**. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, p. 699. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Respiratory Tract Disease, pp. 339-340.

Question 1

Pleural fibroma is differentiated from mesothelioma by the presence of which of the following markers in the former?

Accepted Answer

Cytokeratin

Answer

CD14

Answer

CD24

Answer

ERBB2 positive

Question 2

What is the most common termination of lobar pneumonia?

Accepted Answer

Resolution

Answer

Consolidation

Answer

Abscess formation

Answer

Empyema

Question 3

What is true about alpha-1 antitrypsin deficiency?

Accepted Answer

It can lead to pulmonary emphysema.

Answer

It is an autosomal dominant condition.

Answer

It makes hepatic cells resistant to disease.

Answer

Hepatic cells are orcein stain positive in this condition.

Question 4

Alpha-1 antitrypsin deficiency is associated with which type of emphysema?

Accepted Answer

Panacinar emphysema

Answer

Centriacinar emphysema

Answer

Paraseptal emphysema

Answer

Irregular emphysema

Question 5

A lung section from an autopsy of an AIDS patient with a CD4 count less than 100/mm³ shows desquamation of type 1 pneumocytes with prominent intranuclear basophilic inclusion bodies surrounded by a clear halo. What is the most likely diagnosis causing these features?

Accepted Answer

CMV pneumonia

Answer

Acute respiratory distress syndrome

Answer

Pneumocystis jirovecii pneumonia

Answer

Mycobacterium avium-intracellulare pneumonia

Question 6

All of the following statements are true regarding the histological features of emphysema, except?

Accepted Answer

The pores of Kohn become narrower and obstructed.

Answer

There is loss of attachments of the alveoli to the outer wall of small airways.

Answer

It causes a decrease in the capillary bed area.

Answer

There are large abnormal airspaces, blebs, and bullae.

Question 7

In a patient of mesothelioma, what is often found?

Accepted Answer

All of the above

Answer

Hypoglycaemia

Answer

An association with asbestosis

Answer

Haemorrhagic pleural effusion

Question 8

The Reid index is increased in which of the following conditions?

Accepted Answer

Chronic bronchitis

Answer

Emphysema

Answer

Bronchiectasis

Answer

ARDS

Question 9

Emphysema is associated with a deficiency of which of the following?

Accepted Answer

Alpha-1 Anti-trypsin

Answer

Trypsin

Answer

Trypsinogen

Answer

Bradykinin

Question 10

A 45-year-old coal mine worker presents with cutaneous nodules, joint pain, and occasional cough with dyspnea. His chest radiograph shows multiple small (1-4 cm) nodules in bilateral lung fields. Some of the nodules show cavitation and specks of calcification. What is the most likely diagnosis?

Accepted Answer

Caplan's syndrome

Answer

Sjogren's syndrome

Answer

Silicosis

Answer

Wegener's granulomatosis

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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