Chapter·PathologyPulmonary

Obstructive lung diseases (emphysema, bronchitis)Downloads

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Sample Questions

1

A 60-year-old man who is a chronic smoker comes to the hospital with the chief complaint of shortness of breath which has worsened over the past 2 days. He also has a productive cough with yellowish sputum. There is no history of hemoptysis, chest pain, fever, palpitations, or leg swelling. He had a viral illness one week ago. He has been using an inhaler for 10 years for his respiratory disease. He sleeps with 2 pillows every night. He received 100 mg of hydrocortisone and antibiotics in the emergency department, and his symptoms have subsided. His FEV1/FVC ratio is < 0.70, and FEV1 is 40% of predicted. What is the most likely finding that can be discovered from the histology of his bronchi?

AIncrease Reid index

BCurschmann spirals

CNon-caseating granuloma

DFerruginous bodies

ECharcot-Leyden crystals

2

A 28-year-old patient presents to the hospital complaining of progressively worsening dyspnea and a dry cough. Radiographic imaging is shown below. Pulmonary function testing (PFT's) reveals a decreased FEV1 and FEV1/FVC, but an increased TLC. The patient states that he does not smoke. Which of the following conditions is most consistent with the patient's symptoms?

AHypersensitivity pneumonitis

BChronic bronchitis

CAlpha1-antitrypsin deficiency

DPneumothorax

EAsthma

3

A 63-year-old man with alpha-1-antitrypsin deficiency is brought to the emergency department 1 hour after his daughter found him unresponsive. Despite appropriate care, the patient dies. At autopsy, examination of the lungs shows enlargement of the airspaces in the respiratory bronchioles and alveoli. Enzymatic activity of which of the following cells is the most likely cause of these findings?

AAlveolar macrophages

BCiliated bronchiolar epithelial cells

CElastic fibers in alveolar septa

DType I pneumocytes

EAlveolar septal cells

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