Chapter·PathologyPulmonary

Restrictive lung diseasesDownloads

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1

A 61-year-old male presents to your office with fever and dyspnea on exertion. He has been suffering from chronic, non-productive cough for 1 year. You note late inspiratory crackles on auscultation. Pulmonary function tests reveal an FEV1/FVC ratio of 90% and an FVC that is 50% of the predicted value. Which of the following would you most likely see on a biopsy of this patient's lung?

AArteriovenous malformations

BHyaline membranes

CCharcot-Leyden crystals

DSubpleural cystic enlargement

ELinear immunofluorescence along alveolar basement membranes

2

A 35-year-old woman comes to the physician because of a 3-month history of progressive fatigue, shortness of breath, and pain in her knees and ankles. Her temperature is 37.6°C (99.7°F). Physical examination shows mild hepatomegaly and tender, red nodules on her shins. There are purple, indurated lesions on her nose, nasolabial fold, and cheeks. A biopsy of the liver shows scattered aggregations of multinucleated giant cells with cytoplasmic inclusions and eosinophilic, needle-shaped structures arranged in a star-like pattern. Which of the following is the most likely cause of this patient's symptoms?

AHypereosinophilic syndrome

BHemochromatosis

CSarcoidosis

DSerum sickness

ESystemic lupus erythematosus

3

A 60-year-old woman presents to the clinic with a 3-month history of shortness of breath that worsens on exertion. She also complains of chronic cough that has lasted for 10 years. Her symptoms are worsened even with light activities like climbing up a flight of stairs. She denies any weight loss, lightheadedness, or fever. Her medical history is significant for hypertension, for which she takes amlodipine daily. She has a 70-pack-year history of cigarette smoking and drinks 3–4 alcoholic beverages per week. Her blood pressure today is 128/84 mm Hg. A chest X-ray shows flattening of the diaphragm bilaterally. Physical examination is notable for coarse wheezing bilaterally. Which of the following is likely to be seen with pulmonary function testing?

ADecreased FEV1: FVC and decreased total lung capacity

BNormal FEV1: FVC and decreased total lung capacity

CIncreased FEV1: FVC and decreased total lung capacity

DDecreased FEV1: FVC and increased total lung capacity

EIncreased FEV1: FVC and normal total lung capacity

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