Pulm Quizzes 2

zwinthrop's version from 2015-04-19 13:57

Review Q's Interstitial Lung Diseases

1. Features common to diffuse interstitial diseases of the lung include all of the following except:
a. patients have dyspnea and tachypnea, and may eventually develop hypoxemia and cyanosis
b. pulmonary hypertension may develop due to destruction of the pulmonary capillary bed
c. produce obstructive functional alterations in pulmonary function
d. typically bilateral


2. The causes of interstitial lung disease
a. include a variety of environmental antigens
b. can be identified in all cases
c. are the same for everyone
d. respond to antibiotics


3. Participants in the pathogenesis of interstitial lung disease include all of the following except:
a. inflammatory mediators
b. neutrophils
c. macrophages
d. fibroblasts
e. none of the above


4. Honeycomb lung
a. refers to the replacement of alveoli by cystic spaces separated by thick fibrous bands with inflammatory cells
b. refers to the enzymatic destruction of alveolar septa and creation of cystic spaces
c. refers to patchy intraalveolar fibrosis occurring after bacterial pneumonia
d. is manufactured by Kelloggs


5. Which statement is incorrect? Sarcoidosis
a. may be associated with cutaneous anergy
b. is a systemic disease of unknown etiology
c. rarely responds to corticosteroid therapy
d. is associated with increased CD4+ T-cells in the lungs, with oligoclonal expansion of T-cell subsets


6. In sarcoidosis, which of the following structures may be seen in granulomas?
a. asteroid bodies
b. acid fast bacilli
c. fungi
d. talc
7. Farmer's lung is a type of
a. localized lung disease
b. idiopathic pulmonary fibrosis
c. hypersensitivity pneumonitis
d. infectious lung disease


8. A lung biopsy shows interstitial pneumonitis, chronic bronchiolitis, and granulomas. Treatment for this process usually includes
a. antibiotics
b. cytotoxic chemotherapy
c. identification and avoidance of the etiologic agent
d. surgery to remove the affected portion of lung


9. Clinical characteristics of idiopathic pulmonary fibrosis include all of the following except:
a. usually steroid responsive
b. insidious onset of dyspnea
c. survival after diagnosis is less than 5 years
d. restrictive functional alterations in pulmonary function


10. Histologic features of idiopathic interstitial fibrosis
a. are also seen with other disorders
b. include numerous hyaline membranes in the acute stage
c. include interstitial fibrosis and granulomas
d. reflect the initiation of the process by a stimulus at a single point in time


11. Cryptogenic organizing pneumonia
a. is irreversible
b. demonstrates numerous neutrophils in bronchioles
c. is often preceded by symptoms of gastroenteritis
d. has pathologic features that can be similar to infections, aspiration, or collagen vascular diseases


12. Pneumoconioses may be associated with inhalation of
a. silica.
b. iron oxide.
c. beryllium.
d. coal dust.
e. all of the above.


13. Which statement regarding pneumoconioses is incorrect?
a. Particle size is an important determinant of where in the respiratory tract a particle will settle.
b. Symptoms of a pneumoconiosis usually occur within days of exposure.
c. Progressive massive fibrosis can be the outcome of a variety of pneumoconioses.
d. Pneumoconioses includes cases of hypersensitivity pneumonitis and asthma caused by organic dusts.
14. Complications related to pneumoconioses include all of the following except:
a. neoplasia.
b. Caplan's syndrome.
c. left-sided heart failure.
d. pulmonary hypertension.


15. Asbestos
a. is not normally found in human lungs.
b. exposure is reflected by the presence of concentric nodules with birefringent material.
c. is a highly soluble substance which is quickly digested and removed from the lung.
d. is used in a variety of products employed in building construction.


16. The relative risk of developing lung carcinoma is highest in a(n)
a. asbestos-exposed nonsmoker.
b. nonexposed smoker.
c. asbestos-exposed smoker.
d. nonexposed nonsmoker.


17. Histologic diagnosis of asbestosis requires which two of the following findings?
a. asbestos bodies.
b. separate densely collagenous nodules.
c. granulomas.
d. diffuse interstitial fibrosis.
18. Participants in the pathogenesis of pneumoconioses are thought to include
a. macrophages.
b. fibroblasts.
c. fibrogenic factors.
d. all of the above.


19. Which infectious disease occurs with significantly increased frequency in patients with silicosis?
a. histoplasmosis.
b. bacterial pneumonia.
c. tuberculosis.
d. viral pneumonia.


20. Histologic findings expected in silicosis include which two of the following?
a. collagenous nodules with concentric laminations.
b. crystals which are birefringent with polarization.
c. necrotizing granulomas.
d. ferruginous bodies.


21. An elderly coal miner complains of worsening dyspnea and a chronic cough productive of blackish sputum. His chest X ray shows multiple large (>2 cm.) densities in both lungs, particularly in the upper lobes. What would his lung biopsy be expected to show?
a. collagenous nodules with concentric laminations
b. large scars with numerous coal dust - containing macrophages
c. granulomas
d. mesothelioma