RESPIRATORY SYSTEM - PATHOLOGY-

PULSE

- Lung cancer involving cavitations?

Answer : squamous cell carcinoma

- Which of the restrictive diseases doesn't include fibrosis?

Answer: Sacridosis

- Earliest genetic abnormality in lung cancers ?

A )P53

B )3p loss

C )KRAS

Answer : B

- Which of the following is the most cause of indirect lung injury ?

Answer : sepsis

- The most common cause of hospital acquired pneumonia ?

A ) staph.aureus

B ) gram negative bacilli

Answer : The key answer was B , but they consider this question as bonus

- What is INCORRECT regarding restrictive lung diseases ?

A ) Macrophages do play a major role in interstitial lung diseases.

B ) Many of the conditions end with fibrosis.

C ) The alveoli are mainly affected.

D ) the problem in restrictive lung disease is in EXPIRATION

Answer : D

- Hypercalemia related to Preneoplastic changes include which of the following

cancers?

Answer : squamous cell carcinoma

- Which of the following is not a risk factor for aspiration pneumonia ?

A ) alcoholic

B ) anesthesia

C ) seizure

D ) using antibiotic

Answer : D

EHSAN

1) Esophageal Hiatus is located at :

A. T10

4) in which of the following the occupational asthma is less likely :

A. bakery

B. metallic salts

2) Which of the following about pneumoconiosis is wrong :

A. X-Ray is the best way to diagnose it

B. caused by inhalation of organic dust

C. the comparison b/w two X-Rays is highly important for the diagnosis

D. caused by direct effect of inhaled dust on lung tissue

3) One of the following regarding BOOP is false :

Ans: it's associated with good prognosis, often healing within 2-8 months .

4) One of the following is not a fibrosing reaction of RPD :

Ans: Sarcoidosis

5) Which is false about Centriacinar emphysema :

Ans: Centriacinar is less common than panacinar

6)The least lung tumor associated with smoking is :

Ans: Adenocarcinoma

7) The paraneoplastic syndrome with hypercalcemia is associated with :

Ans: Squamous cell lung cancer

8) One of these doesn't cause chronic pneumonia :

-Histoplasma capsulatum

-MTB blastomyces

- Coccidioidomycosis

-Pseudomonas aeruginosa

9) Regarding atopic asthma, one statement is false :

Ans: associated with decreased levels of IgE

10) Which of the following organisms is responsible of acute exacerbation of

COPD :

Ans: Maroxella Catarrhalis

11) Which would not cause an Acute Exacerbations of COPD :

1. Streptococcus pneumoniae

2. Haemophilus influenzae

3. Moraxella catarrhalis

4. Pseudomonas aeruginosa

5. Streptococcus mutans

13- The latency period of pneumoconiosis is :

- 5 y

- 5 -10 y

- 10 -15

- 15-20 y

- >> 20 y

15- One of the following is true about pulmonary hypertension :

- Pulmonary circulation is normally of high resistance

- TGF-B signaling pathway plays a role in sporadic primary pulmonary hypertension

- The primary form is the most common form

- Plexiform lesion are characteristic of the primary (idiopathic) form

- A decrease in endothelin cause vasoconstriction and pulmonary hypertension

16- All might show interstitial pneumonia pattern except :

-Mycoplasma pneumonia

-Resp.syncitial virus

-Chlamydia

-Rickettsia

-Stap.aureus

17- All are features of asthma except :

- repeated immediate hypersensitivity and late phase reaction in lung

- intermittent and reversible airway obstruction

- chronic bronchial inflammation with eosinophils

- bronchial smooth muscle cell hypertrophy and hyperactivity

-atopic type show normal to decrease level of IgE

18- Reid index is used to confirming the diagnosis of :

chronic bronchitis

19- All are feature of restrictive lung disease except :

- decrease lung compliance

- increase in effort to breath

- damage to alveolar epithelium and vasculature leads to abnormalities in ventilation-perfusion

ratio and hypoxia

- X-ray will show canon ball pattern

- progression to respiratory failure, pulmonary hypertension is common in non-treated cases

20 - The main inflammatory pathogenesis in fibrosis in interstitial lung disease :

Ans: Macrophage

21- RB mutation is seen in :

-Small cell carcinoma

-Adenocarcinoma

-Squamous cell carcinoma

-Large cell carcinoma

-Adenosquamous carcinoma

22- The most common laryngeal carcinoma is :

-Squamous cell carcinoma

-Large cell carcinoma

-Lymphoma

-Adeoncarcinoma

23- One false about TB :

- once bacterimia develop in primary TB most patients would symptomatic

- the development of cell mediated immunity occurs approximately 3 week after exposure

- IFNγ release CD4+ T-cell is crucial in activating macrophage

- the genetic makeup of the individual may influence the course of the disease

- IL-12 , TNF and nitric oxide participate in killing the mycobacterium

24-ALL of the following are risk factor of aspiration causing hospital acquired

pneumonia except :

- abnormal swelling

- exaggerated gag reflex

-altered consciousness

-delayed gastric emptying

-decrease gastric motility

25- Regarding asthma and COPD :

-asthma usually start in young while COPD in old

-asthma patient usually have also a history of allergy

-COPD patient usually have long smoking history

-both asthma and COPD can be diagnosed by pulmonary function test

-both asthma and COPD are completely reversible with bronchodilation

26- Which of the following is paraneoplastic syndrome associated with

squamous cell carcinoma ?

- increase secretion of parathyroid -like hormone

-increase secretion of ADH

-increase secretion of ACTH

-increase secretion of thyroxin

-increase secretion of aldosteron

27 - A 34 years old pateint presented to GP clinic complaining of shortness of

breath, productive cough and wieght loss , biopsy was taken and sent to lan ,

the most likely diagosis ?

-small cell carcinoma

-squamous cell carcinoma

-adenocarcinoma of primary lung origin

-metastatic colorectal carcinoma of lung

-carcinoid tumor

28 - 55 years old man smokers presented to clinic with coughing blood , weight

loss , night sweat , constipation and increase urination for 3 months ; chest

X-ray showed right apical mass , the mass was biopsied and it came back

positive for lung cancer , the most likely type of cancer is

small cell carcinoma

squamous cell carcinoma

bronchial carcinoma

large cell carcinoma

adenocarcinoma of primary lung origin

HOPE

1.Which of the following diseases is associated with decreased protein

secretions

due to a defect in type II alveolar cells?

(i)Emphysema

(ii)Acute Respiratory Distress Syndrome(ARDS)

(iii)Bronchitis

Answer: (ii)Acute Respiratory Distress Syndrome(ARDS)*

2. A 50 year old patient presents with a cough that has started about 4 months

ago. The patient has lost about 5kgs since 4 months. The patient has a low grade

fever as well as blood streaking in his sputum. A chest X-ray shows bilateral apical

focal cavitations in the lungs. Which of the following diagnostic procedures should

be done next?

(i)Auramine stain on a sputum sample

(ii)Gram stain on a sputum sample

(iii)CT guided lung biopsy

Answer: (i)Auramine stain on a sputum sample

Explanation: The clinical findings are consistent with either a TB infection or a

tumor of the lungs. The bilateral involvement on the chest X-ray is more

indicative of a TB infection. Auramine is an alternative stain used to detect acid

fast bacilli

3.Which of the following is correct about Ziehl-Neelsen stain :

(i)It only stains Mycobacterium Tuberculosis

(ii)It is commonly misspelled by doctors

(iii)It is uncommonly used in diagnostics

Answer: (ii)It is commonly misspelled by doctors

Explanation: (i) is wrong because Nocardia is also partially acid fast, (iii) is wrong

because it is commonly used to diagnose TB, one of the biggest killers on our

planet. The doctor has mentioned that several doctors misspell it, which was

also found in the slides as well that the doctor used during the lecture

4. A 55 year old patient presents with cough, weight loss and dypnea. Studies

showed a mass in his lung that when tested for marker was TTF-1 and CK-7

negative but CK-20 positive. Which of the following is the most likely etiological

cause of his findings ?

(i)Adenocarcinoma of colonic origin

(ii)Primary Adenocarcinoma of the lung

Answer: (i)Adenocarcinoma of colonic origin

Explanation: Adenocarcinoma’s of colonic origin are TTF-1 negative and CK-20

positive while adenocarcinoma of the lung is TTF-1 positive and CK-7 positive

5.EBV(Epstein-Barr virus) is associated with which of the following cancers?

Answer: Nasopharyngeal carcinoma

6.Which of the following are more associated with the EGFR gene mutation ?

(i)Adenocarcinoma

(ii)Non-smoking

(iii)Women

(iv)Asian

(v) All

7.Which of the following isn’t associated with asthma ?

Answer: Its severity doesn’t increase with times

8.Which of the following is true about Reid’s index?

Answer: It measures the thickness of the mucous layer

9. A 50 year old patient who has worked in a shipyard in Germany about 25 years ago has

been experiencing increasing dyspnea during the few months before. (Can’t remember the

rest of the case)

Answer: Asbestosis

Explanation: Asbestos has been used in shipyards, as well as construction sites

about 20 years ago. Exposure to asbestos is likely to induce asbestosis( and

fibrosis) about 20-40 years after initial exposure to asbestos.

SAMA

Q1.Sarcoidosis resemble or can be miss-diagnosed what :

1.TB

2.anthracosis

3.sillicosis

4.asbestosis

Q2.In Compression atelectasis, the mediastinum :

1.shifts to the opposite side.

2.Shifts to the same side.

3.No shifting.

4.Either direction shift

Q3.One of following is true related to diaphragm hernia :

A: lead to lung hypoplasia

Q4.All of the followings cause occupational asthma EXCEPT:

1. Formaldehyde

2.Chloride

3. Diisocyanate

Q5.Which of the following is least associated with pneumonia :

1.cough.

2.fever.

3.chest pain.

4.hemoptsis

Q6.Aschoff bodies characteristic of:

A: Rheumatic heart disease

Q7.Late phase of asthma stars after :

1.12-24 hours

2. 6-12 days

3.30 minutes

4. 4-8 hours

Q8.Which is wrong about chronic bronchitis :

A: it has pink puffer

Q9.Which is true about bronchoalveolar lung cancer:

-Its central mass

** this is not the answer

Q10.Which is false about silicosis :

1.Patients more susceptible to T.B.

2.small nodule but Later large nodules ….

none of these choices false but there are other choices

Q11.All the following are correct expect :

1-Carcinoid ---> neuroendocrine cells

2- hamartoma ----> coin lesion

3- Lymphangitis Carcinomatosa ----->lymph channel inflammation

the Qs was wrong in the exam

Q13.Least related to Occupational Asthma :

1.Teacher

2.Meat Worker

HAYAT

Q1.Precursor of adenocarcinoma :

A : Atypical hyperplastic gland

Q2.Decrease in lung compliance and increase in elastic recoil is seen in :

1.emphysema

2.lung fibrosis

Q3.The most common associated with bronchial carcinoid tumor :

A: Asbestosis