Chronic Non-specific Lung Diseases

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A 19-year-old woman presents with urticaria that developed after she took aspirin for a headache. She has a history of chronic rhinitis, and physical examination reveals the present of nasal polyps. This patient is at an increased risk of developing which one of the following pulmonary disease following the ingestion of aspirin?

@Asthma

Chronic bronchitis

Emphysema

Interstitial fibrosis

Pulmonary hypertension

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A patient with bronchial asthma got viral infection that provoked status asthmaticus with the death. At the histological examination of lungs spasm and oedema of bronchioli were revealed. The walls were infiltrated with lymphocytes, eosinophiles and other leucocytes; there was also a degranulation of labrocytes. What mechanism of hypersensivity is meant?

Inflammatory

@Reaginic reaction of hypersensivity

Autoimmune

Immune complex

Immune-mediated cellular cytolysis

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The major pathlogic injury in interstitial lung disease is generally accepted to be

Diffuse pneumonia

Bronchopneumonia

Bronchiolitis

Bronchitis

@Alveolitis

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A patient died from cardiopulmonary decompensation. Histological examination revealed diffused pulmonary lesion together with interstitial edema, infiltration of tissue by limphocytes, macrophages, plasmocytes; pulmonary fibrosis, panacinar emphysema. What disease corresponds with the described picture?

Pulmonary atelectasis

@Fibrosing alveolitis

Bronchial asthma

Bronchopneumonia

Chronic bronchitis

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Examination of a miner revealed pulmonary fibrosis accompanied by disturbance of alveolar ventilation. What is the main mechanism of this disturbance?

Constriction of superior respiratory tracts

Disturbance of neural respiration control

@Limitation of respiratory surface of lungs

Limitation of breast mobility

Bronchi spasm

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From the childhood the patient had chronic inflammatory lung diseases. There was a little of sputum that had white color. The patient was hospitalized with the signs of pulmonary and heart insufficiency, the last one caused his death. What changes were revealed at the section?

Macroscopically the heart is not changed

Hypertrophy and dilatation of the left ventricle

Hypertrophy of the both ventricles

Dilatation of the both ventricles

@Hypertrophy and dilatation of the right ventricle

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A 68-year old patient, with a history of the chronic inflammatory disease of lungs since his childhood, presented to the hospital with coughing accompanied by scanty sputum (expectoration). The complications of pulmonary and a heart failure resulted in his death. What changes in heart have been found at post-mortem?

@Right ventricular hypertrophy and dilatation

Left ventricular hypertrophy and dilatation

Ventricular hypertrophy

Ventricular dilatation

Heart without gross change

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A female patient, with 10 years history of cough with a purulent sputum and dyspnea, died from respiratory and heart failure. A post-mortem gross investigation of a dead body revealed her fingers reminded drum sticks. A dissection of lugs showed a bronchial alteration with a saccular deformity and purulent inflammation. What is the most likely diagnosis?

@Bronchiectatic disease

Tuberculosis

Chronic bronchitis

Abscess

Acute bronchitis

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A 48-year-old male with a long history of chronic bronchitis presents his physician a cough with a mucopurulent sputum (especially in the morning), dyspnea, and fingers deformity in a shape of the drum sticks. A pulmonal and heart insufficiency was also diagnosed. Make the preliminary diagnosis.

@Bronchiectatic disease

Bronchial asthma

Chronic bronchitis

Bronchopneumonia

Emphysema of lungs

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An autopsy of 55-year-old male with a 3 years history of a dry cough, a dyspnea, pulmonary insufficiency and quick weight loss, revealed a pulmonary heart and lungs fibrosis with a honey-comb pattern of the lungs tissue. Histological investigation demonstrated an interstitial fibrosis with the apparent infiltration of a stroma with lymphocytes, histiocytes and some neutrophils. What is the most likely diagnose?

@Bronchiectatic disease

Postinflammatory pneumosclerosis

Chronic bullous emphysema

Fibrosing alveolitis

Dusty pneumosclerosis

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A 27-year-old man presents with a chronic productive cough. Pertiment medical history is that he has had recurrent sinusitis and numerouslower respiratory tract infections since childhood. He has been married for 6 years and has no children, although he and his wife do not use any form of birth control. His chest x-ray reveals the apex of the heart to be directed toward the right (the cardiac apical impulse is feltbest in the sixth intercostals space), and a CBC reveals a normocytic normochromic anemia. Semen analysis reveals his spermatozoa to be immotile and lack the normal ATPase-containingdynein arms. Without treatment, which of the following changes is most likely to result from his disease?

@Abnormal permanent dilation of the bronch in the lungs

Destruction of the walls of the alveoli in the base of the lungs

Fatty metamorphosis of the hepatocytes in the liver

Hyperplasia of the smooth-muscle cells of the bronchioles in the lungs

Irreversible deposition of collagen in the subendothelial spacesin the liver

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A 42-year old male, with a history of the amyloidosis, died of chronic renal failure. A post- mortem revealed in the lower lung lobe multiple dilated bronchi filled with abundant foul sputum. A gross investigation of a cut surface showed a honey-comb pattern of a lungs tissue. A microscopic study demonstrated the chronic inflammation within bronchial wall and also a replacement of elastic and muscular fibers by a connecting tissue. These changes in a lung are regarded as:

@Bronchiectasis

Bronchopneumonia

Chronic bronchitis

Chronic pneumonia

Abscesses of lungs

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An autopsy of the middle age man with a long history of bronchiectasis revealed markedly enlarged adrenals volume at the expense of a cortical layer. Adrenals were pale, dense, and sebaceous. Microscopic investigation showed the unstructured, amorphous, eosinophilic, Congo red positive deposits by reticular stroma and within vessels walls. These changes indicate a development of:

@Amyloidosis

Mucoid swelling

Fibrinoid swelling

Lipidosis

Hyalinosis

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A 46-year old male, with a history of the chronic bronchiectasis, died from uremia. An autopsy revealed enlarged, firm kidneys, with sebaceous (waxy) cut surface. To what disease there correspond such changes?

@Amyloidosis of kidney

Glomerulonephritis

Acute tubular necrosis

Pyelonephritis

Arteriolosclerotic nephrosclerosis

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A 54-year old male, with a history of destructive purulent bronchitis died of multiple organ failure. An autopsy revealed cardiomegaly, a sebaceous (waxy) kidney and a sago spleen. What process has complicated bronchitis?

@Secondary amyloidosis

Senile amyloidosis

Tumor-like amyloidosis

Primary amyloidosis

Generalized hyalinosis

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A 7-year-old boy accidentally inhales a small peanut, which lodges in one of his bronchi. A chest x-ray reveals the mediastinum to be shifted toward the side of the obstruction. Which of the following pulmonary abnormalities is most likely present in this boy?

@Absorptive atelectasis

Compression atelectasis

Contraction atelectasis

Patchy atelectasis

Hyaline membrane disease

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X-ray examination discovered lungs emphysema in the patient. What is the reason of short breath development in this case?

@Decreased lungs elasticity

Decreasing of alveoli receptors sensitivity

Increased lungs elasticity

Inhibition of respiratory center

Excitation of respiratory center

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At the autopsy: lungs are enlarged in size, pale, of soft consistence, not collapsed, don’t crepitate cutting. Microscopically, the widening of the alveolar paths and the signs of intercapillary sclerosis can be seen. Also the interalveolar membranes are thin. What lung disease are these signs typical for?

Pneumonia

Pneumosclerosis

Pneumothorax

Atelectasis

@Emphysema

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An autopsy of the 47-year-old man revealed within lungs areas of increased pulmonary volume, with some bullas, that bulged out from beneath the pleura. Histological investigation showed thinning and rupture of interalveolar septas resulted in large multiform cavities formation. What is the most likely diagnosis?

@Emphysema of lungs

Bronchiectatic disease

Cavernous tuberculosis

Chronic bronchitis

Fibrosing alveolitis

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A 50-year-old man has died because of chronic pulmonary-cardiac insufficiency. In autopsy the pathologist has found out in the lungs: areas of abnormal enlargement with large subpleural blebs (diameter 0,5-1,5 cm). Microscopic investigation: laceration of the airspace, thinning of alveolar walls with formation of large cavities of the different form. What disease is revealed in lungs?

@Emphysema

Bronchoectatic disease

Cavernous tuberculosis

Chronic bronchitis

Hamman-Rich-syndrome

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A 53-year old male, with a history of the chronic diffusive bronchitis, presented to the hospital symptoms of cardiopulmonary insufficiency, then resulted in the lethal outcome of the disease. An autopsy revealed increased volume and hyperinflation of lungs, which covered a mediastinum with their edges and keep their form when removed from the body and put at autopsy table. Gross investigation showed a pale grey colour of lungs and a crunch sound while making an incision of a pulmonal tissue. A pressing a finger on a lungs tissue creates a fossa. A mucopurulent exudate was determined within bronchi's lumen. What is the most likely diagnosis?

@Chronic diffuse obstructive emphysema

Chronic focal emphysema

Intestinal emphysema

Primary idiopathic, emphysema

Vicarious compensatory emphysema

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An autopsy of the 56-year-old man revealed increased pulmonary volume, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Gross investigation disclosed a crunch sound while making an incision of a pulmonal tissue. Histological investigation showed dilated alveolar ducts and alveoli, thinned interalveolar septas and capillary walls sclerosis. For what disease of lungs such morphological picture is characteristic?

@Emphysema

Pneumosclerosis

Pneumothorax

Atelectasis

Pneumonia

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An autopsy of the 69-year-old man with a long history of chronic bronchitis revealed increased pulmonary volume and hyperinflation, pale grey color, soft texture lungs that kept their form when removed from the body and put at autopsy table. Histological investigation showed markedly dilated proximal acini, thinned and somewhere ruptured interalveolar septas. For what disease of lungs such morphological picture is characteristic?

@Emphysema of lungs

Chronic intestinal pneumonia

Atelectasis of lungs

Bronchiectatic disease

Pleural empyema

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A patient, who had chronic obstructive pulmonary emphysema, died of pulmonary-heart insufficiency. What changes can be revealed in the heart?

Amyloidosis

Left ventricle hypertrophy

@Right ventricle hypertrophy

Large focal cardiosclerosis

Cardiac rupture

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A 63-year-old man who is a long-term smoker present with increasing shortness of breath and dyspnea. He has smoked more than 2 packs of cigarettes per day for more than 40 years. He denies havinga productive cough or any recent infection. Physical examination reveals a thin elderly-appearing man in moderate respiratory distress. While sitting him leans forward slightly and breathe quickly through pursed lips. He is afebrile and his blood pressur is within normal limits. Examination of his chest reveals an increased anteroposterior diameter and his lung are hyper-resonant to percussion. His respiratory rate is increased, but no clubbing or cyanosis is present. Chest x-ray reveals his heart to be of normal size, but there is hyperinflation of his lung. Laboratory examination reveals that while breathing room air, his arterial Po₂ is decreased but his arterial Pco₂ is normal. Which of the following statements is a correct association concerning the pathogenesis of this man’s pulmonary disease?

Destruction of entire acinus caused panlobular emphysema

Destruction of the cilia on the respiratory epithelial cells resulted in bronchiectasis

@ Destruction of proximalacinus caused centrilobular emphysema

Hyperplasia of the respiratory smooth-muscle cells resulted in intrinsic asthma

Hyperplasia of the respiratory mucus glands caused chronic bronchitis

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An autopsy of a patient, who had been working within 20 years the coal worker, revealed grayish- black dense, sclerotic lungs. The vast areas of collagen tissue new growth and multiple macrophages, carrying black pigment within cytoplasm, were recognized under microscope. What is the most likely disease?

@Anthracosis

Anthracosilicosis

Silicoanthracosis

Talcosis

Siderosis

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A 49-year-old patient had been working as a coal miner many years and died of a chronic pulmonary and cardiac insufficiency. A post-mortem revealed hypoinflated, firm, sclerotic, lungs with emphysematous apexes. Pleura had a grayish-black coloring. Gross investigation of the lungs sectional view also showed deep black coloring of the pulmonary tissue. What is the most likely disease resulted in patient's death?

@Anthracosis

Silicosis

Talcosis

Asbestosis

Aluminosis

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A routine chest x-ray performed on an asymptomatic adult man who works at sandblasting reveals a fine nodularity in the upper zones of the lungs and “eggshell” calcification of the hilar lymph nodes. The patient’s serum calcium level is 9.8 mg/dL, while his total protein is 7.2 g/dL. He denies any history of drug use or cigarette smoking. A biopsy from his lung reveals birefringent particles within macrophages. What is this material?

Asbestos

Beryllium

Carbon

@Silica

Talc

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An autopsy of a male, who had been working within 9 years the stone polisher, revealed multiple, roundish, dense, diffuse nodules. Histological investigation of nodules showed concentric whorls of dense collagen fibers. At the periphery there were aggregated of mononuclear cells, mostly lymphocytes, and fibroblasts. What is the most likely disease?

@Silicosis

Acute pneumonia

Bronchiectatic disease

Chronic bronchitis

Bronchial asthma

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An autopsy of the miner, who had worked in coal mine more of 10 years, revealed in a lung whitish fibrous fibers and nodules 0,2-0,3 cm in diameter. Histological investigation of nodules showed bundles of interacting concentric pink collagen with apparent hyalinosis. There was a minimal inflammatory reaction and also noticeable amount of a brownish dust. What is the most likely type of pneumoconiosis in this case?

@Silicosis

Talcosis

Asbestosis

Siderosis

Berylliosis

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Histological investigation of pulmonary segment, removed from a coal worker's lung, revealed multiple roundish, nodules composed of concentric whorls of dense, hyaline fibers of collagen. What is the most likely disease?

@Silicosis

Tuberculosis

Bronchitis

Fibrosing alveolitis

Cancer of lungs

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An autopsy of a patient, who had a long history of exposure to free dioxide of silica in the inhaled air, revealed enlarged, firm lungs with multiple miliary and larger roundish areas of a sclerosis. Gross study showed grey and grey-black colour of his lungs' tissue. What is the most likely diagnose?

@Nodular form of silicosis

Diffusive - sclerotic form of silicosis

Anthracosilicosis

Silicoanthracosis

Asbestosis

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An autopsy of a patient, who had been working within 20 years the coal worker, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, round, grayish-black, diffuse nodules were discovered. Histological study showed nodules composed of concentric whorls of dense collagen fibers, some of them- with hyaline degeneration. What is the most likely disease?

@Nodular form of silicosis

Miliary tuberculosis of lung

Bronchiectatic disease

Croupous pneumonia

Diffusive - sclerotic form of silicosis

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An autopsy of a 54-year-old male, who died of a chronic pulmonary and cardiac insufficiency, revealed enlarged, slightly firm and hypoinflated lungs. At the gross investigation of the lungs sectional view multiple, whitish, 2-3 mm in diameter nodules were discovered. Histological study showed nodules composed of concentric whorls of dense, sparsely cellular collagen. What is the most likely disease?

@"Nodular form of silicosis

Miliary tuberculosis of lung

Fibrosing alveolitis

Microfocal pneumonia

Metastasis tumor of lungs

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After the histological examination of a biopsy material taken from the wall of the bronchus in a patient with chronic bronchitis was detected the overgrowth of the granulation tissue that elevated above the surface and contained a diffuse inflammatory infiltration. What type of bronchitis does the patient have?

Chronic deforming

Chronic mucopurulent

Chronic mucous

Chronic purulent

@Chronic polypous

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Histological investigations of the bronchus wall biopsy material, from the patient with a history of chronic bronchitis, revealed granulation tissue and diffuse inflammatory infiltrate. What kind of a bronchitis was diagnosed?

@Chronic polypous bronchitis

Chronic mucopurulent bronchitis

Chronic mucous bronchitis

Chronic purulent bronchitis

Chronic deforming bronchitis

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A 54-year-old man presents with several roblems involving his face and pain in his shoulder. He states that he has smoked 2 packs of cigarettes a day for almost 40 years. Physical examination reveals ptosis of his left upper eyelid, constriction of his left pupil, and lack of sweating (anhidrosis) on the left side of his face. No other neurologic abnormalities are found. Which of the following tumors is most likely to be present in this individual?

A bronchioloalveolar carcinoma involving the left upper lobe

A small-cell carcinomainvolving the hilum of his left lung

A squamous cellcarcinoma involving the left mainstem bronchus

@An adenocarcinoma involving the apex of his left lung

An endobronchial carcinoid tumor involving the right mainstem bronchus

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Histological investigation of a lung's biopsy revealed atypical cells which formed multiple acinar structures and produced mucus. What is the most likely histological diagnosis?

@High differentiated adenocarcinoma

Differentiated adenoarcinoma

Undifferentiated cancer

Differentiated squamous cell carcinoma

Glandular - squamous cell carcinoma?

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Thereupon the obturation of the middle lobe bronchus by the nodule of soft tissues the atelectasis of the middle lobe of the right lung had formed. At the bronchobiopsy was revealed the overgrowth of the glandular atypical epithelium with pathological mitoses that grew through the underlied tissues and the cartilage. What disease is the most possible due to these signs?

Inflammatory polyp

Deforming bronchitis

@Bronchogenic cancer of the lung

Dysplasia of the bronchial epithelium

Sarcoma of the bronchus

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A patient presents to his physician a middle lobar bronchial obstruction with a node of intraluminal soft masses, resulted in the atelectasis of middle lobe of the right lung. A bronchoscopy revealed in the obturation zone a new growth of glandular type atypical epithelium with pathological mitosises which penetrated the wall of the bronchus and infiltrated along the peribronchial tissue and a cartilage. What is the most likely diagnosis?

@Bronchogenic carcinoma of lung

Deforming bronchitis

Inflammatory polyp

Dysplasia of bronchial epithelium

Bronchus sarcoma

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A 39-year-old woman presents with a cough and increasing shortness of breath. A chest x-ray is interpreted by the radiologist as showing right lower lobe (RLL) pneumonia. No mass lesions are seen. The woman is treated with antibiotics, but her symptoms do not improve. On her return visit, the area consolidation appears to be increased. Bronchoscopy is performed. No bronchial masses are seen, but a transbronchial biopsy is obtained in an area of mucosal erythema in the RLL. After the diagnosis is made, the RLL is removed and section from this specimen reveals well-differentiated mucus-secreting columnar epithelial cells that infiltrate from alveolus to alveolus. Which of the following is the most diagnosis?

@Bronchioloalveolar carcinoma

Carcinoid

Large cell carcinoma

Small cell carcinoma

Squamous cell carcinoma

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Histological investigation of a biopsy of a bronchus revealed a tumor which is constructed from clusters of atypical cells of a laminated (stratified) squamous epithelium, some areas with typical "pearls". What is the most likely diagnosis?

@Squamous cell keratinous carcinoma

Squamous cell nonkeratinous carcinoma

Solid carcinoma

Mucinous carcinoma

Scirrhous carcinoma

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The biopsy is taken from a suspicious site at the mucous the right bronchus of a 58-year old male, with a history of the chronic bronchitis, pneumosclerosis and cardiopulmonary insufficiency. Histological investigation revealed cellular and tissue atypia, presence of a "cancer pearls" structures. What pathological process associated with histological changes listed below?

@Squamous cell keratinous carcinoma

Chronic polypous bronchitis

Bronchiectasis

Acute bronchitis

Squamous metaplasia of the bronchial epithelium

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A 67-year-old man who is a long-term smoker presents with weight loss, a persistent cough, fever, chest pain, and hemoptysis. Physical examination reveals cachectic man with clubbingof his fingers and dullness to percussion over his right lower lobe. A chest x-ray reveals 3.5-cm hilar mass on the right and postobstructive pneumonia of the right lower lobe. Sputum cytology is suspicious for malignant cells. Histologic examination of transbronchial biopsy specimen reveals infiltrating groups of cells with scant cytoplasm. No glandular structures or keratin production are seen. The nuclei of these cells are about twice the size of normal lymphocytes and do not appear to have nucleoli. Which of the following is the most likely diagnosis?

Adenocarcinoma

Hamartoma

Large-cell undifferentiated carcinoma

@Small-cell undifferentiated carcinom

Squamous cell carcinoma

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A 68-year-old man who worked for many years in the asbestos industry presents with weight loss and increasing chest pain. Examination of his sputum finds very rare asbestos bodies, while a CT scan shows a large mass involving the apical surface of his left lung. Surgery is performed and gross examination finds a lesion similar in appearance to that seen in the associated gross photograph of a sagittal section of the lung. Sections from this mass examinated by electron microscopy reveal tumor cells with long microvilli on their surface. Which of the following is the most likely diagnosis?

@Malignant mesothelioma

Malignant thymoma

Metastatic malignant melanoma

Poorly differentiated adenocarcinoma

Small-cell carcinoma

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During a routine physical examination, a 43-year-old man is found to have a 2.5-cm “coin” in the peripheral portion of his right upper lobe (RUL). Several sputum samples sent for cytology are unremarkable, and a bronchoscopic examination is also unremarkable. Surgery is performed and the mass is resected. Histologic examination reveals lobulesof connective tissue that contains mature hyaline cartilage. These lobules are separated by clefts that are lined by respiratory epithelium. Which of the following is the most likely diagnosis?

Adenocarcinoma

Bronchioloalveolar carcinoma

Carcinoid

Fibroma

@Hamartoma

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Konec:

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Date: 2016-03-03; view: 1546