Pathoma: Respiratory- Test Questions and Answers
What is the symptomatic time period necessary for a diagnosis of chronic bronchitis?
Correct Ans-Productive cough lasting at least 3 months over a minimum of 2 years.
What is the Reid index and what is its normal value? Correct Ans-Reid index- thickness of
mucus glands in bronchi relative to the thickness of the entire wall. Normally <40%.
What is the Reid index in chronic bronchitis? Correct Ans->50% (increased thickness of
mucinous glands relative to the entire thickness of the bronchial wall).
A "blue bloater" has what disease? Correct Ans-Chronic bronchitis
What causes centriacinar emphysema? Correct Ans-Smoking (usually in upper lobes)
What causes panacinar emphysema? Correct Ans-Alpha 1 antitrypsin deficiency (destroy
the entire acinus)
In which lobes is centriacinar emphysema usually found? Correct Ans-Upper (smoke
travels up in the lungs)
In which lobes is panacinar emphysema usually found? Correct Ans-Lower lobes
, Pathoma: Respiratory- Test Questions and Answers
Pink PAS positive globules on liver biopsy is indicative of... Correct Ans-Alpha 1 antitrypsin
deficiency
What is the most common mutation seen in A1AT deficiency? Correct Ans-PiZ allele
Where does alpha-1 antitrypsin accumulate in individuals with A1ATD? Correct Ans-
Endoplasmic reticulum
Explain the mechanism of wall collapse in emphysema. Correct Ans-Normally, recoil of
alveoli serves to hold lower airways open during expiration. When their septa are destroyed
in emphysema, they lose this ability, and the airways collapse.
Why do patients with emphysema breathe with pursed lips? Correct Ans-It creates back
pressure to keep the small airways open (they would otherwise collapse in emphysema
because of loss of recoil from alveoli to keep them open)
What disease does a "pink puffer" have? Correct Ans-Emphysema
What 3 cytokines do TH2 cells secrete? Correct Ans-IL-4, IL-5, IL-10
What does IL-4 do? Correct Ans-Promotes class switching to IgE
What cytokine is a key eosinophil activator? Correct Ans-IL-5
, Pathoma: Respiratory- Test Questions and Answers
What are the two mechanisms that cause early inflammation in asthma? Correct Ans-Mast
cell destabilization and release of preformed histamine.
Production of LTC4, LTD4, LTE4
What are Curschmann spirals? Correct Ans-Twisted mucous plugs admixed with sloughed
epithelium in asthma
What are Charcot-Leyden crystals? Correct Ans-Crystals in sputum formed from
breakdown of eosinophils in sputum
What is bronchiectasis? Correct Ans-Permanent dilation of bronchioles and bronchi (large
airways)
What are some causes of bronchiectasis? Correct Ans-Bronchial obstruction, Kartagener's
syndrome (dysfunction of dynein arms of cilia), CF, allergic bronchopulmonary aspergillosis.
What is paraseptal (distal acinar) emphysema? Correct Ans-Emphysema of distal airway
structures - associated with apical bullae that can rupture in tall, thin, male patients, creating
a spontaneous pneumothorax.
What is the symptomatic time period necessary for a diagnosis of chronic bronchitis?
Correct Ans-Productive cough lasting at least 3 months over a minimum of 2 years.
What is the Reid index and what is its normal value? Correct Ans-Reid index- thickness of
mucus glands in bronchi relative to the thickness of the entire wall. Normally <40%.
What is the Reid index in chronic bronchitis? Correct Ans->50% (increased thickness of
mucinous glands relative to the entire thickness of the bronchial wall).
A "blue bloater" has what disease? Correct Ans-Chronic bronchitis
What causes centriacinar emphysema? Correct Ans-Smoking (usually in upper lobes)
What causes panacinar emphysema? Correct Ans-Alpha 1 antitrypsin deficiency (destroy
the entire acinus)
In which lobes is centriacinar emphysema usually found? Correct Ans-Upper (smoke
travels up in the lungs)
In which lobes is panacinar emphysema usually found? Correct Ans-Lower lobes
, Pathoma: Respiratory- Test Questions and Answers
Pink PAS positive globules on liver biopsy is indicative of... Correct Ans-Alpha 1 antitrypsin
deficiency
What is the most common mutation seen in A1AT deficiency? Correct Ans-PiZ allele
Where does alpha-1 antitrypsin accumulate in individuals with A1ATD? Correct Ans-
Endoplasmic reticulum
Explain the mechanism of wall collapse in emphysema. Correct Ans-Normally, recoil of
alveoli serves to hold lower airways open during expiration. When their septa are destroyed
in emphysema, they lose this ability, and the airways collapse.
Why do patients with emphysema breathe with pursed lips? Correct Ans-It creates back
pressure to keep the small airways open (they would otherwise collapse in emphysema
because of loss of recoil from alveoli to keep them open)
What disease does a "pink puffer" have? Correct Ans-Emphysema
What 3 cytokines do TH2 cells secrete? Correct Ans-IL-4, IL-5, IL-10
What does IL-4 do? Correct Ans-Promotes class switching to IgE
What cytokine is a key eosinophil activator? Correct Ans-IL-5
, Pathoma: Respiratory- Test Questions and Answers
What are the two mechanisms that cause early inflammation in asthma? Correct Ans-Mast
cell destabilization and release of preformed histamine.
Production of LTC4, LTD4, LTE4
What are Curschmann spirals? Correct Ans-Twisted mucous plugs admixed with sloughed
epithelium in asthma
What are Charcot-Leyden crystals? Correct Ans-Crystals in sputum formed from
breakdown of eosinophils in sputum
What is bronchiectasis? Correct Ans-Permanent dilation of bronchioles and bronchi (large
airways)
What are some causes of bronchiectasis? Correct Ans-Bronchial obstruction, Kartagener's
syndrome (dysfunction of dynein arms of cilia), CF, allergic bronchopulmonary aspergillosis.
What is paraseptal (distal acinar) emphysema? Correct Ans-Emphysema of distal airway
structures - associated with apical bullae that can rupture in tall, thin, male patients, creating
a spontaneous pneumothorax.
