PATHOLOGY EXAM 3 CASE STUDIES | 2025/2026
UPDATE | QUESTIONS AND ANSWERS | 100%
CORRECT!!
A 63-year-old man presents to your office after noticing that his left eyelid is
droopy. Upon further questioning, he admits to some shortness of breath over
the past 2 months, but he attributes that to his 40-year-long heavy smoking
habit. Physical examination reveals ptosis and miosis of the left eye and
extremely dry skin of the left face. A CXR demonstrates an irregular mass in the
apex of his left lung. You admit the patient to the hospital for a biopsy of the
mass, but you fear that the prognosis is not good Answer - Bronchogenic
carcinoma
A 71-year-old man presents to your office because of water retention. He states
that he keeps himself well-hydrated, but he does not feel that his intake
matches his output. Pertinent past medical history includes shortness of breath
and weight loss of 15 lb over the past 3 months. He has smoked two and a half
packs of cigarettes per day for 50 years. Besides looking into possible causes of
urinary obstruction and other diagnoses, you decide to send the man for a CXR,
which reveals a central coin lesion. Based on the patient's history, you expect
to see small, round cells with scant cytoplasm on a biopsy of the mass. Answer
- BRONCHOGENIC CARCINOMA/Horner syndrome/Lambert-Eaton
syndrome/Pancoast tumor/superior vena cava syndrome
A 22-year-old man presents to the emergency department complaining of
severe chest pain and shortness of breath. Physical examination reveals a tall,
thin man with decreased breath sounds, decreased tactile fremitus, and
hyperresonance to percussion over the right chest. His ECG appears normal,
, but a supine CXR reveals a deep sulcus sign over the right costophrenic angle as
well as tracheal deviation. You immediately place him on oxygen and prepare
him for chest tube placement. Answer - Pneumothorax
You are called emergently to see a newborn baby boy in the nursery. The
mother reports that the baby started choking and coughing up breast milk
upon her first attempt to feed him. On physical examination, the baby is
excessively salivating and appears slightly blue in color. You order laboratory
studies, expecting to find severe fluid and electrolyte imbalances, and you
order a CXR to look for signs of a gastric air bubble. You also call a pediatric
surgical consult as you suspect that the child will need immediate surgical
repair of his condition Answer - .Tracheoesophageal fistula
A 45-year-old man with a 3-year history of gastroesophageal reflux presents to
a gastroenterologist with the chief complaint of increasing heartburn and
regurgitation after meals. He has been taking antacids and proton pump
inhibitors daily for the last year with reasonable relief of symptoms before the
recent increase in heartburn and regurgitation even with antacid use. You, as
the gastroenterologist, perform an endoscopy and find orange, gastric-type
epithelium extending upward from the stomach into the distal esophagus in a
circumferential fashion. You take a biopsy and send it to the laboratory for
histologic studies, but you fear that this man is now at an increased risk for
developing esophageal adenocarcinoma. Answer - Barrett esophagus
A 55-year-old Caucasian man presents to your gastroenterology clinic. He
reports that he has had difficulty keeping down both solids and liquids over the
last several months. After obtaining a more detailed history, you find that the
patient has regurgitated small amounts of undigested food after almost every
meal for the last 3 weeks. He also complains of substernal pain even hours
after eating small meals. A barium esophagography reveals a characteristic
"bird-beak" at the LES. The patient asks what can be done to stop the pain and
you answer that botulinum toxin can be injected directly into the affected
esophageal site with relief that can last for months. Answer - Achalasia
UPDATE | QUESTIONS AND ANSWERS | 100%
CORRECT!!
A 63-year-old man presents to your office after noticing that his left eyelid is
droopy. Upon further questioning, he admits to some shortness of breath over
the past 2 months, but he attributes that to his 40-year-long heavy smoking
habit. Physical examination reveals ptosis and miosis of the left eye and
extremely dry skin of the left face. A CXR demonstrates an irregular mass in the
apex of his left lung. You admit the patient to the hospital for a biopsy of the
mass, but you fear that the prognosis is not good Answer - Bronchogenic
carcinoma
A 71-year-old man presents to your office because of water retention. He states
that he keeps himself well-hydrated, but he does not feel that his intake
matches his output. Pertinent past medical history includes shortness of breath
and weight loss of 15 lb over the past 3 months. He has smoked two and a half
packs of cigarettes per day for 50 years. Besides looking into possible causes of
urinary obstruction and other diagnoses, you decide to send the man for a CXR,
which reveals a central coin lesion. Based on the patient's history, you expect
to see small, round cells with scant cytoplasm on a biopsy of the mass. Answer
- BRONCHOGENIC CARCINOMA/Horner syndrome/Lambert-Eaton
syndrome/Pancoast tumor/superior vena cava syndrome
A 22-year-old man presents to the emergency department complaining of
severe chest pain and shortness of breath. Physical examination reveals a tall,
thin man with decreased breath sounds, decreased tactile fremitus, and
hyperresonance to percussion over the right chest. His ECG appears normal,
, but a supine CXR reveals a deep sulcus sign over the right costophrenic angle as
well as tracheal deviation. You immediately place him on oxygen and prepare
him for chest tube placement. Answer - Pneumothorax
You are called emergently to see a newborn baby boy in the nursery. The
mother reports that the baby started choking and coughing up breast milk
upon her first attempt to feed him. On physical examination, the baby is
excessively salivating and appears slightly blue in color. You order laboratory
studies, expecting to find severe fluid and electrolyte imbalances, and you
order a CXR to look for signs of a gastric air bubble. You also call a pediatric
surgical consult as you suspect that the child will need immediate surgical
repair of his condition Answer - .Tracheoesophageal fistula
A 45-year-old man with a 3-year history of gastroesophageal reflux presents to
a gastroenterologist with the chief complaint of increasing heartburn and
regurgitation after meals. He has been taking antacids and proton pump
inhibitors daily for the last year with reasonable relief of symptoms before the
recent increase in heartburn and regurgitation even with antacid use. You, as
the gastroenterologist, perform an endoscopy and find orange, gastric-type
epithelium extending upward from the stomach into the distal esophagus in a
circumferential fashion. You take a biopsy and send it to the laboratory for
histologic studies, but you fear that this man is now at an increased risk for
developing esophageal adenocarcinoma. Answer - Barrett esophagus
A 55-year-old Caucasian man presents to your gastroenterology clinic. He
reports that he has had difficulty keeping down both solids and liquids over the
last several months. After obtaining a more detailed history, you find that the
patient has regurgitated small amounts of undigested food after almost every
meal for the last 3 weeks. He also complains of substernal pain even hours
after eating small meals. A barium esophagography reveals a characteristic
"bird-beak" at the LES. The patient asks what can be done to stop the pain and
you answer that botulinum toxin can be injected directly into the affected
esophageal site with relief that can last for months. Answer - Achalasia
