Respiratory Pathology MCQs

Pathology · 10 free questions with answers & explanations.

1. A 65-year-old lifelong smoker undergoes pulmonary function testing showing an FEV1/FVC ratio of 0.58, irreversible after bronchodilator. CT scan reveals hyperinflation and enlarged air spaces distal to the terminal bronchiole with destruction of alveolar walls but no fibrosis. The primary enzymatic mechanism underlying this lesion is:
2. An autopsy on a patient who died of lobar pneumonia shows a red-brown, firm, airless lobe that sinks in water. Microscopically, the alveoli are filled with fibrin, red blood cells, and neutrophils with preserved alveolar walls. This morphological stage is called:
3. A 35-year-old HIV-positive man with a CD4 count of 70 cells/μL presents with fever, night sweats, and bilateral upper lobe infiltrates with cavitation on chest X-ray. Sputum culture grows acid-fast bacilli. The predominant mechanism of tissue destruction in pulmonary tuberculosis is:
4. A 60-year-old male smoker presents with a central hilar mass on CXR with post-obstructive atelectasis. Bronchoscopic biopsy shows malignant cells with nuclear molding, scant cytoplasm, and positive immunostaining for synaptophysin and CD56. What is the most likely diagnosis?
5. A 55-year-old non-smoking woman presents with a peripheral lung nodule on CT. Biopsy shows a lepidic growth pattern with columnar cells lining alveolar walls without stromal invasion. TTF-1 is positive. This lesion is best classified as:
6. A 45-year-old woman with rheumatoid arthritis develops progressive exertional dyspnea. HRCT shows bilateral basal-predominant reticular opacities with honeycombing and traction bronchiectasis. Biopsy reveals temporal heterogeneity with fibroblastic foci and subpleural honeycombing. This pattern is called:
7. A 35-year-old woman on oral contraceptives develops sudden onset pleuritic chest pain and dyspnea 10 days after orthopedic surgery. D-dimer is elevated. CT pulmonary angiography confirms bilateral pulmonary emboli. What is the most common source of pulmonary emboli?
8. A 50-year-old coalmine worker develops progressive massive fibrosis on CXR. Biopsy shows silicotic nodules with concentric whorls of collagen fibers with a necrotic center. The central necrosis in these nodules is caused by:
9. Histopathology of a pleural-based lung tumor in a 60-year-old shipyard worker shows biphasic morphology with epithelioid cells forming tubulo-papillary structures and spindle-shaped sarcomatoid areas. Immunostaining shows calretinin and WT1 positivity. What is the diagnosis?
10. A 30-year-old woman presents with recurrent episodes of wheezing and dyspnea triggered by aspirin use. Bronchoalveolar lavage shows eosinophilia. Lung biopsy during a severe attack would most likely show: