Idiopathic Pulmonary Fibrosis Pathology Quiz
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Questions and Answers

What is the main characteristic of idiopathic pulmonary fibrosis described in the text?

  • Excessive mucus production
  • Fibrosis surrounding residual airspaces (correct)
  • Inflammation of lung tissue
  • Dilated blood vessels
  • Which process contributes to the severity of idiopathic pulmonary fibrosis?

  • Fibroblast depletion
  • Reduced diffusion block
  • Enhanced gas exchange
  • Collagen deposition and fibroblast proliferation (correct)
  • What does a Trichrome stain help visualize in idiopathic pulmonary fibrosis?

  • Inflammatory cells
  • Collagen fibrosis (correct)
  • Blood vessels
  • Alveolar sacs
  • What type of repair process is idiopathic pulmonary fibrosis an example of?

    <p>Maladaptive repair</p> Signup and view all the answers

    Where are areas of fibrosis mainly located?

    <p>Peripheral zones of lobules</p> Signup and view all the answers

    How does the extent of fibrosis impact the severity of idiopathic pulmonary fibrosis?

    <p>It reduces gas exchange efficiency</p> Signup and view all the answers

    What does the subpleural fibroblastic focus consist of?

    <p>Fibroblasts and myofibroblasts</p> Signup and view all the answers

    What does the honeycombing seen in idiopathic pulmonary fibrosis correspond to?

    <p>Usual interstitial pneumonia pattern</p> Signup and view all the answers

    How is architectural destruction highlighted in the imaging of idiopathic pulmonary fibrosis?

    <p>Prominent bright interstitial markings</p> Signup and view all the answers

    What is typically seen in smaller darker, round lucent areas on imaging of idiopathic pulmonary fibrosis?

    <p>Honeycomb change</p> Signup and view all the answers

    What does the elastic stain highlight in idiopathic interstitial pneumonias?

    <p>Architectural destruction seen as thick fragmented elastic fibers</p> Signup and view all the answers

    What are the learning objectives related to restrictive lung diseases and chronic interstitial diseases?

    <p>Understanding the radiologic features of idiopathic pulmonary fibrosis</p> Signup and view all the answers

    Which term is commonly used to describe idiopathic pulmonary fibrosis?

    <p>Usual interstitial pneumonia</p> Signup and view all the answers

    What is a characteristic feature of hypersensitivity pneumonitis?

    <p>Hypersensitivity reaction to inhaled allergens</p> Signup and view all the answers

    Which condition is known for its association with smoking and presents with desquamation of alveolar macrophages?

    <p>Desquamative interstitial pneumonitis</p> Signup and view all the answers

    What is a common feature of radiation-induced lung injury?

    <p>Damage due to exposure to ionizing radiation</p> Signup and view all the answers

    Which pathology is associated with respiratory bronchiolitis and interstitial lung disease?

    <p>Respiratory bronchiolitis-associated interstitial lung disease(s)</p> Signup and view all the answers

    What is the 2nd most common type of interstitial pneumonia mentioned in the text?

    <p>Nonspecific interstitial pneumonia</p> Signup and view all the answers

    Which gender is more commonly affected by nonspecific interstitial pneumonia according to the text?

    <p>Female non-smokers</p> Signup and view all the answers

    What type of fibrosis involves the alveolar septa uniformly and diffusely in nonspecific interstitial pneumonia?

    <p>Loose fibrosis</p> Signup and view all the answers

    Which of the following is unlikely to be found in the histology of nonspecific interstitial pneumonia?

    <p>Fibrosing infiltrates</p> Signup and view all the answers

    In what age range does nonspecific interstitial pneumonia most commonly affect patients?

    <p>50-60 years</p> Signup and view all the answers

    What lung architecture changes may occur in later phases of nonspecific interstitial pneumonia?

    <p>Cystic changes</p> Signup and view all the answers

    What is the histologic feature seen in cryptogenic organizing pneumonia?

    <p>Polypoid plugs of loose connective tissue</p> Signup and view all the answers

    Which cell types are predominantly found in the polypoid plugs of cryptogenic organizing pneumonia?

    <p>Fibroblasts and myofibroblasts</p> Signup and view all the answers

    Which lung disease is characterized by the histologic pattern of usual interstitial pneumonia (UIP)?

    <p>Idiopathic pulmonary fibrosis</p> Signup and view all the answers

    What is the main difference between idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia?

    <p>Presence of interstitial fibrosis</p> Signup and view all the answers

    Which autoimmune disease can lead to nonspecific interstitial pneumonia as a pulmonary manifestation?

    <p>Systemic lupus erythematosis (SLE)</p> Signup and view all the answers

    What is a key feature of cryptogenic organizing pneumonia in terms of prognosis?

    <p>Good prognosis but may relapse</p> Signup and view all the answers

    What is a potential treatment option for nonspecific interstitial pneumonia according to the text?

    <p>Glucocorticoids with/without other immunosuppressive drugs</p> Signup and view all the answers

    Which pulmonary function test result is typically decreased in patients with nonspecific interstitial pneumonia?

    <p>Diffusing capacity of lung for carbon monoxide (DLCO)</p> Signup and view all the answers

    What is a common symptom associated with nonspecific interstitial pneumonia as described in the text?

    <p>Fatigue</p> Signup and view all the answers

    Which of the following is NOT a feature typically seen in the histology of nonspecific interstitial pneumonia?

    <p>Granulomas</p> Signup and view all the answers

    In nonspecific interstitial pneumonia, what pattern is observed on imaging that corresponds to alveolar filling with exudates and fibroblastic foci?

    <p>Consolidation</p> Signup and view all the answers

    Which cells play a key role in generating loose fibrosis in cryptogenic organizing pneumonia?

    <p>Fibroblasts</p> Signup and view all the answers

    What is the main characteristic imaging finding in cryptogenic organizing pneumonia?

    <p>Ground-glass opacities</p> Signup and view all the answers

    Which clinical feature is most commonly associated with cryptogenic organizing pneumonia?

    <p>Dyspnea</p> Signup and view all the answers

    What is the histologic term used to describe the polypoid plugs of loose connective tissue seen in cryptogenic organizing pneumonia?

    <p>Masson bodies</p> Signup and view all the answers

    Which underlying condition can potentially trigger cryptogenic organizing pneumonia?

    <p>Rheumatoid arthritis</p> Signup and view all the answers

    What is the treatment of choice for cryptogenic organizing pneumonia with a good response rate?

    <p>Oral corticosteroids</p> Signup and view all the answers

    What characterizes the pathophysiology of nonspecific interstitial pneumonia?

    <p>Uniform fibrosis involving the alveolar septa uniformly and diffusely</p> Signup and view all the answers

    Which imaging feature differentiates nonspecific interstitial pneumonia from usual interstitial pneumonia?

    <p>Temporal and spatial homogeneity</p> Signup and view all the answers

    In the later phase of nonspecific interstitial pneumonia, what can occur due to traction?

    <p>Cystic changes</p> Signup and view all the answers

    Which age group is typically affected by nonspecific interstitial pneumonia?

    <p>50-60 years old</p> Signup and view all the answers

    What distinguishes cryptogenic organizing pneumonia from idiopathic pulmonary fibrosis in terms of histology?

    <p>Balls of fibroblasts within alveoli</p> Signup and view all the answers

    Which autoimmune disease can manifest as nonspecific interstitial pneumonia?

    <p>Systemic lupus erythematosus (SLE)</p> Signup and view all the answers

    What is a histological difference between the cellular and fibrosing patterns of nonspecific interstitial pneumonia?

    <p>Looser fibrosis in cellular pattern</p> Signup and view all the answers

    What type of cells are predominantly found in the histology of nonspecific interstitial pneumonia?

    <p>Lymphocytes and plasma cells</p> Signup and view all the answers

    What is the main prognostic factor for cryptogenic organizing pneumonia?

    <p>Relapse potential</p> Signup and view all the answers

    Which feature differentiates nonspecific interstitial pneumonia from idiopathic pulmonary fibrosis?

    <p>Younger patient population</p> Signup and view all the answers

    In which lung structures are fibroblasts predominantly found in cryptogenic organizing pneumonia?

    <p>Airspaces (alveolar ducts, alveoli)</p> Signup and view all the answers

    What differentiates the histologic pattern of usual interstitial pneumonia (UIP) from nonspecific interstitial pneumonia?

    <p>Absence of honeycombing</p> Signup and view all the answers

    Which type of lung disease is associated with inhaled nitrogen gas from plant material?

    <p>Silo filler lung</p> Signup and view all the answers

    What is a characteristic feature of pulmonary eosinophilia?

    <p>Eosinophils in alveolar and interstitial spaces</p> Signup and view all the answers

    What proinflammatory cytokine release is associated with radiation-induced lung injury?

    <p>TNF-alpha</p> Signup and view all the answers

    Which lung disease is uncommon and requires exclusion of various conditions like drug reactions and infections?

    <p>Pulmonary eosinophilia</p> Signup and view all the answers

    What is the most common manifestation of radiation-induced lung injury after 6-12 months?

    <p>Fibrosis</p> Signup and view all the answers

    Which lung disease involves interstitial disease with loosely formed granulomas and chronic inflammation centered around bronchioles?

    <p>Hypersensitivity pneumonitis</p> Signup and view all the answers

    What is the primary mechanism for airway obstruction in emphysema?

    <p>Loss of elastic tissue in alveoli walls</p> Signup and view all the answers

    Which cell type is chemotactically attracted to the alveoli in emphysema due to the presence of nicotine?

    <p>Neutrophils</p> Signup and view all the answers

    What contributes to the collapse of respiratory bronchioles during expiration in emphysema?

    <p>Loss of radial traction</p> Signup and view all the answers

    Which pattern of emphysema is most commonly associated with smoking?

    <p>Centrolobular (centriacinar) emphysema</p> Signup and view all the answers

    What is a consequence of emphysema on pulmonary capillaries?

    <p>Decreased number</p> Signup and view all the answers

    What histological feature is characteristic of emphysema?

    <p>Alveolar walls destruction</p> Signup and view all the answers

    What is a characteristic clinical feature of emphysema that may lead to the appearance of callouses or swollen bursae on extensor forearm surfaces?

    <p>Pursed lips breathing</p> Signup and view all the answers

    Which sign may indicate severe hypercapnia in emphysema patients?

    <p>Paradoxical retraction of lower interspaces during inspiration</p> Signup and view all the answers

    What imaging finding is most supportive of a diagnosis of emphysema?

    <p>Hyperinflation especially in upper lobes</p> Signup and view all the answers

    Which accessory muscles are commonly used by emphysema patients due to respiratory distress?

    <p>Neck and shoulder girdle muscles</p> Signup and view all the answers

    In emphysema, what clinical feature is often seen in patients leaning forward with their arms outstretched and weight supported on palms or elbows?

    <p>Progressive dyspnea</p> Signup and view all the answers

    Which condition is characterized by the presence of bullae and is often associated with 1-antitrypsin deficiency?

    <p>Emphysema</p> Signup and view all the answers

    What is the underlying pathology associated with the term 'pink puffer' in emphysema?

    <p>Gradual destruction of pulmonary capillary bed</p> Signup and view all the answers

    How do patients with ‘pink puffer’ emphysema compensate for diminished oxygen?

    <p>Hyperventilation</p> Signup and view all the answers

    What is a potential consequence of progressively diminished oxygen levels in 'pink puffer' patients?

    <p>Muscle wasting and weight loss</p> Signup and view all the answers

    What contributes to the 'pink' appearance of individuals with 'pink puffer' emphysema?

    <p>Work involving neck and chest muscles</p> Signup and view all the answers

    Why do 'pink puffer' patients have relatively normal arterial blood gases (ABGs)?

    <p>Compensatory hyperventilation</p> Signup and view all the answers

    How do patients with 'pink puffer' emphysema differ from 'blue bloaters' in terms of hypoxemia?

    <p>'Blue bloaters' have more severe hypoxemia</p> Signup and view all the answers

    What is the main reason behind the 'blue bloater' appearance in patients with chronic bronchitis?

    <p>Hypercarbia with increased carbon dioxide retention</p> Signup and view all the answers

    Which histopathologic finding is characteristic of chronic bronchitis?

    <p>Increased Reid index</p> Signup and view all the answers

    How do patients with chronic bronchitis adapt to hypoventilation?

    <p>Use of accessory muscles decreasing caloric demand</p> Signup and view all the answers

    In what way does chronic bronchitis differ from pure emphysema?

    <p>Increased carbon dioxide retention with compensatory elevations in plasma 'bicarbonate'</p> Signup and view all the answers

    What is the primary pathology seen in chronic bronchitis?

    <p>Mucus gland hyperplasia</p> Signup and view all the answers

    How can ventilation to perfusion mismatch lead to hypoxemia in chronic bronchitis?

    <p>Hypoxemia with decreased oxygenation</p> Signup and view all the answers

    What is the most common cause of bronchiectasis in the United States?

    <p>Cystic fibrosis</p> Signup and view all the answers

    Which lung disease presents with foul-smelling sputum and tube-like dilatations filled with pus?

    <p>Bronchiectasis</p> Signup and view all the answers

    In bronchiectasis, what imaging feature might be seen that indicates abundant sputum in the airways?

    <p>Airbronchograms</p> Signup and view all the answers

    Which lung disease is associated with recurrent infections, malabsorption, and an autosomal recessive genetic defect?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What is a key feature that distinguishes bronchiectasis from idiopathic pulmonary fibrosis?

    <p>Airbronchograms</p> Signup and view all the answers

    Which lung disease is characterized by absent or deficient cystic fibrosis transmembrane conductance regulator (CFTR)?

    <p>Bronchiectasis</p> Signup and view all the answers

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