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 (A)</p> Signup and view all the answers

Where are areas of fibrosis mainly located?

<p>Peripheral zones of lobules (B)</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 (D)</p> Signup and view all the answers

What does the subpleural fibroblastic focus consist of?

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

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

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

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

<p>Prominent bright interstitial markings (B)</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 (A)</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 (C)</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 (D)</p> Signup and view all the answers

Which term is commonly used to describe idiopathic pulmonary fibrosis?

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

What is a characteristic feature of hypersensitivity pneumonitis?

<p>Hypersensitivity reaction to inhaled allergens (D)</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 (A)</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 (D)</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) (A)</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 (A)</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 (D)</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 (A)</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 (C)</p> Signup and view all the answers

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

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

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

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

What is the histologic feature seen in cryptogenic organizing pneumonia?

<p>Polypoid plugs of loose connective tissue (D)</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 (B)</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 (C)</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 (C)</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) (B)</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 (C)</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 (C)</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) (C)</p> Signup and view all the answers

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

<p>Fatigue (B)</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 (A)</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 (D)</p> Signup and view all the answers

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

<p>Fibroblasts (C)</p> Signup and view all the answers

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

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

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

<p>Dyspnea (A)</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 (A)</p> Signup and view all the answers

Which underlying condition can potentially trigger cryptogenic organizing pneumonia?

<p>Rheumatoid arthritis (A)</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 (B)</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 (D)</p> Signup and view all the answers

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

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

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

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

Which age group is typically affected by nonspecific interstitial pneumonia?

<p>50-60 years old (A)</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 (C)</p> Signup and view all the answers

Which autoimmune disease can manifest as nonspecific interstitial pneumonia?

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

What is the main prognostic factor for cryptogenic organizing pneumonia?

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

Which feature differentiates nonspecific interstitial pneumonia from idiopathic pulmonary fibrosis?

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

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

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

What is a characteristic feature of pulmonary eosinophilia?

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

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

<p>TNF-alpha (B)</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 (C)</p> Signup and view all the answers

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

<p>Fibrosis (A)</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 (C)</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 (B)</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 (C)</p> Signup and view all the answers

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

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

Which pattern of emphysema is most commonly associated with smoking?

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

What is a consequence of emphysema on pulmonary capillaries?

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

What histological feature is characteristic of emphysema?

<p>Alveolar walls destruction (C)</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 (A)</p> Signup and view all the answers

Which sign may indicate severe hypercapnia in emphysema patients?

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

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

<p>Hyperinflation especially in upper lobes (C)</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 (C)</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 (C)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>Hyperventilation (D)</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 (B)</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 (C)</p> Signup and view all the answers

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

<p>Compensatory hyperventilation (B)</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 (D)</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 (A)</p> Signup and view all the answers

Which histopathologic finding is characteristic of chronic bronchitis?

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

How do patients with chronic bronchitis adapt to hypoventilation?

<p>Use of accessory muscles decreasing caloric demand (A)</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' (C)</p> Signup and view all the answers

What is the primary pathology seen in chronic bronchitis?

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

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

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

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

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

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

<p>Bronchiectasis (C)</p> Signup and view all the answers

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

<p>Airbronchograms (C)</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 (D)</p> Signup and view all the answers

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

<p>Airbronchograms (A)</p> Signup and view all the answers

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

<p>Bronchiectasis (D)</p> Signup and view all the answers

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