Soft B Lecture Midterm (Study this one!

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Deep breaths, deeper prayers, good luck!

If you were studying the 73 term one, this one is better!

Most common pulmonary neoplasm in the teen years?

a. small cell (most rapid growth + metastasis)

carcinoid
b. carcinoid
c. large cell
d. squamous cell
Irritant gas exposure without a fatal outcome can be a risk factor
for?

a. bronchiolitis obliterans
bronchiolitis obliterans
b. chronic bronchitis
c. bronchiectasis (dilation of bronchi)
d. cryptogenic organizing pneumonia/BOOP (resembles pneu-
monia)
Erythema nodosum is a cutaneous manifestation of?

a. moniiasis (candida albicans - segmental consolidation)

loefgren's syndrome (sarcoid + coccidiomycosis)
b. loefgren's syndrome (sarcoid + coccidiomycosis)
c. histoplasmosis (segmental consolidation + LAN)
d. blastomycosis (segmental/lobar consolidation w/ cavitation)
Lupus pernio and erythema nodosum are cutaneous manifesta-
tions of?

a. tuberculosis sarcoidosis
b. sarcoidosis
c. histoplasmosis
d. blastomycosis
Which of the following may result in pulmonary hypertension as
well as dysphagia?

a. coccidioidomycosis tuberculosis
b. tuberculosis
c. aspergillosis
d. histoplasmosis
Cylindrical bronchiectasis may mimic?

a. acinonodular consolidation
acinonodular consolidation
b. miliary nodular disease
c. normal lung
d. air trapping

A patient from eastern Kentucky (300 miles north of atlanta) pre-

senting with a pulmonary segmental consolidation and acute low
back pain with lumbar plain film findings suggestive of infectious
spondylodiscitis may have _______________? blastomycosis (TX, AK, north, east)

a. actinomycosis (jaw bacteria w/ cavitation)

b. blastomycosis (TX, AK, north, east)

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c. moniliasis (candida albicans)
d. coccidioidomycosis (southwest)
Negative chest xray would be expected with acute bronchitis and?

a. congenital lung cyst

T0 bronchogenic cancer (radiographically occult)
b. emphysema (bilateral hyperlucency)
c. T0 bronchogenic cancer (radiographically occult)
d. cryptogenic organizing pneumonia (consolidation)
A ranke complex seen with tiny hepatic and splenic calcifications
is likely related to previous?

a. histoplasmosis histoplasmosis
b. tuberculosis
c. coccidioidomycosis
d. blastomycosis
A ranke complex seen with apical pleural thickening is likely re-
lated to previous?

a. histoplasmosis coccidioidomycosis
b. tuberculosis
c. coccidioidomycosis
d. blastomycosis
Silicosis with progressive systemic sclerosis (scleroderma) is re-
ferred to as?

a. felty's (RA + splenomegaly + granulocytopenia) erasmus (silicosis + PSS)

b. erasmus (silicosis + PSS)
c. little jack horner's (miosis + ptosis)
d. sjogren's
A patient presenting with a bronchogenic cancer history, who is
familiar with their staging number, tells you they have a stage IIIB
non-small cell neoplasm. What is their five year survival potential?

a. 80-90% (stage I) 25-30%

b. 60-80% (stage II)
c. < 10% (stage IV)
d. 25-30%
e. 30-35% (stage IIIA)
The least common of the major subtypes of primary epithelial
related malignancy of the lungs is?

a. alveolar cell carcinoma (5%) alveolar cell carcinoma (5%)

b. carcinoid tumor (10%)
c. bronchial adenoma (10%)
d. bronchogenic carcinoma (85%)
This tumor makes up about 42% of all malignant epithelial tu-
mors?

a. adenocarcinoma adenocarcinoma
b. large cell
c. carcinoid
d. squamous cell
Clinical suspicion of bronchiectasis is confirmed by which imaging
procedure?

a. plain film chest series pulmonary CT (gold standard)

b. pulmonary CT (gold standard)
c. pulmonary MRI
d. bronchography

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Complete opacification of an entire hemothorax with the medi-
astinum displaced toward the increased density would most likely
be related to?
main stem bronchus obstructive/resorption atelectasis
a. massive pleural effusion and passive atelectasis
b. pneumothorax and resorption atelectasis
c. fibrothorax and passive atelectasis
d. main stem bronchus obstructive/resorption atelectasis
Which radiographic cause of a cavitary space is not directly relat-
ed to tissue necrosis?

a. cystic bronchiectasis cystic bronchiectasis

b. squamous cell carcinoma
c. pulmonary metastasis
d. wegener's granulomatosis
Beryllium pneumoconiosis produced which form of acute pul-
monary disease?

a. subsegmental air space consolidation widespread acinonodular consolidation

b. widespread acinonodular consolidation
c. interstitial (chronic)
d. lobar atelectasis
Pulmonary cavitation with this disorder has no predictable pul-
monary location?

a. staphylococcus pneumonia staphylococcus pneumonia

b. klebsiella pneumonia (upper lung)
c. viral pneumonia
d. aspiration pneumonia (RML/RLL)
Pulmonary cavitation would not be expected with this pneumonia
category?

a. staphylococcus pneumonia viral pneumonia

b. klebsiella pneumonia
c. viral pneumonia
d. aspiration pneumonia
Which pulmonary tumor may spread to the pleura and mimic
mesothelioma?

a. squamous adenocarcinoma
b. large cell
c. adenocarcinoma
d. alveolar cell
Commonly associated with recurring paranasal sinus infection?

a. ehlers-danlos syndrome
kartagener's syndrome
b. marfan's syndrome
c. kartagener's syndrome
d. cystic fibrosis
Commonly associated with LLQ pain and appendicitis?

a. ehlers-danlos syndrome
kartagener's syndrome (situs inversus)
b. marfan's syndrome
c. kartagener's syndrome (situs inversus)
d. cystic fibrosis

Commonly associated with RLQ pain and appendicitis?

cystic fibrosis
a. ehlers-danlos syndrome
b. marfan's syndrome
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c. kartagener's syndrome
d. cystic fibrosis
This condition may cause, by some author's estimates, up to 50%
of cases of bronchiectasis?

a. ehlers-danlos syndrome cystic fibrosis

b. marfan's syndrome
c. kartagener's syndrome
d. cystic fibrosis
Iceberg sign is related to?

a. aspergillosis
echinococcosis (aka hydatid disease)
b. nocardiosis
c. blastomycosis
d. echinococcosis (aka hydatid disease)
Which of the following would NOT be part of the TNM system of
tumor staging?

a. T1 (small tumor) T5
b. T5
c. M1 (distant METS)
d. M0 (no METS)
Pneumoconiosis could be associated with which of the following
work groups or jobs? (Remember the big 7)

I. Quarrying
II. Sugar cane processing
III. Mining
IV. Air conditioner repair I, III, V
V. Naval ship refurbishing

a. I, II, III
b. I, III, V
c. I, III, IV
d. I, II, IV
Silicosis - Quarry
Asbestosis - Mechanics, Navy
Talcosis - Asbestosis + Silica
Not a question just a reminder! The Big 7: Bauxite - Aluminum Ore (Mining)
Coal Worker's - Mining
Dialomite - Crushed Sea Shells (toothpaste)
Berryliosis - Fluorescent Lights
Which one of the following is the likely cause for 7E? (Diagnostic
marker for histoplasma capsulatum)

a. coccidioidomycosis histoplasmosis
b. aspergillosis
c. tuberculosis
d. histoplasmosis
This disorder may occur as a complication of rheumatoid arthritis
or dermatomyositis and most recover after months of steroid
treatment?
cryptogenic organizing pneumonia (antibiotics don't work)
a. cryptogenic organizing pneumonia (antibiotics don't work)
b. chronic bronchitis
c. acute bronchitis
d. bronchiolitis

Respiratory syncytial virus (RSV) is the most common cause of?

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a. cryptogenic organizing pneumonia
b. chronic bronchitis
bronchiolitis
c. acute bronchitis
d. bronchiolitis
Which of the following would be associated with inflammatory or
non-inflammatory granulomatous lymph node calcification?

I. Silicosis
II. Histoplasmosis
III. TB
IV. Sarcoidosis I, II, III, IV (the other correct is coccidioidomycosis)
V. Asbestosis

a. I, III, IV, V
b. I, III, IV
c. IV, V
d. I, II, III, IV (the other correct is coccidioidomycosis)
Five-year survival rates with lung cancers are generally consid-
ered to be in a range of?

a. 25-30% 10-13%
b. 30-35%
c. 45-55%
d. 10-13%
A patient with a current bronchogenic cancer history, familiar with
their cell type tells you they have a small peripheral squamous
cell neoplasm less than 3 cm. (T1) in diameter and with all oth-
er assessments currently negative (N0) except for a small liver
metastasis (M1). What is their five year survival potential and likely
staging? <10%, T1,N0,M1

a. 80-90%, T1N1M0
b. <50%, T3N0M0
c. <35%, T1N1M1
d. <10%, T1,N0,M1
Sequela of *previous* granulomatous infection include?

I. Calcified Granuloma
II. Splenic calcification
III. Upper Lung Fibrosis
IV. Calcified Lymph Nodes
I, II, III, IV, V
V. Pleural Effusion

a. I, II, III, IV
b. I, II, III
c. II, IV
d. I, II, III, IV, V
Occupational disease related to mineral dust inhalation produce
which form of pulmonary disease?

a. subsegmental air space only interstitial

b. widespread acinonodular consolidation
c. lobar consilidation (irritant gas + moldy dust)
d. interstitial
Mineral Dust: Interstitial Lung Disease
Irritant Gas: Interstitial Lung Disease + Consolidation
Another Reminder! Remember:
Moldy Dust: Interstitial Lung Disease + Consolidation + Hypersen-
sitivity Lung
Air-crescent or monod's sign is associated with?

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 Soft B Lecture Midterm (Study this one!)
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a. coccidioidomycosis
b. mycetoma (aka fungus bell)
mycetoma (aka fungus bell)
c. tuberculosis
d. histoplasmosis
Which of the following is NOT classified as an acute infectious
pneumonia?

a. pneumocystis jirovecii pneumonia pneumocystis jirovecii pneumonia

b. pneumococcal pneumonia
c. viral pneumonia
d. klebsiella pneumonia
Lobar - Streptococcus Pneumonia
Acute Pneumonias: Bronchopneumonia - Staphylococcus Pneumonia
Acute Interstitial - Viral/Mycoplasmal Pneumonia
Of the causes of infective/abcess cavitation, which one might be
considered by location?

a. fungal pneumonia (no location) aspiration pneumonia (5, 7, 10, RML)

b. streptococcus pneumoniae
c. staph aureus pneumonia (no location)
d. aspiration pneumonia (5, 7, 10, RML)
T1N0M0 lung cancer staging has which 5 year survival average?

a. 80-90%
80-90%
b. 60-65%
c. 25-30%
d. 10-15%
T1 - < 3 cm and doesn't invade surrounding lung tissues
T2 - 3-5 cm and can invade visceral pleura
What is this T1N1M1 crap about? T is for Tumor Size --->
T3 - 5-7 cm and can extend to chest wall
T4 - > 7 cm and can extend to heart and trachea
N0 - no regional lymph node involvement
N1 - spread to nearby lymph nodes within lung or bronchus
What is this T1N1M1 crap about? N is for Lymph Node Involve- N2 - spread to lymph nodes in the center of chest or on the same
ment ----> side as the tumor
N3 - spread to lymph nodes on the opposite side of the tumor or
above the collar bone
M0 - no distant metastasis
What is this T1N1M1 crap about? M is for Metastasis ---->
M1 - cancer has spread to distant organs
Irritant gases and chemicals (from the occupational disease
group) cause?

a. basilar consolidation capillary hyperpermeability (pulmonary edema)

b. widespread miliary nodules
c. capillary hyperpermeability (pulmonary edema)
d. upper lung fibrosis
End-stage tuberculosis, and late silicosis have __________ in
common which may lead to __________?

a. air space consolidation, cavitation fibrotic nodules, conglomerate masses

b. fibrotic nodules, conglomerate masses
c. nodular densities, multiple calcific nodules
d. cicatrization, pulmonary arterial hypertension

Central endobronchial lung tumors may produce _________ or

_________?
hyperaerated air-trapping, atelectasis
a. atelectasis, cavitation
b. fuzzy bordered mediastinal widening, hyperaerated air-trapping

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c. cavitation, horner's syndrome
d. hyperaerated air-trapping, atelectasis
Cicatrical atelectasis in a non-smoker would be a risk for?

a. squamous cell carcinoma (smoker)

adenocarcinoma
b. adenocarcinoma
c. bronchiolar carcinoma
d. small cell carcinoma (obstructive atelectasis + smoker)
Cicatrical atelectasis in a smoker would be a risk for?

a. squamous cell carcinoma

squamous cell carcinoma
b. adenocarcinoma (non-smoker)
c. bronchiolar carcinoma
d. small cell carcinoma (obstructive atelectasis)
Obstructive atelectasis in a smoker would be a risk for?

a. squamous cell carcinoma (cicatrical atelectasis + non-smoker)

small cell carcinoma
b. adenocarcinoma
c. bronchiolar carcinoma
d. small cell carcinoma
Widespread honeycomb fibrosis may be the result of inhalation of
aluminum oxide (bauxite) and in addition, sometimes also silica
particulates, used in the production of abrasives, resulting in this
disorder?
bauxite lung/fibrosis (aka shaver's disease or smelter's lung)
a. bauxite lung/fibrosis (aka shaver's disease or smelter's lung)
b. baritosis
c. berylliym granulomatosis
d. diatomite pneumoconiosis
Which one of the following symptoms would be more likely ex-
pected with a right hilus tumor? (not sure about this one. lots of
conflicting sources)
facial edema (due to right hilus proximity to superior vena cava)
a. hemoptysis
b. cough
c. facial edema (due to right hilus proximity to superior vena cava)
d. hoarseness (left)
May be found in RLL segment #7?

a. post-primary TB (apical and posterior)

aspiration pneumonia (5, 7, 10)
b. central squamous cell carcinoma (upper lobes)
c. aspiration pneumonia (5, 7, 10)
d. pulmonary infarction (varies)
This cavitary radiolucency typically occurs peripheral to the pneu-
monia?

a. TB pneumatocele
b. squamous cell carcinoma
c. aspiration pneumonia
d. pneumatocele

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