Developmental And Vascular Pulmonary Disease

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| By Chachelly

Chachelly

Community Contributor

Quizzes Created: 507 | Total Attempts: 620,328

Questions: 5 | Attempts: 315 | Updated: Mar 22, 2023

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Questions and Answers

1.

A 22-year-old Caucasian female presents with fatigue, cyanosis, progressing dyspnea, and pitting edema of the lower legs. She denies any history of previous respiratory or cardio-vascular diseases. Physical examination reveals left parasternal heave and accentuated second sound over the pulmonic valve; liver is slightly enlarged and tender. Echocardiography detects dilation of the right heart chambers with thickening of the right ventricle wall. Coagulation tests are within normal limits. Which of the following pathologic changes are most likely to be found within the pulmonary artery?
- A.
  
  Perivascular mononuclear infiltrates in the adventitia
- B.
  
  Saddle thromboembolus
- C.
  
  Multiple thromboemboli of the small branches
- D.
  
  Atherosclerotic plaques
Correct Answer
D. Atherosclerotic plaques

Explanation
The correct answer is atherosclerotic plaques. This is the most likely pathologic change to be found within the pulmonary artery based on the patient's symptoms and physical examination findings. The patient's presentation is consistent with pulmonary hypertension, which can be caused by atherosclerosis in the pulmonary arteries. The dilation of the right heart chambers and thickening of the right ventricle wall seen on echocardiography are also indicative of pulmonary hypertension. The other options, such as perivascular mononuclear infiltrates and thromboemboli, are less likely to be the cause of the patient's symptoms.

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2.

The most likely cause of the morphological change seen in this pulmonary blood vessel is:
- A.
  
  Asthma
- B.
  
  Chronic alveolar lung disease
- C.
  
  Pulmonary saddle embolus
- D.
  
  Left-sided heart failure
Correct Answer
D. Left-sided heart failure

Explanation
The morphological change seen in the pulmonary blood vessel is most likely caused by left-sided heart failure. Left-sided heart failure can lead to increased pressure in the pulmonary circulation, causing pulmonary congestion and ultimately resulting in morphological changes in the blood vessels. This can include thickening of the vessel walls, dilation of the vessels, and the presence of fluid in the surrounding tissues.

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3.

68-year-old male, who suffered from congestive heart disease due to aortic stenosis, was brought to the ER with a sudden stabbing chest pain. Examination of the lungs revealed a pleural friction rub. The patient was admitted to the ICU and next day, after an episode of acute severe dyspnea and hemoptysis, he passed away. Postmortem examination of the lungs revealed the shown histologic changes. Which of the following is the most likely pathomorphologic diagnosis?
- A.
  
  Hemorrhagic bronchitis with hemorrhagic bronchopneumonia
- B.
  
  Hemorrhagic bronchopneumonia and postmortem clot within a branch of the pulmonary artery
- C.
  
  A pulmonary thromboembolus and liquefactive necrosis of the alveolar septa
- D.
  
  A pulmonary thromboembolus and coagulative necrosis of the alveolar septa
Correct Answer
D. A pulmonary thromboembolus and coagulative necrosis of the alveolar septa

Explanation
The most likely pathomorphologic diagnosis based on the given information is a pulmonary thromboembolus and coagulative necrosis of the alveolar septa. The patient's symptoms, such as sudden stabbing chest pain, dyspnea, and hemoptysis, along with the presence of a pleural friction rub, suggest a pulmonary embolism. The postmortem examination revealing coagulative necrosis of the alveolar septa further supports this diagnosis.

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4.

Which of the following is the most likely set of findings found in a patient with massive pulmonary thromboembolism of one hour duration?
- A.
  
  Bronchial breath sounds, normal EKG, abnormal CXR
- B.
  
  Bronchial breath sounds, abnormal EKG, and normal CXR
- C.
  
  Vesicular breath sounds, normal EKG, abnormal CXR
- D.
  
  Vesicular breath sounds, abnormal EKG, and normal CXR
Correct Answer
D. Vesicular breath sounds, abnormal EKG, and normal CXR

Explanation
There are two normal breath sounds. Bronchial and vesicular .
Breath sounds heard over the tracheobronchial tree are called bronchial breathing and breath sounds heard over the lung tissue are called vesicular breathing.
The only place where tracheobronchial trees are close to chest wall without surrounding lung tissue are trachea, right sternoclavicular joints and posterior right interscapular space. These are the sites where bronchial breathing can be normally heard. In all other places there is lung tissue and vesicular breathing is heard.

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5.

A 9-year-old boy was identified in childhood as having an elevated sweat chloride. Though he appeared to be a normal term baby, his neonatal course was complicated by the development of meconium ileus. Throughout childhood he has experienced multiple increasingly severe bouts of pneumonia with a productive cough, often with Pseudomonas aeruginosa cultured from sputum. Based upon these findings, he is at greatest risk for development of which of the following pulmonary abnormalities?
- A.
  
  Adenocarcinoma
- B.
  
  Bronchiectasis
- C.
  
  Pleural plaques
- D.
  
  Pneumothorax
- E.
  
  Pneumocystis carinii pneumonia
Correct Answer
B. Bronchiectasis

Explanation
The boy's history of elevated sweat chloride, meconium ileus, and recurrent pneumonia with Pseudomonas aeruginosa cultured from sputum suggests that he has cystic fibrosis (CF). CF is a genetic disorder that affects the production of sweat, digestive juices, and mucus. It leads to the formation of thick, sticky mucus in the lungs, which can result in recurrent infections and inflammation. Over time, this can lead to the dilation and scarring of the airways, known as bronchiectasis. Therefore, the boy is at greatest risk for developing bronchiectasis as a result of his CF.

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Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Jul 19, 2012

Quiz Created by
Chachelly

Developmental And Vascular Pulmonary Disease

The most likely cause of the morphological change seen in this pulmonary blood vessel is:

Which of the following is the most likely set of findings found in a patient with massive pulmonary thromboembolism of one hour duration?