Pathology
Anatomy
Not Anatomy And Pathology
100
Name 2 histological features of atopic asthma.
- Charcot-Leyden crystals
- Curschmann spirals
- Eosinophilia
100
A cardiothoracic surgeon performing hemiarch replacement for acute type A aortic dissection is working near the aortic arch. They must be cautious of a nerve which loops under the aortic arch to travel superiorly. Which nerve is this (be specific)?
Left recurrent laryngeal nerve
100
Which class of pulmonary disorder is indicated by the spirogram below?
Restrictive lung disorder
200
Which histological feature can be seen below and what condition does it represent?
Bonus (100 points): Name an occupation where there is an increased risk of silicosis
Asbestosis bodies: golden-brown (brown - iron) beaded rods with translucent core that represent lung macrophages trying to engulf inhaled asbestos fibers
200
A 24-year-old man presents to ED following a high speed MVA. eFAST scan demonstrates anechoic fluid in the right pleural cavity and in combination with the clinical presentation, haemothorax is confirmed. A chest tube is inserted to drain blood within this space. Where should it be placed?
Immediately above the superior part of the rib in the 5th intercostal space, along the anterior-mid axillary line (triangle of safety).
200
A 62-year-old man with a history of chronic tophaceous gout presents to the oncology clinic after being diagnosed with Burkitt lymphoma. He is scheduled to begin highly aggressive cytotoxic chemotherapy tomorrow morning. Given his large tumor burden and high mitotic rate, he is at extreme risk for developing tumor lysis syndrome (TLS). To prevent acute urate nephropathy, the oncologist initiates prophylactic oral therapy.
The prescribed medication works by decreasing the formation of new uric acid. What is the name of this drug and what is its mechanism of action?
Allopurinol - inhibits xanthine oxidase, the enzyme responsible for converting hypoxanthine to xanthine
300
We've all heard of the term 'blue bloater' used to describe patients with chronic bronchitis, but do we know what it actually means? Explain what the 'blue' and 'bloater' refers to, and outline why this occurs
- Blue -> cyanosis (shunting and pulmonary vasoconstriction)
- Bloater -> systemic oedema due to RHF and pulmonary HT
300
A 26-year old male with a known history of Marfan's syndrome presents to the ED complaining of sudden, sharp chest pain and dyspnoea. CXR confirms tension pneumothorax. What best describes what has happened to the trachea, and has it been pushed away from the affected side or pulled toward the affected side?
Tracheal deviation - pushed away from affected side
300
A 19-year-old woman presents to the ED hyperventilating, very anxious and tingling sensations throughout her body. A venous blood gas is performed. Which acid-base disorder is present, and what would the pH, CO2 and bicarb read?
Bonus (150 points): Explain why she is experiencing tingling
Acute respiratory alkalosis
- pH: high
- CO2: low
- Bicarb: normal or minimally decreased
Tingling: respiratory alkalosis -> calcium binds to albumin in place of hydrogen -> destabilises nerve cell membranes
400
A 71-year-old male presents to her GP complaining of worsening shortness of breath, cough and generalised fatigue. Additionally, he has been experiencing deep pain in his bones and discomfort around his abdomen. He mentions there have been streaks of blood in his sputum, and a 40-pack-year smoking history. CT confirms a lesion near the right main bronchus. A lung biopsy is performed. What is the diagnosis?
Squamous cell carcinoma of the lungs
400
Interpret the CXR below. What is your top differential and provide 2 supporting features that point towards this specific differential?
- Air bronchograms
- Alveolar consolidation
- Silhouette sign
400
A 57-year-old man presents to the ED with SVT. He is given adenosine, however, this fails to slow his HR. He manages to find a few words, and tells you that he has a history of severe asthma and is taking an oral tablet for maintenance therapy that he cannot remember the name of. Which drug class does this medication fall under?
Theophylline