JCU MB4 Term 1 Week 4 (COPD)

1

42-year-old male smoker, chronic mild dyspnoea, productive cough with white sputum for 4 years. Picture shows lung biopsy. What is the diagnosis?

Chronic Bronchitis Biopsy


  Lung abscess

  Panlobular emphysema

  Chronic bronchiectasis

  Centrilobular emphysema

  Chronic bronchitis

2

60-year-old male, post-MI, bedrest for 12 days. Develops right-sided severe chest pain & tachypnoea. Lung gross specimen shown. What is the preceding disorder?

Lung Infarction


  COPD & cor pulmonale

  HIV infection

  Centrilobular emphysema

  Deep vein thrombosis

  MI with haemorrhage


Picture shows haemorrhagic infarction of lung tissue - haemorrhagic infarctions occur in three situations: venous occlusion (blood cannot escape), when an organ has dual blood supply (e.g. lungs, liver) and in soft tissues.

This situation is actually unlikely to occur in a hospital setting as the patient should have been treated with heparin to avoid thrombosis.

3

45-year-old male with chronic productive cough. Lung gross specimen shown. What is the diagnosis?

Bronchiectasis


  Chronic bronchitis

  Bronchiectasis

  COPD & bronchitis

  Chronic pneumonia

  Lobar pneumonia


Bronchioles can be observed to extend almost to the border of the lung.

4

29-year-old male, high fever, cough, dyspnoea. Sputum gram stain shown. What is the likely type of pneumonia?

Streptococcus Pneumoniae Gram Stain


  Lobar pneumonia

  Broncho pneumonia

  Interstitial pneumonia

  Fungal pneumonia

  Lung abscess


Gram stain shows gram-positive cocci - likely Streptococcus pneumoniae, which is characteristically associated with lobar pneumonia. Note that it is actually rare to see lobar pneumonia in practice because patients generally seek medical attention before the infection reaches that stage. However, it can still occur especially if the patient is immunodeficient.

5

35-year-old male smoker. Bronchial biopsy shown. What is the diagnosis?

Chronic bronchitis - mucosal hyperplasia


  Bronchiectasis

  Chronic bronchitis

  Centrilobular emphysema

  Panacinar emphysema

  Asthma


Lining mucosa exhibits squamous metaplasia. Note Reid index of mucosal glands - this is diagnostic of chronic bronchitis.

6

45-year-old male, cough, purulent sputum for 1 year. Bronchus biopsy shown. What is the diagnosis?

Bronchiectasis biopsy


  Chronic bronchitis

  Bronchiectasis

  COPD

  Centriacinar emphysema

  Lung abscess


Biopsy shows ulcerated bronchial wall, the lumen is packed with plenty of inflammatory exudate. The wall also shows heavy inflammation and fibrosis.

7

32-year-old male, chronic COPD for 20 years. He presents with worsening dyspnoea and right sided heart failure since 3 months. Lung gross specimen shown. What is the diagnosis?

Centrilobular emphysema


  Chronic bronchitis

  Honeycomb lung

  Emphysema

  Bronchiectasis

  Lung abscess


Picture shows characteristic upper lobe involvement and some dark staining.

8

42-year-old male smoker with a history of COPD for 20 years. He presents with abundant productive cough with greenish sputum since 3 months. Lung gross specimen shown. What is the diagnosis?

Bronchiectasis


  Chronic bronchitis

  Honeycomb lung

  Emphysema

  Bronchiectasis

  Lung abscess


Picture shows dilated bronchioles extending almost to the surface.

9

52-year-old male with a history of chronic productive cough. What is the diagnosis?

Bronchiectasis


  Chronic bronchitis

  Panlobular emphysema

  Emphysema & chronic bronchitis

  Bronchiectasis

  Lung abscess

10

What is the most common type of emphysema seen in smokers?


  Panlobular

  Bullous

  Irregular

  Centrilobular

  Interstitial


Also called centriacinar.