a 30-year x 2 pack/day history of cigarette smoking undergoes bronchoscopy

[Oak]

A 57-year-old woman with a 30-year x 2 pack/day history of cigarette smoking undergoes bronchoscopy. Biopsy of bronchial tissue shows replacement of the normal pseudostratified ciliated columnar epithelium with stratified squamous epithelium. This change represents:

A. dysplasia
B. hyperplasia
C. malignant transformation
D. metaplasia
E. necrosis and repair

[bharat]

Originally Posted by Oak

A 57-year-old woman with a 30-year x 2 pack/day history of cigarette smoking undergoes bronchoscopy. Biopsy of bronchial tissue shows replacement of the normal pseudostratified ciliated columnar epithelium with stratified squamous epithelium. This change represents:

A. dysplasia
B. hyperplasia
C. malignant transformation
D. metaplasia
E. necrosis and repair

D. Metaplasia ho ni

[Hero]

The correct answer is D. Squamous metaplasia is a frequent airway response to chronic irritation from cigarette smoking. It represents the replacement of one differentiated tissue with another mature, differentiated tissue. It is believed that the squamous epithelium is more resistant to injurious agents, and so represents an adaptive response.
Dysplasia (choice A) is characterized by pleomorphism (the individual cells may vary widely in appearance) and by loss of normal tissue architecture, rather than by replacement with another mature epithelium (squamous).

Hyperplasia (choice B) refers to growth of a tissue or organ by cellular proliferation.

Malignant transformation (choice C) is the multistep process by which normal cells progress to the "cancer" phenotype. Metaplasia is not malignant transformation, although the stimuli producing metaplasia may also be associated with the development of malignancy.

Necrosis and repair (choice E) typically result in re-epithelialization and/or fibrosis, not metaplasia.

[Hero]

Guys,i'm a 4th yr student,am gonna start my internship after few weeks. I am feeling very tough solving these questions. Don't you have lil bit simple questions? Why u ppl paste such a tough question? I suggest u to follow any text book n then make a question by urself...this is my personal request. If others wanna solve such tough questions then i don have to say anytjing..but no one is answering ur questions

[Oak]

Yup the correct answer is D.

Squamous metaplasia is a frequent airway response to chronic irritation from cigarette smoking. It represents the replacement of one differentiated tissue with another mature, differentiated tissue. It is believed that the squamous epithelium is more resistant to injurious agents, and so represents an adaptive response.

Dysplasia (choice A) is characterized by pleomorphism (the individual cells may vary widely in appearance) and by loss of normal tissue architecture, rather than by replacement with another mature epithelium (squamous).
Hyperplasia (choice B) refers to growth of a tissue or organ by cellular proliferation.

Malignant transformation (choice C) is the multistep process by which normal cells progress to the "cancer" phenotype. Metaplasia is not malignant transformation, although the stimuli producing metaplasia may also be associated with the development of malignancy.

Necrosis and repair (choice E) typically result in re-epithelialization and/or fibrosis, not metaplasia.

[Oak]

Guys,i'm a 4th yr student,am gonna start my internship after few weeks. I am feeling very tough solving these questions. Don't you have lil bit simple questions? Why u ppl paste such a tough question? I suggest u to follow any text book n then make a question by urself...this is my personal request. If others wanna solve such tough questions then i don have to say anytjing..but no one is answering ur questions

HERO, you are right Clinical MCQs is mean to have the discussion, I am trying my best to present the case scenario which I frequently encounter in the hospital. And try to co-relate the clinical presentaion with the basic science.

Even you make mistake in MCQs that doesn't mean that you don't know anything, instead you learn a lot and won't commit the same mistake again and again for e.g. I just missed one diagnosis (bharat's MCQ), I overlooked age and sex I went according to the prevelance of the disease and that should have been B Cell Lymphoma, I didn't co-relate age and sex.

If I wouldn't have blindly gone through its prevanlance I would have picked the correct answer which is T Cell Lymphoma which is common in relatively young adult male. Whereas B Cell Lymphoma is common in Female with median age 30 yrs. My point of going for B Cell Lymphoma was: its very common 90% and its also present with mediastinum involvement. So, I will be careful in the future, not to commit the same mistake.

Thats how we have to develop the habbit of co-ralating clinical findings, and don't ever feel shy even if you commit mistake in the discussion because you wouldn't commit it when you check the patient.

My bottom line is: You are liable to commit mistake infact I urge you to pick anyone of the listed option evenif you are not sure. Check back when the MCQ is answered and look for the explanation. That way you will learn a lot.

Don't feel shy when you can't answer correctly give dammmm care to those who think you don't know anything when you pick the wrong answer they don't know how much your gaining by commiting mistake in the discussion.

Ok, lets discuss the more common case we encounter in the daily life now onwards.

[bharat]

Originally Posted by Hero

Guys,i'm a 4th yr student,am gonna start my internship after few weeks. I am feeling very tough solving these questions. Don't you have lil bit simple questions? Why u ppl paste such a tough question? I suggest u to follow any text book n then make a question by urself...this is my personal request. If others wanna solve such tough questions then i don have to say anytjing..but no one is answering ur questions

well hi I am Bharat , iam just 3rd year student (in china,at weifang medical collage) well i also expect question regarding the pathology, pherma. micro,immunity so that we also could solve it by our won mind but any way i look at books, search diffrent places for the answer so it will help to know diffrent thing rather than only course book.
well i also request OAK bro. to make question little simpler so we feel easy to solve.
but any way most of the time there is enough explanation so finnaly we can know the mecanism . see u ..later