Australian Society of Cytology

CEC Resources

Respiratory Cytology Multiple Choice - Questions

Mark Stevens CFIAC
Medical Scientist
Institute of Medical and Veterinary Science
Adelaide, Australia 5000

The following multiple choice questions are designed to test your understanding of the respiratory cytology lectures. Choose the correct answer by clicking on the hypertext link.
The answers are contained on a single web page. To avoid viewing answers to subsequent questions use the navigation links provided rather than scrolling through the page.

1. Cellular changes most suggestive of cytomegalovirus (CMV) infection include:

(A). Multinucleation, cytoplasmic inclusions only and presence of cilia
(B). Nuclear and cytoplasmic inclusions, 'owls-eye' appearance and cytomegaly
(C). Nuclear inclusions only, cytomegaly and 'owls-eye' appearance

2. Ciliocytophthoria is a cellular change characterised by:

(A). Intact columnar cells with degenerate nuclei and cytoplasmic viral inclusions
(B). Repair like cells with prominent nuclei and abundant cytoplasm
(C). Degenerate columnar cell nuclei and detached cytoplasm with cilia

3. A diagnosis of Mycobacterium tuberculosis can be suggested if the following features are present in BAL fluid:

(A). Gram positive branching filaments, granulomatous reaction and negative images of bacilli
(B). Acid fast bacilli, granulomatous reaction and negative images of bacilli
(C). Sulphur granules, microcalcifications and ciliocytophthoria

4. Actinomyces israelii is characterised by:

(A). Gram positive branching filaments and sulphur granules
(B). Branched beaded filaments and 'chinese characters'
(C). Small bacilli best detected with the Warthin-Starry and Dieterle procedure

5. Which fungus is characterised by thick walled spherules containing numerous endospores:

(A). Blastomycosis dermatitidis
(B). Cryptococcus neoformans
(C). Coccidioides immitis

6. The differential diagnosis of pulmonary histoplasmosis includes all of the following except:

(A). Torulopsis glabrata and pneumocystis carinii
(B). Leishmania and Toxoplasma
(C). Aspergillus fumigatus and mucomycosis

7. Broad based budding and thick double contoured walls are features of:

(C). C neoformans
(B). B dermatitidis
(C). Histoplasma capsulatum

8. Fungi within the genera Mucor are characterised by:

(A). Long, uniform and septate hyphae with progressive and dichotomous branching
(B). Mycelium containing swollen or globose hyphae up to 15um in diameter
(C). Broad pleomorphic hyphae which are thin walled, delicate and pauciseptate

9. The liberated endospores of C immitis most resemble:

(A). H capsulatum
(B). Capsule deficient forms of C neoformans
(C). B dermatitidis

10. Pseudohyphae seen in Candidiasis are formed by:

(A). Development of hyphae from spores
(B). Elongation of budding yeast forms and constriction of hyphae at points of attachment
(C). Bulbous swelling at the ends of hyphae segments

11. The hyphae of the contaminant alternaria can be distinguished from aspergillus by all the following except:

(A). Bulbous swelling at the ends of hyphae segments near point of separation
(B). Absence of 45 degree branching
(C). Thin walled pauciseptate hyphae with branches orientated at right angles

12. Pneumocystis carinii can be diagnosed on the following features:

(A). Broad based budding and thick cellular walls
(B). Capsular material and intra-alveolar exudate
(C). Identification of cyst forms and trophozoites

13. Differential diagnosis of P carinii includes all the following except:

(A). Candida and Torulopsis
(B). C immitis and H capsulatum
(C). Red blood cells and B dermatitidis

14. The cysts of P carinii are best detected by all the following stains except:

(A). GMS and PAS
(B). Toluidine blue and Gram-Weigert
(C). PAP and H&E

15. Differential diagnosis of Toxoplasma gondii include all the following except:

(A). Strongloides stercoralis and Echinococcus granulosus
(B). H capsulatum and CMV
(C). Leishmania and Trypanosoma

16. Tumour cells surrounding cylindric cores of hyaline basal lamina material suggests a diagnosis of:

(A). Chondroid hamartoma
(B). Carcinoid
(C). Adenoid cystic carcinoma

17. A diagnosis of Chondroid hamartoma is based on the recognition of all the following except:

(A). Intranuclear cytoplasmic pseudo-inclusions
(B). Mature cartilage and/or fibromyxomatous fragments
(C). Sheets of bronchial epithelium and fat

18. Ultrastructural identification of short microvilli, rootlets and core filaments may suggest a diagnosis of:

(A). Metastatic colonic adenocarcinoma
(B). Malignant melanoma
(C). Malignant Fibrous Histiocytoma

19. Tumour cells exhibiting positive immunostaining for S-100, HMB-45 and vimentin would suggest a diagnosis of:

(A). Metastatic renal cell carcinoma
(B). Malignant melanoma
(C). Metastatic breast carcinoma

20. Clear cell appearance can be identified in all the following tumours except:

(A). Renal cell carcinoma
(B). Adrenal cortical carcinoma
(C). Non-Hodgkins lymphoma
(D). Hepatocellular carcinoma