Term
| Prolonged substernal pain and ST segment elevation in leads I and V3-6 |
|
Definition
|
|
Term
| What are some common consequences of an MI? |
|
Definition
LV Failure
Cardiogenic Acute Pulmonary Edema
Pulmonary Venous Hypertension
Transudate of Plasma into interstitium and alveoli |
|
|
Term
| In the lungs, what cell types causes tissue damage and leads to abscess formation? |
|
Definition
| Neutrophils and Macrophages secrete lysosomal enzymes |
|
|
Term
| Why is the pO2 in the Left Atrium lower than in the pulmonary veins? |
|
Definition
| Deoxygenated blood from the bronchiole arteries are added |
|
|
Term
| What does the V/Q ratio do when you move from the apex to the base of the lung? |
|
Definition
|
|
Term
| Is an HIV patient with a CD4+ count of >200 immunocompetant? |
|
Definition
|
|
Term
| What is the most common bug for immuno-competant patients? |
|
Definition
|
|
Term
| What are Superior Vena Cava Syndrome symptoms and causes? |
|
Definition
Symptoms: facial swelling, headaches
Cause: mediastinal mass that is pressing on the SVC |
|
|
Term
| Percardial effusion signs and symptoms |
|
Definition
| Dyspnea, distended neck veins, distant heart sounds, pulsus paradoxus |
|
|
Term
|
Definition
superior sulcus lung tumor
1. Severe shoulder area pain that radiates towards axilla or scapula (lower brachial plexus)
2. Horner's Syndrome : ipsilateral ptosis, anhydrosis, myosis (cervical sympathetic ganglia)
3. Upper Extremity Swelling compression of subclavian
4. spinal cord compression/paraplegia (extension into cervical foramina) |
|
|
Term
| Small Cell lung tumors often secrete what hormones? |
|
Definition
ACTH which leads to Cushings
ADH which leads to SIADH
"ants are small" |
|
|
Term
| Squamous cell lung tumors often secrete what hormones? |
|
Definition
Parathyroid and calcitonin
"PC's are square" |
|
|
Term
| Classic presentation of Legionella infection |
|
Definition
very high fever in a smoker
diarrhea, confusion, cough causing chest pain |
|
|
Term
| What kind of lung issues arise in Rheumatoid Arthritis patients? |
|
Definition
|
|
Term
| How does a Mycoplasma Pneumoniae infection cause anemia? |
|
Definition
| It shares antigens with human erythrocytes, thus causing antibodies (cold agglutinins) to attack those as well as the mycoplasma) |
|
|
Term
| What does ether or organic solvents do to viruses? |
|
Definition
| Disrupts the envelope on enveloped viruses |
|
|
Term
| Why do lung abscesses form? What bugs are involved? |
|
Definition
1. Aspiration of oropharyngeal contents: Fusobacterium, Peptostreptococcus, Bacteroids
2. Necrotizing pneumonia: Staph Aureus, E. coli, Klebsiella, Strep Pneumonia
3. septicemia or infectious endocarditis: Staph, Strep |
|
|
Term
| What conditions predispose you to aspiration lung abscesses? |
|
Definition
loss of consciouness
ex) alcoholism, seizure disorders, prolonged anesthesia, severe neurologic diseases |
|
|
Term
|
Definition
-measures severity of chronic bronchitis (mucus gland enlargement)
- ratio: thickness of mucus gland layer in the bronchial wall submucosa/thickness of bronchial wall between respiratory epithelium and bronchial wall
- normal 0.4 |
|
|
Term
| What are the two variants of scleroderma? |
|
Definition
|
|
Term
| What is the patho/phys of scleroderma? |
|
Definition
| increased collagen deposition in tissues |
|
|
Term
| What physical signs would you see in someone with lung problems due to scleroderma? |
|
Definition
Pulmonary hypertension leads to....
- accentuated pulmonary component of heart sounds
- signs of right sided heart failure |
|
|
Term
| Why is pus sometimes green? |
|
Definition
| Release of myelopyroxidase from neutrophil azurophilic granules |
|
|
Term
| Where does TB proliferate? |
|
Definition
|
|
Term
| Idiopathic Pulmonary Fibrosis presentation |
|
Definition
- insiduous onset progressive dyspnea
- restrictive PFT's
- honeycomb lung |
|
|
Term
| Churg Straus pulmonary symptoms and histology |
|
Definition
- severe asthma
- obstructive PFT
- bronchial wall thickening
- necrotizing vasculitis with granulomas
- eosinophil infiltration |
|
|
Term
| Spontaneous Pneumothorax presentation |
|
Definition
- sudden onset unilateral chest pain
- absent breath sounds
- hyper resonance |
|
|
Term
| What is the most common cause of Spontaneous pneumothorax? |
|
Definition
rupture of apical subpleural blebs
-primary is usually in tall thin males
- secondary can be due to emphysema |
|
|
Term
| How do Echinocandins work? |
|
Definition
| inhibit polysaccharid glucan in fungus walls |
|
|
Term
| How do you treat Small Cell Carcinoma? |
|
Definition
chemotherapy or radiation... not surgery
*most aggressive |
|
|
Term
| What is non-typable Haemophilus Influenza? Is it virulent? |
|
Definition
| H Flu without a capsule. It is still virulent. |
|
|
Term
|
Definition
E
Meningitis
Otitis Media
Pneumonia |
|
|
Term
| What is one of the side effects of Ethambutol? |
|
Definition
|
|
Term
What vitamin deficiency is often linked to isoniazad use?
What symptoms does it cause? |
|
Definition
|
|
Term
| What do you give pregnant moms going into premature labor to stimulate surfactant production in the fetal lungs? |
|
Definition
|
|
Term
| What is a common cause of retinal neovascularization in premature babies? Especially in developing counties. |
|
Definition
|
|
Term
| pleural plaques are indicative of... |
|
Definition
|
|
Term
| If fecal cultures of a pregnant woman in her 35-37 wks gestation is positive for b-hemolytic gram positive cocci that's bacitran resistant in chains, what do you give her and why? What bug is it? |
|
Definition
ampicillin
To prevent GBS sepsis, meningitis, pneumonia in the baby
Group B Strep (S. Agalactiae) |
|
|
Term
What carcinoma looks like "tall columnar cells that line the alveolar septa without evidence of vascular or stromal invasion" under a microscope?
It is rare and peripheral in non-smokers |
|
Definition
| bronchoalveolar carcinoma |
|
|
Term
| What does Legionella require to grow? |
|
Definition
charcoal-yeast extract medium
cysteine |
|
|
Term
| What happens in chronic rejection of a lung transplant? |
|
Definition
small airways are effected
bronchilitis obliterans syndrome
Sx: dyspnea and wheezing |
|
|
Term
| What gene predisposes a patient to pulmonary hypertension? |
|
Definition
BMPR2
Then a secondary insult starts the disease process which leads to vascular smooth muscle proliferation in pulmonary vasculature and elevated pulmonary pressures. |
|
|
Term
What bug causes acute upper airway obstruction?
What do you treat it with? |
|
Definition
Respiratory Syncitial Virus
Ribavirin |
|
|
Term
| What part of the respiratory cycle is pulmonary vascular resistance the lowest? |
|
Definition
functional residual capacity
-inhalation increases resistance because the expanding alveoli press on the vasculature
-forced expiration increases resistance because of the positive pressure placed on the lungs from the pleura |
|
|
Term
| What bugs are "acid-fast"? |
|
Definition
ones with mycolic acid in their cell walls
- Mycobacterium and some Nocardia species |
|
|
Term
| What vaccine is conjugated with Diptheria toxin? |
|
Definition
|
|
Term
| What substance leads to granuloma formation? What cell type is it from? |
|
Definition
| T lymphocytes secrete IFN-gamma |
|
|
Term
| What is the PP of Chronic Granulomatous Disease? |
|
Definition
Lack of NADPH oxidase
nuetrophils don't turn blue |
|
|
Term
| Which hyperimmunoglobulin syndrom is associated with lymphoid hyperplasia and recurrent sino-pulmonary infections? |
|
Definition
|
|
Term
| Why are patients with silicosis more likely to get TB? |
|
Definition
| impaired macrophage killing |
|
|
Term
| What are some B cell surface markers? |
|
Definition
|
|
Term
| What is X-linked agammaglobulinemia? |
|
Definition
| Low levels of B cells and all immunoglobulins |
|
|
Term
| Does Sarcoidosis have high or low CD4+? |
|
Definition
high
... in contrast to AIDS pt with lymphocytic interstitial pneumonia and hypersensitivity pneumonitis |
|
|
Term
kid with:
frequent fungal/viral/bacterial infections, thymic hypoplasia, constant diarrhea, failure to thrive, hypoglobinemia |
|
Definition
SIDS
... both B cell and T cell issues |
|
|
Term
| Langhans giant cells in TB are caused by what cells? |
|
Definition
|
|
Term
| Do killed/viral component vaccines stimulate a stronger humoral or a stronger cell mediated immune response? |
|
Definition
|
|
Term
| How does Omalizumab work? What is it used for? |
|
Definition
| anti-IgE used in treating severe asthma |
|
|
Term
|
Definition
Mast cell stabilizer
prevents mast cell degranulation |
|
|
Term
| How does Omalizumab work? |
|
Definition
It prevents IgE from binding to mast cells.
Used in treating asthma |
|
|
Term
| Heavy smoker with increase AP diameter and decrease diaphragm excursion |
|
Definition
|
|
Term
| What is the FEV1/FVC ratio expected with COPD |
|
Definition
|
|
Term
|
Definition
increased TLC
decreased FEV1/FVC
decrease FVC
increased RV |
|
|
Term
| Which direction would the trachea go if there was pleural effusion? |
|
Definition
|
|
Term
| Which direction would the trachea go if there was volume loss? |
|
Definition
|
|
Term
| What would you see on Xray of a main stem obstructive lesion that leads to lung collapse? |
|
Definition
| opacified lung with trachea deviating towards the opacity |
|
|
Term
|
Definition
distal small bowel obstruction due to dehydrated meconium
associated with CF |
|
|
Term
| Meconium ileus signs/symptoms |
|
Definition
| bilious vomiting, abdominal distension, air fluid levels, small bowel dilation |
|
|
Term
| What do CF patients usually die from? |
|
Definition
Pneumonia
(bronchiectasis, cor pulmonale, bronchitis obstructive pulmonary disease) |
|
|
Term
| What yeast is associated with gardening (thorn pricks) |
|
Definition
|
|
Term
| What yeast is associated with southwestern states (dessert areas)? |
|
Definition
|
|
Term
| What yeast is associated with Ohio, Mississippi River, bird/bat droppings? |
|
Definition
|
|
Term
| What yeast is associated with soil near Ohio/Mississippi River, Great lakes? |
|
Definition
|
|
Term
| What yeast is associated with Central/South America? |
|
Definition
| Paracoccidioides brasiliensis |
|
|
Term
| Shipyard worker with bloody pleural effusion and pleural thickening |
|
Definition
|
|
Term
| When would you want to use Rifampin monotherapy? |
|
Definition
prophylactically to treat pt's exposed to N. Meningitidis and H. Flu
- resistance usually occurs quickly when used by itself in other cases |
|
|
Term
| What does Rifampin do to CYP450? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What bug requires hematin to grow? |
|
Definition
H. Flu
-Also needs V factor (NAD+) and chocolate agar |
|
|
Term
| Does H Flu need a capsule to be systemic? |
|
Definition
|
|
Term
| What is H Flu's virulence factor? |
|
Definition
PRP (Polyribosyl Ribotol Phosphate)
derived from the capsule |
|
|
Term
| Nontypable/capsulated H Flu causes.... |
|
Definition
local infections
-sinusits
-otitis media
-bronchitis |
|
|
Term
| Does blood flow per minute stay the same in the pulmonary and systemic blood flow? |
|
Definition
|
|
Term
| WHich system has a higher pressure? Pulmonary or systemic |
|
Definition
|
|
Term
| Does increased pCO2 cause cerebral dilation or constriction? |
|
Definition
|
|
Term
| How will pH change in a pt with COPD? |
|
Definition
| increased CO2 -> respiratory acidosis |
|
|
Term
| Does chronic hypoxia cause pulmonary vasoconstriction/dilation? |
|
Definition
|
|
