02. Pulmonology & Dermatology I Flashcards
1
Q
What is considered an acute cough?
A
Less than 3 weeks in duration
2
Q
What is a sub-acute cough?
A
3-8 weeks
3
Q
What is considered a chronic cough?
A
Longer than 3 weeks
4
Q
What is the purpose of a cough?
A
To keep the airways clear
5
Q
A cough from asthma is which type of hypersensitivity reaction?
A
Type 1
6
Q
A cough associated with green mucous is typical of what?
A
Bacterial infection
7
Q
Which class of drugs may induce an “annoying” cough?
A
ACE inhibitors (-il suffix)
8
Q
A cough accompanies by unintentional weight loss and night sweats may be attributed to what condition?
A
TB
9
Q
What is hemoptysis?
A
Coughing up blood
10
Q
Hemoptysis may be due to what 3 main conditions?
A
TB
Bronchitis
Lung cancer, or non-malignant lung tumors
11
Q
What is the most common cause of hemoptysis?
A
Bronchitis
12
Q
Which of the three main causes of hemoptysis usually involves more copious amounts of blood?
A
Lung cancer/non-malignant lung tumors
13
Q
Wheezing is more noticeable when breathing: in/out.
A
Out
14
Q
Wheezing is often associated with what?
A
Allergy and asthma
15
Q
When is wheezing concerning?
A
When associated with shortness of breath
16
Q
What is stridor?
A
High pitched sound on inhalation
17
Q
Stridor should trigger concern for what?
A
Life-threatening upper airway obstruction
18
Q
Respiratory insufficiency causes what?
A
Hypoxemia
19
Q
What are the 3 mechanisms for respiratory insufficiency?
A
Hypoventilation
Ventilation/perfusion mismatch
Diffusion impairment
20
Q
What are the 2 major systemic evidences of hypoxemia?
A
Clubbing of fingers and toes
Increased pulmonary vascular resistance
21
Q
Respiratory insufficiency causes reduced ___ resistance.
A
Arterial
22
Q
Increased pulmonary vascular resistance may result in what?
A
Right heart failure
23
Q
Increased pulmonary vascular resistance causes increased systemic ___ pressure.
A
Venous
24
Q
What are the 2 major ocular findings associated with COPD?
A
Dilation of conj vessels
Dilation of major retinal arteries and veins
25
Congenital cyanotic heart disease typically presents with what 5 major ocular findings?
```
Dusky, dilated conj vessels
Conj edema
Dilation of major retinal arteries and veins
Striate retinal hemorrhages
Optic disc edema
```
26
What are the 2 main ocular findings of carbon monoxide poisoning?
Flame hemes
| Venous engorgement
27
What is the treatment for hypoxemia of altitude?
Acetazolamide
28
What are the typical ocular findings of high altitude retinopathy (HAR)?
Retinal hemorrhages
| Dilated venules and engorged arterioles
29
What are the 7 treatment options for asthma?
```
Beta-agonists
Theophylline
Anti-cholinergic drugs
Corticosteroids
Cromolyn
Leukotriene modifiers
ATs
```
30
Albuterol, proventil, and ventolyn are what type of drugs, used to treat what?
Beta-agonists
| Tx Asthma
31
How does Theophylline treat asthma?
Relaxes bronchial smooth muscle
32
What are the major side effects of the anti-cholinergic drugs used to treat asthma?
Dry mouth
| Dry eye
33
What 2 anti-cholinergic drugs may be used to treat asthma?
Atropine
| Ipratroprium bromide
34
Which corticosteroid may be used to treat asthma?
Prednisone
35
How does Cromolyn help treat asthma?
Blocks mediator release from inflammatory cells
36
Which drugs used to treat asthma may induce glaucoma?
Anti-cholinergics
37
Anti-cholinergics are contraindicated in what condition?
Narrow angles
38
What is the progression of lung disease with tobacco smoking?
Asthma, chronic bronchitis
Emphysema
COPD
39
How are pack years calculated?
Packs per day * years
| 20 cigs per pack
40
What constitutes obstructive lung disease?
Inflammation and thickening of the airways
| Destruction of tissue facilitating oxygen exchange
41
What 3 things characterize COPD?
Chronic bronchitis
Emphysema due to smoking
Usually a combo of both
42
What are the 7 symptoms of COPD?
```
Chronic cough
Shortness of breath
Frequent respiratory infections
Fatigue
Cyanosis of finger beds
Sputum
Wheezing
```
43
What are the 3 tests for COPD?
Spirometry
Chest X-ray
Arterial blood gas
44
The use of beta-blockers are contraindicated in what 3 things?
COPD
Asthma
Certain CV diseases
45
What morphological changes occur in emphysema?
Abnormal, permanent enlargement of the airspaces distal to the terminal bronchiles
46
What are the 5 signs of emphysema?
```
Productive cough and sputum increase
Exertional dyspnea
Wheezing
Morning headache
Cyanosis
```
47
What are the ocular complications of emphysema?
Secondary cataract from steroids (PSC)
Glaucoma (steroid responders)
Papilledema
Optic neuritis
48
What is the usual cause of pneumonia in the hospital?
Methicillin resistant organisms like staph aureus (MERSA)
49
What is pneumoconiosis?
Deposition of large amounts of dust or particulate matter in the lungs
50
What workers often get penumoconiosis?
Coal workers - black lung, coal dust
51
What is the most common life threatening genetic disease in caucasians?
Cystic fibrosis
52
What is the inheritance pattern of cystic fibrosis?
Autosomal recessive
53
Cystic fibrosis affects which type of glands?
Exocrine
54
Cystic fibrosis causes the exocrine glands to do what?
Produce excessive secretions
55
Cystic fibrosis mainly affects what 2 systems?
GI tract
| Respiratory system
56
What are the 2 main ocular findings of cystic fibrosis?
Dry eye - abnormal tear secretion
| Xerophthalmia - vit A deficiency
57
What are the 3 types of sleep apnea?
Airway obstruction
Decreased respiratory center
Mixed
58
What questionnaire is used to screen for sleep apnea?
Berlin questionnaire
59
What 4 ocular conditions may arise in conjunction with sleep apnea?
Floppy eyelid syndrome
Glaucoma -(NTG)
NAION
Papilledema
60
How do most chest wall tumors occur?
As metastases from adjacent structures (breast, lung, pleura, mediastinum)
61
What is the leading cause of cancer related death?
Carcinoma of the lung
62
Carcinoma of the lung 85% of the time relates to what?
Cigarette smoking
63
What imaging should be done for lung carcinoma?
Chest X-ray or CT
64
What are the 3 classifications of lung carcinoma?
Small cell (oat cell)
Non-small cell
Other
65
Which classification of lung carcinoma is most likely to metastasize?
Small cell (oat cell)
66
What is an example of a non-small cell lung carcinoma?
Pancoast's tumor
67
Where do symptoms arise in para-neoplastic syndromes?
Away from the primary cancer site
68
What causes neurologic syndromes in para-neoplastic syndromes?
Antibodies to the tumor attack self (brain)
69
Which is elevated, a macule or a papule?
Papule
70
A flesh colored macule must be further investigated to rule out what?
Early basal cell
71
A flesh colored macular lesion is often what?
Sebaceous gland hyperplasia
72
A pigmented papular lesion of irregular shape may be what?
Melanoma
73
A pearly papular lesion may be what?
Basal cell carcinoma
74
Describe a squamous cell carcinoma.
Erythematous, firm, papular lesion with keratin plug
75
Which types of sub-dermal skin tumor are fixed to deep structures?
Liposarcoma
| Neurofibroma
76
What is typically the first of the allergic diseases?
Eczema
77
Eczema is a collective name for what symptoms?
Inflamed, red, scaly, itchy skin
78
What is seborrheic dermatitis?
Inflammation of skin with high density of sebaceous cysts
79
Seborrheic dermatitis is common in what conditions?
```
HIV
Neurologic disorders (Parkinson's)
```
80
Seborrheic dermatitis may be due to what normal skin organism?
Pityrosporum ovale
81
Seborrheic dermatitis may be a symptom of a deficiency of what vitamin?
Riboflavin
82
Impetigo is common in what age group?
Infants/children
83
What is impetigo?
Superficial skin infection with crusting and bullae
84
What 2 organisms may be the cause of impetigo?
Streptococci
| Staphylococci
85
What is the Tx for impetigo?
Warm soaks followed by topical antibiotics
86
Erysipelas is due to what organism?
Group A hemolytic streptococci
87
How does erysipelas typically present?
Shiny, raised, tender lesions with distinct margins
88
What is erysipelas?
Superficial cellulitis with dermal lymphatic involvement, high fever, chills, and malaise
89
How is erysipelas treated?
Oral vanco or penicillin
90
What causes fifth disease?
Parvo B19
91
What are the hallmark signs and symptoms of Fifth disease?
Fever
| Slapped cheek rash
92
Is actinic keratosis malignant or benign?
Premalignant
93
What causes actinic keratosis?
Accumulated years of sun damage
94
What differentiates actinic keratosis from seborrheic keratosis?
Seborrheic occurs in non-sun exposed areas
95
Basal cell carcinomas arise from what?
Keratinocytes
96
What is the hallmark characteristic of a basal cell carcinoma?
Pearly boarders
97
What is the "basal cell cycle"?
Bleeds, crusts, heals
98
What is Bowen's Disease?
Superficial squamous cell carcinoma in situ
99
How is Bowen's disease diagnosed?
Biopsy
100
What is a squamous cell carcinoma?
Malignant tumor of the keratinocytes
101
Where is the bulk of the tumor located in a squamous cell carcinoma?
Below the skin
102
What is the typical presentation of a squamous cell carcinoma?
Red papule/plaque
| Scaly, waxy surface
103
What is the Tx for squamous cell?
Topical imiquimod
5-fluorouracil
Surgery
Radiation
104
Metastasis of melanomas correlate with what?
Depth of skin invasion
105
What is a Kaposi sarcoma?
Multi-centric vascular tumor
106
What causes Kaposi sarcoma?
Herpes virus 8
107
Kaposi sarcoma is associated with what condition?
AIDS
108
AIDS associated Kaposi Sarcoma often presents where?
Conjunctiva
109
What are the ocular findings of Juvenile Xanthogranuloma (JXA)?
Mass lesions of eyelid, orbit, uvea
110
An iris mass in JXA is most common with what other finding?
Heterochromia
111
What is the most common etiology of spontaneous hyphema in children?
JXA
112
What is a hemangioma?
Strawberry nevus that blanches with pressure
113
Hemangiomas may induce what type of refractive error?
Astigmatism
114
What 2 ocular conditions can be caused by a hemangioma?
Orbital proptosis
| Optic neuropathy
115
What is the inheritance pattern of Xeroderma Pigmentosum?
Autosomal recessive
116
What characterizes xeroderma pigmentosum?
Defective DNA repair
117
Xeroderma pigmentosum sufferers often share what qualities?
Bird-like faces
| Mental retardation
118
Which type of Ehlers-Danlos syndrome is associated with ocular fractures?
Type 6
119
What is the name of type 6 Ehlers-Danlos syndrome?
Kypho-scoliotic types
120
What is the inheritance pattern of type 6 Ehlers-Danlos syndrome?
Autosomal recessive
121
What are the common ocular findings of Ehlers-Danlos?
Keratoconus
Absent Bowman's layer
LASIK is contraindicated
122
What is a common lenticular finding in EDS?
Ectopia lentis
123
What are the 7 systemic causes of ectopia lentis?
```
EDS
Marfan
Weill-Marchesani
Homocystinuria
Hyperlysinemia
Sulfite oxidase deficiency
Syphilis
```
124
What are the retinal manifestations of EDS?
Depigmentation
| Angioid streaks
125
What is the most common refractive error in EDS?
Myopia
126
What are angioid streaks?
Breaks in Bruch's membrane
127
What are the conditions in which angioid streaks are commonly found?
```
PEPSI-HAAM
Pseudoxanthoma elasticum
EDS
Paget's disease
Sickle cell
Idiopathic
Hemochromatosis
Acromegaly
Age related senile elastosis
Marfan's
```
128
What is the Tx for angioid streaks?
Protective eyewear
FA
Daily home amsler
