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Systemic Disease > 02. Pulmonology & Dermatology I > Flashcards

02. Pulmonology & Dermatology I Flashcards

1
Q

What is considered an acute cough?

A

Less than 3 weeks in duration

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2
Q

What is a sub-acute cough?

A

3-8 weeks

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3
Q

What is considered a chronic cough?

A

Longer than 3 weeks

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4
Q

What is the purpose of a cough?

A

To keep the airways clear

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5
Q

A cough from asthma is which type of hypersensitivity reaction?

A

Type 1

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6
Q

A cough associated with green mucous is typical of what?

A

Bacterial infection

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7
Q

Which class of drugs may induce an “annoying” cough?

A

ACE inhibitors (-il suffix)

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8
Q

A cough accompanies by unintentional weight loss and night sweats may be attributed to what condition?

A

TB

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9
Q

What is hemoptysis?

A

Coughing up blood

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10
Q

Hemoptysis may be due to what 3 main conditions?

A

TB
Bronchitis
Lung cancer, or non-malignant lung tumors

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11
Q

What is the most common cause of hemoptysis?

A

Bronchitis

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12
Q

Which of the three main causes of hemoptysis usually involves more copious amounts of blood?

A

Lung cancer/non-malignant lung tumors

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13
Q

Wheezing is more noticeable when breathing: in/out.

A

Out

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14
Q

Wheezing is often associated with what?

A

Allergy and asthma

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15
Q

When is wheezing concerning?

A

When associated with shortness of breath

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16
Q

What is stridor?

A

High pitched sound on inhalation

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17
Q

Stridor should trigger concern for what?

A

Life-threatening upper airway obstruction

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18
Q

Respiratory insufficiency causes what?

A

Hypoxemia

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19
Q

What are the 3 mechanisms for respiratory insufficiency?

A

Hypoventilation
Ventilation/perfusion mismatch
Diffusion impairment

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20
Q

What are the 2 major systemic evidences of hypoxemia?

A

Clubbing of fingers and toes

Increased pulmonary vascular resistance

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21
Q

Respiratory insufficiency causes reduced ___ resistance.

A

Arterial

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22
Q

Increased pulmonary vascular resistance may result in what?

A

Right heart failure

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23
Q

Increased pulmonary vascular resistance causes increased systemic ___ pressure.

A

Venous

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24
Q

What are the 2 major ocular findings associated with COPD?

A

Dilation of conj vessels

Dilation of major retinal arteries and veins

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25
Q

Congenital cyanotic heart disease typically presents with what 5 major ocular findings?

A 
Dusky, dilated conj vessels
Conj edema
Dilation of major retinal arteries and veins
Striate retinal hemorrhages
Optic disc edema
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26
Q

What are the 2 main ocular findings of carbon monoxide poisoning?

A

Flame hemes

Venous engorgement

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27
Q

What is the treatment for hypoxemia of altitude?

A

Acetazolamide

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28
Q

What are the typical ocular findings of high altitude retinopathy (HAR)?

A

Retinal hemorrhages

Dilated venules and engorged arterioles

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29
Q

What are the 7 treatment options for asthma?

A 
Beta-agonists
Theophylline
Anti-cholinergic drugs
Corticosteroids
Cromolyn
Leukotriene modifiers
ATs
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30
Q

Albuterol, proventil, and ventolyn are what type of drugs, used to treat what?

A

Beta-agonists

Tx Asthma

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31
Q

How does Theophylline treat asthma?

A

Relaxes bronchial smooth muscle

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32
Q

What are the major side effects of the anti-cholinergic drugs used to treat asthma?

A

Dry mouth

Dry eye

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33
Q

What 2 anti-cholinergic drugs may be used to treat asthma?

A

Atropine

Ipratroprium bromide

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34
Q

Which corticosteroid may be used to treat asthma?

A

Prednisone

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35
Q

How does Cromolyn help treat asthma?

A

Blocks mediator release from inflammatory cells

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36
Q

Which drugs used to treat asthma may induce glaucoma?

A

Anti-cholinergics

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37
Q

Anti-cholinergics are contraindicated in what condition?

A

Narrow angles

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38
Q

What is the progression of lung disease with tobacco smoking?

A

Asthma, chronic bronchitis
Emphysema
COPD

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39
Q

How are pack years calculated?

A

Packs per day * years

20 cigs per pack

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40
Q

What constitutes obstructive lung disease?

A

Inflammation and thickening of the airways

Destruction of tissue facilitating oxygen exchange

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41
Q

What 3 things characterize COPD?

A

Chronic bronchitis
Emphysema due to smoking
Usually a combo of both

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42
Q

What are the 7 symptoms of COPD?

A 
Chronic cough
Shortness of breath
Frequent respiratory infections
Fatigue
Cyanosis of finger beds
Sputum
Wheezing
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43
Q

What are the 3 tests for COPD?

A

Spirometry
Chest X-ray
Arterial blood gas

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44
Q

The use of beta-blockers are contraindicated in what 3 things?

A

COPD
Asthma
Certain CV diseases

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45
Q

What morphological changes occur in emphysema?

A

Abnormal, permanent enlargement of the airspaces distal to the terminal bronchiles

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46
Q

What are the 5 signs of emphysema?

A 
Productive cough and sputum increase
Exertional dyspnea
Wheezing
Morning headache
Cyanosis
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47
Q

What are the ocular complications of emphysema?

A

Secondary cataract from steroids (PSC)
Glaucoma (steroid responders)
Papilledema
Optic neuritis

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48
Q

What is the usual cause of pneumonia in the hospital?

A

Methicillin resistant organisms like staph aureus (MERSA)

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49
Q

What is pneumoconiosis?

A

Deposition of large amounts of dust or particulate matter in the lungs

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50
Q

What workers often get penumoconiosis?

A

Coal workers - black lung, coal dust

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51
Q

What is the most common life threatening genetic disease in caucasians?

A

Cystic fibrosis

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52
Q

What is the inheritance pattern of cystic fibrosis?

A

Autosomal recessive

53
Q

Cystic fibrosis affects which type of glands?

A

Exocrine

54
Q

Cystic fibrosis causes the exocrine glands to do what?

A

Produce excessive secretions

55
Q

Cystic fibrosis mainly affects what 2 systems?

A

GI tract

Respiratory system

56
Q

What are the 2 main ocular findings of cystic fibrosis?

A

Dry eye - abnormal tear secretion

Xerophthalmia - vit A deficiency

57
Q

What are the 3 types of sleep apnea?

A

Airway obstruction
Decreased respiratory center
Mixed

58
Q

What questionnaire is used to screen for sleep apnea?

A

Berlin questionnaire

59
Q

What 4 ocular conditions may arise in conjunction with sleep apnea?

A

Floppy eyelid syndrome
Glaucoma -(NTG)
NAION
Papilledema

60
Q

How do most chest wall tumors occur?

A

As metastases from adjacent structures (breast, lung, pleura, mediastinum)

61
Q

What is the leading cause of cancer related death?

A

Carcinoma of the lung

62
Q

Carcinoma of the lung 85% of the time relates to what?

A

Cigarette smoking

63
Q

What imaging should be done for lung carcinoma?

A

Chest X-ray or CT

64
Q

What are the 3 classifications of lung carcinoma?

A

Small cell (oat cell)
Non-small cell
Other

65
Q

Which classification of lung carcinoma is most likely to metastasize?

A

Small cell (oat cell)

66
Q

What is an example of a non-small cell lung carcinoma?

A

Pancoast’s tumor

67
Q

Where do symptoms arise in para-neoplastic syndromes?

A

Away from the primary cancer site

68
Q

What causes neurologic syndromes in para-neoplastic syndromes?

A

Antibodies to the tumor attack self (brain)

69
Q

Which is elevated, a macule or a papule?

A

Papule

70
Q

A flesh colored macule must be further investigated to rule out what?

A

Early basal cell

71
Q

A flesh colored macular lesion is often what?

A

Sebaceous gland hyperplasia

72
Q

A pigmented papular lesion of irregular shape may be what?

A

Melanoma

73
Q

A pearly papular lesion may be what?

A

Basal cell carcinoma

74
Q

Describe a squamous cell carcinoma.

A

Erythematous, firm, papular lesion with keratin plug

75
Q

Which types of sub-dermal skin tumor are fixed to deep structures?

A

Liposarcoma

Neurofibroma

76
Q

What is typically the first of the allergic diseases?

A

Eczema

77
Q

Eczema is a collective name for what symptoms?

A

Inflamed, red, scaly, itchy skin

78
Q

What is seborrheic dermatitis?

A

Inflammation of skin with high density of sebaceous cysts

79
Q

Seborrheic dermatitis is common in what conditions?

A 
HIV
Neurologic disorders (Parkinson's)
80
Q

Seborrheic dermatitis may be due to what normal skin organism?

A

Pityrosporum ovale

81
Q

Seborrheic dermatitis may be a symptom of a deficiency of what vitamin?

A

Riboflavin

82
Q

Impetigo is common in what age group?

A

Infants/children

83
Q

What is impetigo?

A

Superficial skin infection with crusting and bullae

84
Q

What 2 organisms may be the cause of impetigo?

A

Streptococci

Staphylococci

85
Q

What is the Tx for impetigo?

A

Warm soaks followed by topical antibiotics

86
Q

Erysipelas is due to what organism?

A

Group A hemolytic streptococci

87
Q

How does erysipelas typically present?

A

Shiny, raised, tender lesions with distinct margins

88
Q

What is erysipelas?

A

Superficial cellulitis with dermal lymphatic involvement, high fever, chills, and malaise

89
Q

How is erysipelas treated?

A

Oral vanco or penicillin

90
Q

What causes fifth disease?

A

Parvo B19

91
Q

What are the hallmark signs and symptoms of Fifth disease?

A

Fever

Slapped cheek rash

92
Q

Is actinic keratosis malignant or benign?

A

Premalignant

93
Q

What causes actinic keratosis?

A

Accumulated years of sun damage

94
Q

What differentiates actinic keratosis from seborrheic keratosis?

A

Seborrheic occurs in non-sun exposed areas

95
Q

Basal cell carcinomas arise from what?

A

Keratinocytes

96
Q

What is the hallmark characteristic of a basal cell carcinoma?

A

Pearly boarders

97
Q

What is the “basal cell cycle”?

A

Bleeds, crusts, heals

98
Q

What is Bowen’s Disease?

A

Superficial squamous cell carcinoma in situ

99
Q

How is Bowen’s disease diagnosed?

A

Biopsy

100
Q

What is a squamous cell carcinoma?

A

Malignant tumor of the keratinocytes

101
Q

Where is the bulk of the tumor located in a squamous cell carcinoma?

A

Below the skin

102
Q

What is the typical presentation of a squamous cell carcinoma?

A

Red papule/plaque

Scaly, waxy surface

103
Q

What is the Tx for squamous cell?

A

Topical imiquimod
5-fluorouracil
Surgery
Radiation

104
Q

Metastasis of melanomas correlate with what?

A

Depth of skin invasion

105
Q

What is a Kaposi sarcoma?

A

Multi-centric vascular tumor

106
Q

What causes Kaposi sarcoma?

A

Herpes virus 8

107
Q

Kaposi sarcoma is associated with what condition?

A

AIDS

108
Q

AIDS associated Kaposi Sarcoma often presents where?

A

Conjunctiva

109
Q

What are the ocular findings of Juvenile Xanthogranuloma (JXA)?

A

Mass lesions of eyelid, orbit, uvea

110
Q

An iris mass in JXA is most common with what other finding?

A

Heterochromia

111
Q

What is the most common etiology of spontaneous hyphema in children?

A

JXA

112
Q

What is a hemangioma?

A

Strawberry nevus that blanches with pressure

113
Q

Hemangiomas may induce what type of refractive error?

A

Astigmatism

114
Q

What 2 ocular conditions can be caused by a hemangioma?

A

Orbital proptosis

Optic neuropathy

115
Q

What is the inheritance pattern of Xeroderma Pigmentosum?

A

Autosomal recessive

116
Q

What characterizes xeroderma pigmentosum?

A

Defective DNA repair

117
Q

Xeroderma pigmentosum sufferers often share what qualities?

A

Bird-like faces

Mental retardation

118
Q

Which type of Ehlers-Danlos syndrome is associated with ocular fractures?

A

Type 6

119
Q

What is the name of type 6 Ehlers-Danlos syndrome?

A

Kypho-scoliotic types

120
Q

What is the inheritance pattern of type 6 Ehlers-Danlos syndrome?

A

Autosomal recessive

121
Q

What are the common ocular findings of Ehlers-Danlos?

A

Keratoconus
Absent Bowman’s layer
LASIK is contraindicated

122
Q

What is a common lenticular finding in EDS?

A

Ectopia lentis

123
Q

What are the 7 systemic causes of ectopia lentis?

A 
EDS
Marfan
Weill-Marchesani
Homocystinuria
Hyperlysinemia
Sulfite oxidase deficiency
Syphilis
124
Q

What are the retinal manifestations of EDS?

A

Depigmentation

Angioid streaks

125
Q

What is the most common refractive error in EDS?

A

Myopia

126
Q

What are angioid streaks?

A

Breaks in Bruch’s membrane

127
Q

What are the conditions in which angioid streaks are commonly found?

A 
PEPSI-HAAM
Pseudoxanthoma elasticum
EDS
Paget's disease
Sickle cell
Idiopathic
Hemochromatosis
Acromegaly
Age related senile elastosis
Marfan's
128
Q

What is the Tx for angioid streaks?

A

Protective eyewear
FA
Daily home amsler

Systemic Disease (12 decks)

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