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Question 1

What type of antihypertensive medication is contraindicated in patients with lung disease?

Answer 1

Avoid non-selective beta blockers because they cause bronchoconstriction by blocking the B2 receptor

Question 2

What are the top two most common causes of atypical pneumonia in young adults? Which one is an obligate intracellular organism?

Answer 2

1st - mycoplasma pneumoniae

2nd - chlamydophila pneumoniae (obligate intracellular organism)

Question 3

Which bacterial cause of pneumonia is characterized by optochin sensitivity? bacitracin sensitivity? coagulase positivity? presence of cold agglutinins?

Answer 3

optochin sensitivity - strep pneumo
bacitracin sensitivity - strep pyogenes
coagulase positivity - staph aureus
cold agglutinins - mycoplasma pneumoniae

Question 4

Alpha-1-antitrypsin deficiency leads to the destruction of what two organs? What will be found on biopsy?

Answer 4

the lungs (emphysema)
the liver (cirrhosis) - A1AT is made in the liver and in this disease, A1AT is misfolded and builds up in hepatocytes 
Biopsy of the liver will show intracellular periodic acid-Schiff positive globules

Question 5

What does the Prussian-blue stain stain for?

Answer 5

iron (hemochromatosis)

Question 6

What are intracytoplasmic eosinophilic inclusions in the liver called? What condition are they associated with?

Answer 6

Mallory bodies. Are associated with alcohol induced hepatitis and alcoholic cirrhosis

Question 7

Which cephalosporins can be used to treat pseudomonas?

Answer 7

cefepime, ceftazidime, cefoperazone

Question 8

What are the side effects of the asthma drug, salmeterol?

Answer 8

tremor and arrhythmias (palpitations)

Question 9

What kind of lung disease are patients with cystic fibrosis at risk for?

Answer 9

bronchiectasis

Question 10

What is the most common bacterial cause of epiglottitis? What is the next step once you have diagnoses epiglottitis?

Answer 10

haemophilus influenzae (gram negative coccobacillus)
Epiglottitits is a medical emergency so the next step is intubation

Question 11

What are the three most common causes of the common cold?

Answer 11

rhinoviruses, coronaviruses and respiratory syncytial virus

Question 12

With what antibiotic do you treat an atypical pneumonia cause by mycoplasma pneumoniae

Answer 12

a macrolide like azithromycin

Question 13

A defect in CD18/LFA-1 integrin results in what disease? How does it manifest?

Answer 13

Leukocyte adhesion deficiency.

Manifests as delayed separation of the umbilicus at birth and recurrent bacterial infections with no pus formation

Question 14

What is the mechanism of action of isoniazid? What are its adverse effects?

Answer 14

mechanism - inhibits mycolic acid synthesis
adverse effects - inhibits synthesis of pyridoxine (vitamin B6), a precursor of GABA. A deficiency in GABA can lead to seizures
*give vit B6 as a supplement to anyone on isoniazid for TB prophylaxis!

Question 15

What is the treatment of choice for TB prophylaxis?

Answer 15

isoniazid

Question 16

What are the predisposing factors for neonatal respiratory distress syndrome?

Answer 16

maternal diabetes, prematurity/<1.5 L:S ratio, c-section

Question 17

What is the most common mutation in cystic fibrosis? What is the result of this mutation?

Answer 17

a deletion of a phenylalanine at position 508. Leads to defective processing from the endoplasmic reticulum to the golgi apparatus

Question 18

What are the characteristics of legionella infection? How do you visualize Legionella?

Answer 18

acute hyperpyrexia, severe pneumonia with neutrophils and very few organisms on Gram stain
Visualize with silver stain