Cough Flashcards
what dimorphic fungi is endemic to Mississippi and the Ohio River valley?
histoplasmosis
bird/bat droppings
cave spelunking
are buzzwords for what dimorphic fungi?
histoplasmosis
histoplasmosis infects what cell types?
macrophages
(Histo Hides in Macrophages)
histoplasmosis is (larger/smaller/same size) as RBC
smaller
oral ulcers
splenomegaly
pancytopenia
erythema nodosum
are unique symptoms associated with what dimorphic fungi?
histoplasmosi
what dimorphic fungi is endemic to Eastern/Central US and the Great Lakes?
blastomycosis
“broad-based” budding
bastomycosis
blastomycosis is (larger/smaller/same size) as RBC
same size
inflammatory lung disease
disseminates to bone –> verrucuous lesions
may mimic SCC
are unique symptoms associated with what dimorphic fungi?
blastomycosis
what dimorphic fungi is endemic to Southwestern US, California?
coccidiodomycosis
“thick walled spherule filled with endospores”
coccidiodomycosis
coccidiodomycosis is (larger/smaller/same size) as RBC
much larger
what dimorphic fungi is associated with dust exposure in endemic areas?
(excavations, earthquakes)
coccidiodomycosis
erthyema nodosum/multiforme
arthralgias
meningitis
disseminates to bone/skin
are unique symptoms associated with what dimorphic fungi?
coccidiodomycosis
what dimorphic fungi is endemic to Latin America?
para-coccidiodomycosis
“captain’s wheel” formation
para-coccidiodomycosis
para-coccidiodomycosis is (larger/smaller/same size) as RBC
much larger
“acute angle branching of septate hyphae”
aspergillus
dimorphic fungi are […] in the cold and […] in the heat
dimorphic fungi are [mold] in the cold and [yeast] in the heat
(except coccidiomycosis is spherule)
what dimorphic fungi is seen in this microscopy image?
histoplasmosis
white arrows denote intracellular fungi
what dimorphic fungi is circled by the red?
coccidiomycosis
what fungi is depicted
aspergillosis
hypersensitivity response to aspergillosis growing in lung mucus
allergic bronchopulmonary aspergillosis (ABPA)
(diagnosed via IgE and Eosinophils)
infliximab monoclonal antibody targeting […]
TNF-a
pretreatment screening for latent viral infections should be done prior to initiating treatment with […] due to high risk of reactivation
infliximab
(TB, HBV, HCV, VZV, EBV, CMV etc)
TNF is important in […] formation and stabilization
granuloma
(why infliximab predisposes risk for granulomatous infections)
the most common genetic cause of CF is an in-frame deletion of […] in the CFTR gene
F508
CFTR encodes a ATP-gate […] channel
chloride
the 508 deletion in CF causes abnormal protein folding which leads to improper […]
trafficking to cell membrane
the CFTR mutation results in […] Cl- excretion from GI tract and […] Na+ reabsorption
the CTFR mutation results in [decreased] Cl- excretion from GI tract and [increased] Na+ reabsorption
(increased H20 resorption –> thick sticky mucus)
diagnosis of CF can be made via increased […] on pilocarpine sweat test
chloride
misfolded CTFR proteins are retained in the […] of the cell
RER
(cannot proceed to Golgi for glycosylation)
treatment for pancreatic insufficiency in CF patients
PERT
clinical decline in an adolescent with CF may be caused by
non-adherence with therapy
(i.e. chest percussion)
describe what would be increased/decreased in hypovolemic shock
CVP
PCWP
CO
SVR
svO2
CVP: decreased
PCWP: decreased
CO: decreased
SVR: increased
svO2: decreased
describe what would be increased/decreased in cardiogenic shock
CVP
PCWP
CO
SVR
svO2
CVP: increased
PCWP: increased
CO: decreased
SVR: increased
svO2: decreased
describe what would be increased/decreased in obstructive shock due to PE, or tension pneumo
CVP
PCWP
CO
SVR
svO2
CVP: increased
PCWP: decreased
CO: decreased
SVR: increased
svO2: increased
describe what would be increased/decreased in obstructive shock due to cardiac tamponade
CVP
PCWP
CO
SVR
svO2
CVP: increased
PCWP: increased
CO: decreased
SVR: increased
svO2: decreased
describe what would be increased/decreased in distributive shock due to anaphylaxis or sepsis
CVP
PCWP
CO
SVR
svO2
CVP: decreased
PCWP: decreased
CO: increased
SVR: decreased
svO2: increased
describe what would be increased/decreased in distributive shock due to neurogenic injury
CVP
PCWP
CO
SVR
svO2
CVP: decreased
PCWP: decreased
CO: decreased
SVR: decreased
svO2: normal/high
what is the mechanism of hypovolemic shock?
volume depletion
what is the mechanism of cardiogenic shock?
left heart dysfunction
what is the mechanism of obstructive shock?
impeded cardiopulmonary blood flow
what is the mechanism of distributive shock?
systemic vasodilation
when is the hypometabolic phase of a burn injury?
initial 48 hrs
when is the hypermetabolic phase of a burn injury?
5-7 days after burn
what cells are responsible for re-epithelization of skin following burn injury?
keratinocytes
(mitotically active in the basal layer)
equation for fluid resuscitation following burn
4 mL x kg x TBSA
what is used to approximate the body surface area involved in a burn?
rule of 9s
entire head 9%
entire thorax 18%
entire arm 9%
entire abdomen 18%
perineum 1%
entire leg 18%
During the first phase (called the “Ebb phase,” up to 48 hours postburn), cardiac output and metabolism are […]
decreased
Pain, erythema, and blisters that may rupture are consistent with a […] burn
blanches when pressure is applied
superficial partial-thickness
[what type of burn]
eythema
swelling
dry skin
no blisters
superficial (first degree)
erythema, and blisters that may rupture with minimal pain are consistent with a […] burn
dry and does not blanch when pressure is applied
deep partial thickness burn
[what type of burn]
Tissue necrosis with black, waxy-white, or gray leather-like skin (eschar)
Skin appears dry and inelastic
3 rd (full thickness)
or 4th (deeper full thickness)
(if the patient can still sense deep pressure, it is 3rd. if not, 4th)
Pseudomonas aeruginosa secretes […], which inactivates elongation factor-2 (EF-2) by ADP-ribosylation
exotoxin A
deactivation of EF-2 by pseudomonas causes inhibition of […]
protein synthesis
P. aeruginosa produces […], which degrades cell membranes
phospholipase C
[…] is one of the first manifestations of cystic fibrosis seen in newborns, due to defective ATP-gated chloride channels
meconium ileus
Deletion of the codon for […] 508 in the CFTR gene on chromosome 7
phenylalanine
Deletion of the codon for phenylalanine 508 in the CFTR gene on chromosome […]
7
Exocrine pancreatic insufficiency arising in cystic fibrosis (CF) causes failure to thrive due to […]
malabsorption
In CF, positively charged […] ions are also pathologically trapped in sweat by the negatively charged chloride ions in order to balance the net electric charge, resulting in hypertonic sweat.
sodium
The failure of Cl- channels to function leads to a decrease in Cl- in lung secretions. This, in turn, results in an increase in the activity of […] channels
sodium
the accumulation of intracellular Cl- leads to the retention of intracellular […] and […]
sodium
water
CFTR normally codes for a Cl- ion channel that is activated by the binding of […]
ATP
Carbon monoxide has a high affinity for […] of the electron transport chain
cytochrome c oxidase
(inhibits oxidative phosphorylation)
CO also causes a […] shift of the oxygen dissociation curve
left
Measured oxygen saturation in CO poisoning is typically […]
normal
standard pulse oximeters cannot differentiate between oxyhemoglobin and COHb
what is the treatment for CO poisoning?
100% O2 or hyperbaric chamber
