Deck VIII

Question 1

What complication is characteristic of a hemodynamically significant atrial septal defect?

Answer 1

Pulmonary hypertension which may cause Eisenmenger syndrome (reversal of shunting).

Question 2

What do Langerhan’s cells look like histologically?

Answer 2

Multiple nuclei peripherally organized in the shape of a horseshoe.

Question 3

What condition are Langerhan’s cells characteristic of?

Answer 3

Granulomatous conditions.

Question 4

What reflex is mediated by the superior laryngeal nerve (CN X)?

Answer 4

Cough reflex.

Question 5

Name two structures that would likely be injured in a very deep stab wound to the left, 5th intercostal space at the midclavicular line.

Answer 5

Left lung; apex of the heart (L. ventricle)

Question 6

What would you expect the results of a nasal transepithelial potential difference test to be in a patient with CF?

Answer 6

More negative nasoepithelial surface due to increased luminal sodium absorption.

Question 7

What ion imbalances are characteristic of a defective CFTR protein?

Answer 7

Reduced epithelial chloride secretion causing an indirect increase in sodium absorption

Question 8

Describe changes in respiratory tidal volume in a patient with Cheyne-Stokes respirations.

Answer 8

Cyclic breathing in which apnea is followed by gradually increasing tidal volumes and then gradually decreasing tidal volumes until the next apneic period.

Question 9

In what conditions are Cheyne-Stokes respirations seen?

Answer 9

advanced CHF, neurologic disease (stroke, brain tumors, TBI)

Question 10

What is the pathophysiology associated with symptomatic panic attacks?

Answer 10

Hyperventillation causes decreased pCO2. Hypocapnia causes cerebral vasoconstriction and decreased cerebral blood flow leading to dizziness, weakness, and blurred vision.

Question 11

Which types of immune response cells contribute to containing an M. Tuberculosis infection within a caseous granuloma?

Answer 11

CD4+ TH1 lymphocytes and macrophages.

Question 12

In a patient with CHF and fluid in the pulmonary interstitium, what would be the acute cause of dyspnea?

Answer 12

Decreased lung compliance due to fluid buildup.

Question 13

How are most inhaled particles lodged in the bronchial tree removed from the lungs?

Answer 13

Via proximal transport of mucus by ciliated epithelial cells (mucocilliary clearance)

Question 14

Where are goblet cells found?

Answer 14

Only in the trachea and larger bronchioles.

Question 15

Name two factors that are released during anaphylaxis from widespread mast cell degranulation.

Answer 15

Histamine and Tryptase.

Question 16

How is degranulation of mast cells initiated?

Answer 16

Crosslinking of multiple membrane-bound IgE antibodies by a specific antigen resulting in an aggregation of IgE-Fc receptors on mast cell surfaces.

Question 17

In a patient with restrictive lung disease, what may cause expiratory flow rates to be increased?

Answer 17

Decreased lung compliance (increased elastic recoil) and increased radial traction is exerted on the conducting airways by the fibrotic lung.

Question 18

What protein is released by eosinophils to kill helminths?

Answer 18

Major Basic Protein.

Question 19

What finding would you expect in a patient with COPD and longstanding hypercapnea?

Answer 19

Cerebral vasodilation via decreased cerebral vascular resistance to compensate for hypoxia.

Question 20

At what point in the breathing cycle is pulmonary vascular resistance lowest?

Answer 20

At the functional residual capacity.

Question 21

How are large particles (10-15 um) cleared by the respiratory tract?

Answer 21

Trapped in the upper respiratory tract.

Question 22

How are medium sized particles (2.5-10um) cleared by the respiratory tract?

Answer 22

Mucocilliary transport.

Question 23

How are fine particles (less than 2 um) cleared by the respiratory tract?

Answer 23

They reach the terminal bronchi and alveoli and are phagocytosed by macrophages.

Question 24

What is the most common site of obstruction causing fetal hydronephrosis?

Answer 24

Ureteropelvic junction.

Question 25

What are the earliest disease manifestations of Fabry’s disease?

Answer 25

Hypohidrosis (diminished sweating), acroparesthesia (neuropathic pain of the extremities), aniokeratomas (dark, punctuate non blanching red macules and papules usually located between the umbilicus and knees

Question 26

Where along the nephron is the most likely site for uric acid precipitation and why?

Answer 26

Uric acid precipitates in an acidic environment; therefore it most often precipitates in the distal tubules and collecting ducts where pH is lowest.

Question 27

What treatments may reduce the risk of tumor lysis syndrome?

Answer 27

Urine alkalinization, hydration.

Question 28

What is a variocele?

Answer 28

A mass of varicose veins in the spermatic cord.

Question 29

What symptom may occur in a male with a left sided renal vein obstruction?

Answer 29

Left sided varicocele; left gonadal vein drains right into the left renal vein (right gonadal vein drains directly into the IVC)

Question 30

In rapidly progressive glomerurlonephritis, what type of deposition is essential to crescent formation?

Answer 30

Fibrin deposition