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Resp II > Dubin - High Yield Associations > Flashcards

Dubin - High Yield Associations Flashcards

1
Q
  • phospholipid-laden MPs
  • intersitial pnumonitis
  • organizing pneumonia
  • ARDS
  • HSN
A

amiodarone induces plum dz

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2
Q

long rods, ferruginous bodies

A

asbestosis

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3
Q
  • endocarditis hard to tx
  • result of aspiration
  • ass’d with IVDAs
  • blotchy pneumo w/ supperative cavities or nodules b/l
  • murmur over tricuspid
  • septic emboli
  • fever of unk origin
  • normally in the oropharynx
A

HACEK

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4
Q

prophylax for PCP with

A

TMP-SMX (aka bactrim)

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5
Q
  • common pneumo post flu
  • MC community aquired pnumo
  • diplococci
  • rigors
  • chills
A

strep pneumo

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6
Q
  • non-immunized pts
  • enlarged epiglottis > drooling (can’t swallow)
  • common cause of pneumonia in COPD’ers and post-flu
A

H. flu

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7
Q
  • diabetics (DKA)
  • leukemic pts
  • chronic sinusitis
  • no response after 8 wks of Abs
  • dies from erosion into brain!
  • black on nose
A

mucor

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8
Q
  • thermophillic actinomyces
  • around moldy hay
  • IgG and IgM on BAL
  • non-caseating granulomas
  • foam cells
  • episodic
A

Farmer’s Lung - HS pneumonia

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9
Q
  • fungal growth in lung field

- occupying old lesion (possibly pneumonia)

A

aspergilloma

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10
Q
  • difficult to tx asthmatic
  • +++ eosinophils
  • mucous is brown and stringy
  • “gloved finger” on CXR
A

ABPA

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11
Q
  • can infect almost every type of tissue
  • possibly immunocomp pts with low CD4
  • nuchal rigidity
  • photosensitivity
  • evolution into full blown meningitis
A

cryptococcal meningitis

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12
Q

india ink stain

A

cryptococcus

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13
Q
  • cold agglutinins
  • common in adolescnt/college age
  • low PaO and high PaCO2
  • bullous myrigits
A

mycoplasma

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14
Q

tx for mycoplasma penumonia

A

macrolides (eg: erythromycin)

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15
Q
  • immuno def child
  • recurrent ear & sinus infs
  • possible giardia
A

IgA Immunodef

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16
Q
  • pt in MVA w/ blood transfusion

- marked transfusion rxn d/t Abs

A

IgA Immunodef

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17
Q
  • acid fast (Ziehl-Neelson stain)

- can cause miliary TB

A

mycobacterium

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18
Q
  • intense coughing attack during expiration
  • high pictched respiraratory sound
  • forceful inspiration
  • bulging neck vv
  • cyanosis
A

pertussis

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19
Q
  • barking cough

- relieved by humidity

A

croup

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20
Q
  • grows on charcoal yeast
  • ass’d exposure to water source (like AC unit)
  • relative bradycardia
A

legionaires

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21
Q

tx of histo, coccidiomycosis, blasto

A

amphotercin B

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22
Q

tx of aspiraion pneumonia (kills microaerophilic organisma)

A

clindamycin

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23
Q

MC pneumos ass’d with COPD

A

H. flu, moraxella, staph

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24
Q
  • gm - facultative intracellular bacteria
  • transmitted via flea bite
  • birefringent
  • safety pin shaped
  • prairie dogs
A

yersina pestis

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25
Q

tx for + PPD skin test

A

6-12 mo INH

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26
Q

drug that causes hepatotoxicity w/ elevated liver enzymes, peripheral neuropathy

A

isoniazid (INH)

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27
Q

drug that causes deafness

A

streptomycin

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28
Q

drug that causes red-orange secretions (tears, urine, ect)

A

rifampin (RIF)

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29
Q

drug that causes optic neuritis and red-green colorblindness, possible dizziness and vertical nystagmus

A

ethambutol (EMB)

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30
Q

how do you diff btwn BCG vaccine and previous TB inf

A

quantiferron gold

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31
Q
  • infant w/ runny nose, cough, wheezing
  • intercostal retractions w/ grunting
  • worse in winter months
A

RSV

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32
Q
  • ppl on cruise ship with resp s/s

- treats flu A & B

A

oseltamivir (tamiflu)

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33
Q

amatadine and rimatatine tx what?

A

only flu A

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34
Q

tx for pseudomonas

A

gentomycin

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35
Q
  • hunter around great lakes region/ north east
  • skin lesions
  • nodular appearance
  • broad based budding
A

-bastomycosis

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36
Q
  • SW US, CA, and Mexico
  • small calcificaitons on CXR
  • chronic inf gets into bone and joints
  • red, painful skin lesions
  • subQ pre-tibial nodules
  • “coin lesions”
  • hx of fever and non-productive cough
  • recent visit to SW US (AZ)
A

coccidiomycosis

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37
Q
  • ass’d with endocarditis
  • pneumonia-like syndromes
  • cattle birthing season (in amniotic fluid)
  • hepatomegaly w/ elevated liver enzymes
  • very high T
A

Q fever

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38
Q
  • causes Q fever

- intracellular pathogenic bacterial smiliar to rickettsia but w/ genetic and physiologic differences

A

coxiella burnetti

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39
Q
  • rabbits
  • puneumo-like etiology but doesn’t lead to restrictive lung dz
  • hunters who hunt rabbits
A

franciella tularensis

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40
Q
  • dropping DLCO
  • bronchiolitis obliterans with organizing pneumo
  • prodromal s/s of flu
  • SOB for a few mo’s thats been getting worse
A

intersitial pulmonary fibrosis

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41
Q
  • rust colored sputum
  • high fever 102-103
  • chills & rigors
  • MC pnumo in HIV +
  • lobar pneumonia
A

strep pneumo

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42
Q

tx of strep pneumo

A

macrolide (ex: erythromycin)

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43
Q
  • gm - rod causing NCI
  • green sputum
  • CF kids
  • hosp respirators
  • burn pts
A

pseudomonas aeruginosa

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44
Q
  • incarcerated
  • immigrant from “-stan” or india
  • homeless
A

People who’s PPD is + at 10mm

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45
Q

HIV pt’s PPD is + at?

A

5mm

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46
Q

San Joaquin Valley Fever is cause by

A

coccidodies immitis

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47
Q
  • immunocomp pt (esp HIV)
  • oropharyngeal or esophageal colonization
  • person on multiple ABs for a long period of time
  • ICS overuse
A

candida albicans inf

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48
Q
  • widened mediastinum
  • gm + rod
  • spore former
  • add’s with farm animals
  • skin version has black eschar
A

bacillus anthracis

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49
Q
  • ass’d with aspiration pneumonia
  • often causes valvular damage
  • gm - bact often found in oropharynx
A

HACEK organism

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50
Q

HACEK organisms

A 
Haemophilus
Aggregabacter
Carciobacterium
Eikenlla
Kingella
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51
Q
  • red currant jelly sputum
  • etoh abuse
  • bulging fissure on x-ray
  • lives in the gut, skin, mouth
  • lobar
A

klebsiella pneumonia

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52
Q

how do you test for legionella

A

urinary Ag test

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53
Q
  • cave diving
  • ohio river valley
  • low grade temp
  • b/l hilar LAD
  • characteristically restrictive lung dz w/ dec DLCO
  • cavitary lung disease
A

histoplasmosis

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54
Q
  • apex of lung
  • cavitated lesion thats now filled with something (old TB lesion)
  • ball of fungus
A

aspergilloma

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55
Q

tx of aspergilloma that fails antifungal tx

A

surgical removal

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56
Q

tx of ABPA

A

corticosteroids (ex: prednisone)

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57
Q
  • sulfer granules
  • lumpy jaw
  • slow growing
  • penetrates bone and siunus tracts
A

actinomycoses israelii

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58
Q
  • obligate intracellular organism that is a common cause of penumonia
  • ass’d with bird poop (esp parrots)
  • causes high T + myalgias
A

chlamydia psittaci

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59
Q

what drug wouldn’t you use to tx mycoplasma inf? why?

A

penicillin; b/c it doesn’t have a cell wall

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60
Q
  • pneumonia in COPD and elderly
  • kidney bean shaped
  • gm - diplococci
A

moraxella chatarrhalis

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61
Q
  • beta2 agonist
  • stimulates increased in cAMP via adenylcyclase in bronchial smooth mm
  • causes bronchodilation
A

albuterol

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62
Q
  • b/l hilar LAD
  • non-caseating granulomas
  • can cause eye and/or skin lesions
  • hypercalciuria/emia
  • anergy
  • elevated ACE
  • decreased DLCO
A

sarcoidosis

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63
Q
  • hyperventilating and hypoxemic
  • can be d/c from ED based on response to bronchodilator tx
  • needs systemic corticosteroids
A

stage 2 asthmatic

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64
Q
  • not hypoxemic
  • hyperventilating w/ normal PO2
  • facilitate hospital d/c with ipratropium via nebulizer w/ beta agonist
A

stage 1 asthmatic

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65
Q
  • generally ill normal PCO2 d/t resp mm fatigue
  • elective intubation and mechanical ventilation usually indicated
  • admit to ICU
  • parenteral corticosteroids w/ con’t bronchodilator
  • may benefit from theophylline
A

stage 3 asthmatic

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66
Q
  • PO2 is low w/ high PCO2
  • pts have less than 20% lung function
  • require intubation and mech ventilation
  • admit to ICU
  • theophylline may be added to tx
A

stage 4 asthmatic

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67
Q

causes of increased DLCO

A
  • polcythemia
  • early CHF
  • pulmonary hemorrhage
  • L>R cardiac shunt
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68
Q

causes of decreased DLCO

A
  • interstitial lung dz
  • empysema
  • CHF: pulm edema & HTN
  • pulmonary embolism
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69
Q

AEs of corticosteroids

A
  • moon facies
  • buffalo hump
  • cataracts
  • thin skin
  • aseptic necrosis of the femoral head
  • elevated BS
  • abd striae
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70
Q

pts who do not respond to bronchodilators, O2, corticostroids, and IV fluids w/ in 24h should receive

A

aminophylline (theophilline)

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71
Q

what is levalbuterol and what are the benefits of using it?

A
  • R isomer or albuterol

- less AEs: doesn’t affect heart rhythm and less frequent occurrence of tremors

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72
Q

AEs of theophylline

A
  • tachy
  • nausea
  • seizure (decreased threshold, esp in kids)
  • anxiety
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73
Q

fungus that grows as both a yeast and fillamentous cell

A

candida

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74
Q

mast cell stabilizer

A

cromolyn

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75
Q

Status asthmaticus pts on mechanical vent are at very high risk of developing what?

A

penumothorax

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76
Q

Reid index in chronic bronchitis

A

> 0.4

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77
Q

MC cultured oragnisms during a COPD exacerbation

A
  • Strep pneumo

- H. flu

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78
Q

COPD CXR findings

A
  • hyperinflation of lungs
  • flattening of the diaphragm
  • hyperlucency of the lungs
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79
Q

xopenex

A
  • aka levaluterol
  • R isomer of albuterol
  • less AEs: dec tachy & tremors
  • more expensive than albuterol
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80
Q

albuterol

A
  • beta-2-agonist
  • increase cAMP
  • decreases bronchoconstriction
81
Q

montelukast

A

LT modifier

82
Q

MOA: theophylline

A

prevent cAMP breakdown via PDE

83
Q

first line drug fro life-threaning asthma

A

adrenaline (epi)

84
Q

omalixumab

A
  • monoclonal Ab against IgE

- need monthly injection

85
Q

pulsus paradoxis >20 mm Hg

A

severe airway obstruction

86
Q

pulsus paradoxis in pts with severe asthma

A

= 15 mmHg

87
Q

disappearance of wheezing on chest auscultation

A

status asthmaticus

88
Q

every person > 50 yo and chronic lungers get this vaccine

A

pneumococcal vaccine

89
Q
  • intermittant s/s when around allergen
  • IgE mediated
  • Type III HSN rxn
  • FEV1/FVC > 95%
A

HSN pneumonia

90
Q
  • hemoptysis
  • hematuria
  • recent URI
  • c-ANCA
A

Wegner’s granulomatosis (granulomatosis with polyangiitis)

91
Q
  • anti-GBM

- hemoptysis

A

goodpasture’s

92
Q

mnemonic for dd of cavitary lung lesions

A
  • C: carcinoma
  • A: autoimmune
  • V: vascular
  • I: infection
  • T: trauma
  • Y: young/congenital
93
Q
  • hx of RA
  • pleuritis w/ or w/out effusion
  • autoimmune disorder
A

rheumatoid lung

94
Q

velro-like crackles ass’d with

A

interstitial lung process

95
Q

3 drugs that cause lung injury

A
  • bleomycin (chemo)
  • amiodarone (antiarrhythmic)
  • methotrexate
96
Q

tx of drug induced lung dz

A

corticoteroids

97
Q
  • pnemonitis or fibrosis
  • previous hx of radiation
  • possible progression to respiratory failure
A

radiation therapy

98
Q
  • SOB over past year
  • linear opacities on CXR
  • restrictive PFTs
  • decreased diffusion capacity
  • clubbing/cyanosis possible
  • dry cough
  • NKDA and no meds
  • no hx of smoking
A

idiopathic pulmonary fibrosis

99
Q
  • hx of asbestos exposure
  • wt loss
  • possible pleural effusion
  • encasing lung masson CT
  • on biopsy cells can look like mesenchymal stroma or epi cells
A

mesothelioma

100
Q
  • hilar adenopathy
  • erythema nordosum
  • arthritis
A

Lofgren Syndrome (acute presentation of sarcoid)

101
Q
  • uveitis
  • parotid gland involvement
  • fever
  • possible facial nerve palsy
A

Heerfordt’s Syndrome

102
Q

most common ECG finding of pulmonary embolism

A

sinus tachycardia

103
Q

normal pop’s PPD is + at

A

15 mm

104
Q

> /= 10 mm PPD is + for what groups

A
  • incarcerated
  • immigrants from “-stan”
  • hospital workers
105
Q

+ PPD for HIV pts

A

5 mm

106
Q

dx CF with

A

sweat test

107
Q

CF inheritance pattern

A

AR

108
Q

“egg shell” calcifications on CXR

A

silicosis

109
Q
  • ARDS
  • diffuse alveolar infiltrates
  • ground glass appearance on CXR
  • honeycombing
  • DAD on biopsy
  • acute widespread ALI
A

acute interstitial pneumonia

110
Q
  • diaphragmatic pleural plaques
  • decreased DLCO
  • pleural thickening
A

asbestosis

111
Q
  • p-ANCA
  • +++ eosinophils
  • asthma
  • palpable purpura
  • GI s/s
  • elevated IgE
  • elevated BUN:Cr
  • numbness in extremities
A

churg-strauss

112
Q

calcified pleural plaques

A

asbestosis

113
Q

intermittent asthma

A

-s/s less than 1x per wk
-nocturnal s/s no more than 2x per mo
FEV1 or PEF >/= 80%

114
Q

mild persistent asthma

A
  • s/s > 1x/wk but less than 1x per day
  • nocturnal s/s more than 2x per mo
  • FEV1 or PEF >/= 80%
115
Q

moderate persistant asthma

A
  • daily s/s
  • nocturnal s/s occur > 1x/wk
  • daily SABA use
  • FEV1 or PEF 60-80%
116
Q

severe persistent

A
  • daily s/s
  • frequent exacerbations
  • FEV1 or PEF = 60%
117
Q

silicosis pts are at an increased risk of what infection

A

TB

118
Q
  • RA
  • coal worker’s pneumoconiosis
  • intrapulmonary nodules
A

Caplan syndrome

119
Q

golden-brown fusiform rods

A

asbestosis

120
Q

low voltage ECG

A
  • pericardial effusion

- COPD

121
Q
  • +++eosinophils
  • recent travel to tropical area
  • high ESR
  • splenomegaly
  • charcot-leyeden cyrstals in sputum
  • can cause elephatiasis
A

wuchereia bancrofti

122
Q
  • +++ eosinophils in lung
  • response to parasitic infiltrate
  • can cause GI obst d/t parasite
  • high T
  • n/v
A

Loeffler’s syrome

123
Q
  • rat urine
  • deer mouse reservoir
  • aerosolized rodent excretion
  • non cardiogenic shock
  • ARDS
  • pulmonary edema
  • hemorrhagic fever
  • pneumonia
A

hantavirus

124
Q
  • ASA
  • asthma
  • nasal polyps
A

Samter’s Triad (ASA induced asthma)

125
Q

Quelling Reaction + oranisms

A
  • Strep pneumoniae
  • Klebsiella pneumoniae
  • Neisseria meningitidis
  • Haemophilus influenzae
  • Escherichia coli
  • Salmonella
126
Q
  • sickle cell patient

- asplenic pt

A

more susceptible to quelling + organisms

127
Q

candida esophagitis

A

CD4

128
Q
  • hilar LAD
  • peripheral granulomatous lesion
  • middle or lower lung lobes
  • possible calcification
  • langerhans cells with lymphocytes
A

ghon complex

129
Q

bacillus anthracis tx

A

ciprofloxacin

130
Q

cat breeder

A

toxoplasmosis

131
Q
  • hat shaped organism
  • foamy cells
  • methenamine silver stain
A

PCP

132
Q
  • lancet shaped diplococcus
  • gm +
  • alpha-hemolytic
A

strep pnumo

133
Q

legionella tx

A
  • erythromycin or azithromycin

- rifampin

134
Q

MC type of tularemia

A

ulceroglandular (lesions on face and eyes)

135
Q

tx of MRSA

A

vancomycin

136
Q

tx of staph

A

methcillin or nafcillin

137
Q

tx of VRE

A

linezolid

138
Q

tx of flu A and B

A

oseltamivir

139
Q

2 fungi you see skin lesions with

A
  • blasto

- coccidio

140
Q

2 common bugs that cause post flu pneumonia

A
  • h flu

- staph areus

141
Q

cause of croup

A

parainfluenza virus

142
Q

TWAR

A

bad case of chalmydiophilia pneumo

143
Q

organism w/out cell walls

A

mycoplasma

144
Q

AFB organism

A

mycobacterium

145
Q

sandblaster

A

silicosis

146
Q
  • animal urine
  • flu-like stage
  • renal stage > RBC casts
A

leptospirosis

147
Q

how the flu changes from year to year to create new outbreaks/epidemics

A

antigenic drift

148
Q

shift that causes new flu strain and pandemics

A

antigenic shift

149
Q
  • adrenal hemorrhage
  • hypotension
  • DIC
  • N. meningititis inf
A

Waterhouse- Friederichsen Syndrome

150
Q
  • fever
  • chill
  • HA
  • rash sparing face, palms, soles
  • gm -
  • intracellular organism
A

rickettsia prowazekii

151
Q
  • MERS

- SARS

A

coronavirus

152
Q
  • high occurance of nasal polyps
  • bronchiectasis
  • aspergillosis
  • sweat Cl- test
  • pancreatic insufficiency
  • hemoptysis
  • chronic mucoid pseudomonal infection.
A

CF

153
Q

mutation at ch7q3.112

A

CF

154
Q

recurrent penumothorax w/out family hx of A1AT

A

lymhangioleiomyomatosis (LAM)

155
Q
  • superior sulcus tumor
  • non-small cell
  • compression of brachiocephalic v, subclavian a, phrenic n or recurrent laryngeal
  • horner’s syndrome
A

pancoast tumor

156
Q

most common inherited hypercoagulable sate

A

Factor V Leiden

157
Q
  • ass’d w/ small cell lung ca
  • mm weakness
  • Ab against presynaptic Ca channels
  • mm weakness improves with sustained mm contraction
A

Lambert-Eaton Syndrome

158
Q

PE seen with long bone fx

A

fat emboli

159
Q
  • PE seen with giving birth

- ass’d with DIC and ARDS

A

amniotic fluid emboli

160
Q

text-book PE ECG finding

A

S1 Q3 T3

161
Q

tx of PE

A

thorombolytic therapy

162
Q

tx of PE in pregnancy

A

enoaxaprin (HMW heparin) subQ 2x/d

163
Q

where is histamine stored?

A
  • mast cells
  • blood vessels
  • basophils
164
Q

using erythromyci and terfenadine together increased risk of what?

A

torsade de pointes

165
Q

DLCO in interstitial diseases

A

decreased

166
Q

TLC in COPD

A

increased

167
Q

TLC in asthma

A

increased

168
Q

asthma is a _________ disease

A

obstructive

169
Q

DLCO in emphysema

A

decreased

170
Q

FEV1/FVC ratio in obstructive lung disease

A
171
Q

FEV1/FVC ratio in restrictive lung diseases

A

> 95% or normal

172
Q

amount of gas inspired or expired with each breath

A

tidal volume

173
Q

amount of air remaning in the lung after maximal expiraiton

A

residual volume

174
Q

sarcoidosis is a ________ disease

A

restrictive

175
Q

TLC in lung fibrosis

A

decreased

176
Q

breathing through pursed lips

A

emphysema

177
Q

spirometry measures

A

vital capacity

178
Q

whole body plethymography allows you to measure

A

residual volume

179
Q

neuromuscular restrictive lung diseases

A
  • myasthenia gravi

- guillian barre

180
Q

> 15% increased in FEV1 in response to a B2 agonist think

A

asthma

181
Q

residual lung volume is increase in _________ lung diseases d/t air trapping

A

obstructive

182
Q
  • exertional dyspnea
  • dry cough
  • velcro raled
  • clubbing
  • cyanosis
A

intersitial pulmonary fibrosis

183
Q

emphysema in

A

A1AT

184
Q
  • high temp
  • high PaCO2
  • low CO
  • low pH
A

right shift

185
Q
  • low temp
  • low PaCO2
  • high CO
  • high pH
A

left shift

186
Q

pH

A

respiratory acidosis

187
Q

pH

A

metabolic acidosis

188
Q

pH>7.4

PCO2 less than 40 mm Hg

A

respiratory alkalosis

189
Q

pH>7.4

PCO3 > 40 mm Hg

A

metabolic alkalosis

190
Q

common paramyxovirus infecting kids

A

RSV

191
Q
  • larvae in soil
  • GI s/s: N/V/D
  • epigastric pain
A

Strongyloides

192
Q

CD4 lt 50

A

MCA

193
Q

CD4 lt 100

A

toxoplasmosis

194
Q

CD4 lt 200

A

PCP

195
Q

urease positive

A

klebsiella

196
Q

optochin positive

A

strep pneumo

197
Q

c-polysaccharide antigen

A

strep pneumo

198
Q

Serum precipitans

A

IgG

199
Q

Serum precipitans

A

IgG

Resp II (7 decks)

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