Dubin's "Gotta Knows"

Question 1

What are the side effects of long-term steroid use?

Answer 1

Moon facies, buffalo hump, purple stria, thin skin (Cushanoid appearance), stunted growth in kids, aseptic necrosis of femoral head, hyperglycemia

Question 2

What disease is associated with anergy? What is anergy?

Answer 2

Sarcoidosis

Mast cells do not degranulate in response to skin testing

Question 3

Common findings in sarcoidosis?

Answer 3

B/L hilar lymphadenopathy, erythema nodosum, hypercalcemia, hypercalciuria, elevated ACE levels, anergy, and small, non-caseating granulomas

Question 4

What constitutes a + PPD test in different populations?

Answer 4

HIV+ or close contact with someone with TB: 5mm

Health care workers, prisoners, immigrants: 10mm

General public: 15mm

Negative even if they have TB-> Sarcoid, BCG

Question 5

What diseases are associated with inhaled particles from pigeon poop?

Answer 5

C. psittici, Cryptococcus, Histoplasmosis (+ bats)

Question 6

What are the characteristic findings of Legionella pneumonia?

Answer 6

Fever and bradycardia, will see urinary antigens

Question 7

Treatment of choice for aspiration pneumonia?

Answer 7

Clindamycin (covers anaerobes)

Question 8

Treatment of choice for Mycoplasma pneumonia?

Answer 8

Macrolide

Question 9

What stain do you use for PCP?

Answer 9

Methanamine Silver stain (fungus stain)

Question 10

How do you stain Cryptococcus?

Answer 10

India ink

Question 11

Classic INH side effects?

Answer 11

Peripheral neuropathy and hepatitis

INH: Injury to Nerves and Hepatocytes

Get liver enzymes before AND after INH tx

Question 12

Classic Rifampin side effect?

Answer 12

Turns body fluids orange/red

Question 13

Classic Ethambutol side effect?

Answer 13

Optic neuritis, Red/Green color blindness

Question 14

What drug do you need to worry about ototoxicity with?

Answer 14

Streptomycin

Question 15

What is the morphology of Candida?

Answer 15

Diploid fungus that grows as a yeast and filamentous cells

Question 16

What are patients with IgA deficiency prone to getting?

Answer 16

Frequent URI, recurrent otitis media in childhood, bronchiectasis, and giardia

Question 17

What is the most common inherited hypercoagulable state?

Answer 17

Factor V leiden deficiency

Question 18

What is the preferred SABA? If it is causing side effects, what is the alternative?

Answer 18

Albuterol- can be delivered via inhaler, tablets, or liquid. Use Levalbuterol if side effects not tolerated.

Question 19

What is Advair and what are the drug classes?

Answer 19

Salmeterol and Fluticasone (LABA + ICS)

Question 20

How does Theophylline work?

Answer 20

PDE inhibitor–> prevents cAMP breakdown–> increased cAMP leads to smooth muscle relaxation

Question 21

What should you give for impending or current status asthmaticus?

Answer 21

High-dose steroid burst ASAP

+SABA, Theophylline, O2 prn

Question 22

How would you treat ABPA?

Answer 22

Steroids

Question 23

What gene is responsible for CF and what is the likelihood of passing it on?

Answer 23

CFTR gene on 7q31.2

Affected parent has a 1/4 chance of passing it on to kids (AR) if their partner does not have CF.

Question 24

What populations are susceptible to getting ABPA?

Answer 24

Asthmatics and CF patients

Question 25

Nasal polyps and bronchiectasis are characteristic of?

Answer 25

Cystic Fibrosis

Question 26

What is the distribution for Histo, Blasto, and Coccidiodes?

Answer 26

Histoplasmosis- Ohio River Valley, Eastern US

Blastomycosis- SE US, Mississippi River Valley

Coccidiodes- SW US, Cali

Question 27

What does clubbing indicate?

Answer 27

Interstitial lung disease (Fibrosis)

Question 28

What is the buzzword for Amiodarone-induced lung injury?

Answer 28

Foamy, lipid-laden macrophages

(and interstitial lung disease)

Question 29

What will the antibody blood tests be for Wegeners and Churg-Strauss?

Answer 29

Wegeners- c-ANCA

Churg-Strauss- p-ANCA

Question 30

What 2 things are birefringent under plane-polarized light?

Answer 30

Silica and Yersinia pestis