Dubin's "Gotta Knows" Flashcards
What are the side effects of long-term steroid use?
Moon facies, buffalo hump, purple stria, thin skin (Cushanoid appearance), stunted growth in kids, aseptic necrosis of femoral head, hyperglycemia
What disease is associated with anergy? What is anergy?
Sarcoidosis
Mast cells do not degranulate in response to skin testing
Common findings in sarcoidosis?
B/L hilar lymphadenopathy, erythema nodosum, hypercalcemia, hypercalciuria, elevated ACE levels, anergy, and small, non-caseating granulomas
What constitutes a + PPD test in different populations?
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
What diseases are associated with inhaled particles from pigeon poop?
C. psittici, Cryptococcus, Histoplasmosis (+ bats)
What are the characteristic findings of Legionella pneumonia?
Fever and bradycardia, will see urinary antigens
Treatment of choice for aspiration pneumonia?
Clindamycin (covers anaerobes)
Treatment of choice for Mycoplasma pneumonia?
Macrolide
What stain do you use for PCP?
Methanamine Silver stain (fungus stain)
How do you stain Cryptococcus?
India ink
Classic INH side effects?
Peripheral neuropathy and hepatitis
INH: Injury to Nerves and Hepatocytes
Get liver enzymes before AND after INH tx
Classic Rifampin side effect?
Turns body fluids orange/red
Classic Ethambutol side effect?
Optic neuritis, Red/Green color blindness
What drug do you need to worry about ototoxicity with?
Streptomycin
What is the morphology of Candida?
Diploid fungus that grows as a yeast and filamentous cells
What are patients with IgA deficiency prone to getting?
Frequent URI, recurrent otitis media in childhood, bronchiectasis, and giardia
What is the most common inherited hypercoagulable state?
Factor V leiden deficiency
What is the preferred SABA? If it is causing side effects, what is the alternative?
Albuterol- can be delivered via inhaler, tablets, or liquid. Use Levalbuterol if side effects not tolerated.
What is Advair and what are the drug classes?
Salmeterol and Fluticasone (LABA + ICS)
How does Theophylline work?
PDE inhibitor–> prevents cAMP breakdown–> increased cAMP leads to smooth muscle relaxation
What should you give for impending or current status asthmaticus?
High-dose steroid burst ASAP
+SABA, Theophylline, O2 prn
How would you treat ABPA?
Steroids
What gene is responsible for CF and what is the likelihood of passing it on?
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.
What populations are susceptible to getting ABPA?
Asthmatics and CF patients
Nasal polyps and bronchiectasis are characteristic of?
Cystic Fibrosis
What is the distribution for Histo, Blasto, and Coccidiodes?
Histoplasmosis- Ohio River Valley, Eastern US
Blastomycosis- SE US, Mississippi River Valley
Coccidiodes- SW US, Cali
What does clubbing indicate?
Interstitial lung disease (Fibrosis)
What is the buzzword for Amiodarone-induced lung injury?
Foamy, lipid-laden macrophages
(and interstitial lung disease)
What will the antibody blood tests be for Wegeners and Churg-Strauss?
Wegeners- c-ANCA
Churg-Strauss- p-ANCA
What 2 things are birefringent under plane-polarized light?
Silica and Yersinia pestis
