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Medically Complex > Exam 2 part 1 > Flashcards

Exam 2 part 1 Flashcards

1
Q

What are the characteristics of each COPD?

  1. Emphysema?
  2. Chronic bronchitis?
  3. Bronchial asthma?
  4. Chronic bronchitis?
A
  1. Blebs & bullae, pink puffers
  2. Blue bloaters
  3. Grossly hyperaerated lungs touching in midline, mucus production microscopically similar to bronchitis
  4. Marked mucus production, right heart failure*
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2
Q

What is the definition of chronic bronchitis?

A

Production of mucus for certain periods of time - a minimum of 3 months a year for at least 2 years

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3
Q

Where would you find things like Blebs and bullae, curschmann’s spirals? - Which COPD disease would you find these?

A
  • Blebs and Bullae: Emphysema
  • Curschmann spirals: bronchial asthma
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4
Q

What are the characteristics of Alpha-1-Antitrypsin Deficiency?

A
  • Autosomal recessive
  • Anti protease produced by the liver in order to neutralize naturally occuring proteases
  • Causes emphysema
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5
Q

What produces naturally occuring proteases?

A
  • Macrophages
  • Bacteria
  • Neutrophils
  • Monocytes

Alpha-1-Antitrypsin does not - it’s from the liver

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6
Q

What is the association of COPD and poor oral health related to lung infections and cigarette smoking?

A
  • Perio disease is a possible risk factor for COPD
  • Onset and progression of COPD is dependent on smoking in almost all cases and repeated bacterial infections can worsen the lung disease.
  • Perio bacteria could travel to lungs through saliva or normal breathing -> infection
  • Inflammation caused by perio may contribute to inflammation in lining of bronchial tubes, leading to chronic bronchitis
  • Streptococcus & actinomyces, may modify oropharygneal mucosa to promote growth of Pneumococcus (Gram+) and H. influenzae (Gram-)
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7
Q

What is the genus and species of Legionnaires disease? What’s it’s association with water?

A
  • Legionella pneumophilia
  • Gram -
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8
Q

What organism causes Pneumonia and abscesses?

A

Staphylococcal aureus

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9
Q

What organism causes rust colored sputum?

A

Streptococcus pneumonia

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10
Q

What organism causes jelly sputum?

A

Klebsiella pneumoniae

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11
Q

What are the different routes that someone can acquire pneumonia?

A
  • Inhalation of air droplets (most typical)
  • Aspiration of upper respiratory infections (staph/strep infections)
  • Aspiration of infected gastric particles (anaerobic bacteria)
  • Hematogenous spread (blood transfer - common in sepsis, UTI’s or GI tract infection)
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12
Q

Define the different complications of pneumonia:

  1. Pleuritis
  2. Pyothorax
  3. Empynema
  4. Abscess
  5. Chronic lung disease
A
  1. Extension of inflammation to pleural surface
  2. Pus fills pleural cavity
  3. Pus is encapsulated by fibrous tissues into pockets
  4. Associated with staph and causes destruction of lung parenchyma and suppuration
  5. Due to unresponsiveness to treatment - transforms lung into honeycomb-like structure
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13
Q

Differentiate intra-alveolar pneuomia vs interstitial pneumonia. And which one is more viral or bacterial?

A
  • Intra-alveolar - bacterial
  • Interstitial - involves the alveolar septae which includes viral pneumonia
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14
Q

What are the 2 types of intra-alveolar pneumonia?

A
  • Patchy (broncho pneumonia)
  • Diffuse (lobar pneumonia)
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15
Q

What are the general features of tuberculosis?

A
  • Rod-shaped bacterium with waxy capsule
  • Acid-fast - neither gram - or +
  • Does not stain with dyes
  • Obligate aerobe
  • Cell wall contains mycolic acid (a complex lipid that in antiphagocytic)
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16
Q

Does tuberculosis produce toxins?

A

No - we produce the caseating granulating to wall it off

  • CD4+ helper T cells help with this
  • Cell mediated immunity (not humoral)
  • TB’s genus is mycobacterium (not mycoplasma)
17
Q

What’s the definition of Scrofula?

A

Lyphatic spread to the hilar lymph nodes with infection to the neck area.

A unilateral cervical adenitis - presents with swollen non-tender nodes

18
Q

What is Pott’s disease?

A

The spread of TB to the vertebral column, AKA “vertebral osteoarthritis”

19
Q

What is a gohn complex?

A

The initial infection of TB, which consists of a peripheral parenchymal granuloma and a prominent infected draining mediastinal (hilar) lymph node grossly

The healed, subplural ghon nodule is well circumscribed with central necrosis.

Later stages the lesion is fibrotic and calcified

20
Q

What is a tuberculoma?

A

A benign non-neoplastic TB mass

21
Q

How does TB culture?

A

Slowly, it causes caseating granulomas

22
Q

What does the cell wall of TB contain?

A
  • Mycolic acid that is anti-phagocytic
  • Acid fast, but neither gram- or gram+
  • (NOT hydrochloric, sulfuric, or muriatic acid)
23
Q

Differentiate between primary, secondary or reactionary TB.

A
  • Primary - does not remain limited and heal, but spreads to other parts of lungs (most common in children and is called “Progressive Primary TB”)
    • Enlarges rapidly, erosion of bronchi or bronchioles by the necrotic central liquefaction
  • Secondary or Reactionary - reactivation of dormant primary infection. Bacteria spread to apex of lungs, granulomatous pneumonia where they produce cavities - hemoptysis.
    • Large and cystic and can cause erosions into both bronchial tubes and pulmonary blood vessels.
24
Q
  1. What class of hypersensitivity is natural rubber latex allergy?
  2. What are the other 2 contact dermitities?
A
  1. Type 1
  2. Type 4 (delayed) - aka allergic dermatitis (ACD) localized T cell lymphocyte disorder
  3. Non-immune (irritant contact dermititis ICD) due to localized inflammation
25
Q

For natural rubber latex allergy, what heavy chain of antibodies contributes to hypersensitivity reaction?

A

IgE - it mediates anti-NRL antibodies

26
Q

In allergy contact dermititis, know hypersensitivity type and whether cell or humoral mediated.

A
  • Hypersensitivity - Type 4 - delayed
  • Cell mediated - (not humoral)
27
Q

What is the clinical practical use of glutaraldehyde?

A

Disinfectant - can cause irritant contact dermititis (ICD)

28
Q

What are the 2 types of hiatal hernias (sliding) - and which one is more common and which one requires surgical repair?

A
  • Sliding (95%) - more common, can be treated with meds
  • Paraesophageal (5%) - less common, but need surgical repair
29
Q

What is the underlying cell adaptation of Barrett’s esophagus?

A

Replacement of esophageal stratified squamous epithelium to simple columnar epithelium with Goblet cells.

30
Q

What type of cancer is most common with Barrett’s esophagus?

A

Esophageal Adenocarcinoma

31
Q

Differentiate gastric vs duodenal ulcers.

  1. Which one has higher incidence in type O blood?
  2. Higher incidence of helicobacter pylori?
  3. Stronger relation to genetics?
  4. Kissing ulcers?
A
  1. Duodenal - 30% higher for Type O blood
  2. Gastric - 75% of pt w/ gastric harbor H. pylori
  3. Duodenal
  4. Duodenal - paired ulcers on both walls
32
Q

What are the similarities of the features of Crohns vs CUC?

A
  • Crohn’s
    • Non-caseating granulomas
    • Creeping fat
    • Fistula formation
  • CUC
    • Toxic megacolon
    • Higher incidence of cancer
    • Backwash ileitis
33
Q

What are the differences of Crohns vs CUC based on their ulcers?

A
  • Crohns
    • Linear and resemble cobblestones
  • CUC
    • Small patches of uninvolved, inflammed mucosa that produce as inflammatory pseudopolyps
34
Q

What are the differences of Crohns vs CUC based on their locations?

A
  • Crohn’s
    • Right side of colon and ileum
    • Transmural
  • CUC
    • Left side of colon
    • Mucosa and submucosa
35
Q

What are the differences of Crohns vs CUC based on their lesions?

A
  • Crohn’s
    • Skip lesions/cobblestone appearance
  • CUC
    • Diffuse lesions
36
Q

What syptoms are proof that Crohns and CUC were at one time one?

A

They share the same extraintestinal manifestations - skill lesions, arthritis, eye lesions

**Granulomas - skip lesion, transmural inflammation, crypt abscess

37
Q

Where anatomically is Crohns vs CUC going to be seen?

A
  • Crohn’s
    • Right side of colon
    • Transmural
  • CUC
    • Left side of colon
    • Mucosa and submucosa

Medically Complex (5 decks)

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