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neuro > HY - pulm + cardiac > Flashcards

HY - pulm + cardiac Flashcards

1
Q

two organisms of lobar pneumonia

A

streptococcus penumoniae + klebsiella pneumoniae

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2
Q

lung CA of non-smoker + periphery

A

adenocarcinoma

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3
Q

four phases of lobar pneumonia

A

congestion, red hepaization, grey hepatization, resolution

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4
Q

common cause of secondary pneumonia + complicated by abscess or empyema

A

staph aureus

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5
Q

atypical/interstitial penumoniae

A

mycoplasma pneumoniae, chlamydia pneumoniae, RSV, CMV, influenza virus, coxiella burnettie

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6
Q

not visible on gram stain

A

mycoplasma pneumoiae; lack of cell wall, similar to eukaryotes with cholesterol components

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7
Q

aspiration pneumonia + right lower lobe abscess

A

bacterioides, fusobacterium, peptococcus

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8
Q

AFB stain + caseating granuloma

A

mycobacterium

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9
Q

caseating granulomase + meningites at base of brain

A

systemic tb

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10
Q

arsenic + polycyclic hydrocarbons

A

particularly carcinogenic features of smoking

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11
Q

benign coin lesions

A

granulomas + broncial hamartoma (disorganized tissue with lung tissue + cartilage)

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12
Q

keratin pearls + intercellular bridges

A

squamous cell carcinoma

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13
Q

center tumor + ADH, ACTH or eaton-lambert syndrome

A

small cell carcinoma

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14
Q

central tumor + keratin pears and intercellular bridge + PTHrP (hypercalcemia)

A

squamous cell carcinoma

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15
Q

chromogranin positive + polyp-like mass in lung

A

neuroendocrine tumor; carcinoid syndrome

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16
Q

metastasis to lung

A

breast and colon CA

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17
Q

where does lung metastasize to?

A

adrenal gland

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18
Q

lung tumor in apex

A

compresses sympathetic chain; horner syndrome - ptosis, miosis, anhydriosis

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19
Q

exertional dyspnea in a young woman

A

primary pulmonary HTN; inactivating BMPR2 mutation

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20
Q

BMPR2 inactivating mutation + plexiform lesions + atherosclerosis of pulmonary arter

A

pulmonary HTN

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21
Q

pink hyaline membranes

A

ARDS; develop hypoxemia + diffuse collapse of lungs

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22
Q

neutrophil mediated damaged to type 1 and 2 pneumocytes by proteases and FR

A

ARDS

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23
Q

complications of NRDS

A

persistence of PDA, necrotizing enteroclitis; supplemental oxygen increase risk of free radical injury (damage to retina causing blindness, bronchopulminary dysplasia)

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24
Q

centri-acinar emphysema + upper lobes

A

smoker emphysema

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25
Q

PAS + liver in someone with emphysema

A

A1AT deficiency with buildup in liver

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26
Q

prolonged expiration with pursed lips

A

emphysema; back pressure keeps airways open

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27
Q

barrel chest

A

emphysema; lose elastic recoil

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28
Q

lose elastic recoil

A

emphysema

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29
Q

increase elastic recoil

A

pulmonary fibrosis

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30
Q

main cytokines from TH2

A

IL 4 (class-switching), IL5 (recruit eos), IL10 (promote overall reaciton, + TH1 and X TH2)

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31
Q

charcot-leyden crystals

A

eosinophil dervied in sputum of asthmatic

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32
Q

SAA and AA

A

secondary amyloidosis

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33
Q

fibrosis mediator in IPF

A

TGF-b

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34
Q

secondary causes of pulmonary fibrosis

A

radiation, bleomycin, amiodarone

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35
Q

coal workers lung + RA

A

Caplan syndrome

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36
Q

anthracosis

A

collections of carbon-laden macrophages

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37
Q

pneumoconioses that increases risk of TB

A

silicosis; impairs phagolysosomes formation by macrophages

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38
Q

non-caseating granulomas in lung, hilar lymph nodes + systemic organs + aeorospace worker

A

berylliosis; doen’t confuse with sarcoidosis

39
Q

iron ferruginous bodies

A

asbestosis

40
Q

epithelioid histiocytes

A

defining cell of granuloma

41
Q

asterioid body

A

sarcoidosis

42
Q

non-caseating granuloma disease that can mimic sjogrens disease

A

sarcoidosis

43
Q

elevated serum ACE + hypercalcemia (1-a hydroxylase activity) + non-caseating granulomas

A

sarcoidosis

44
Q

hypercalcemia in non-caseating granulomas

A

high levels of 1-a hydroxylase

45
Q

blood supply to papillary muscle

A

RCA; can rupture following ischemia with occlusion of this vessel day 4-7

46
Q

pericarditis several weeks following MI

A

Dressler syndrome; auto-antibodies against pericardium

47
Q

coagulative necrosis following MI

A

4-34 hrs, no inflammation cells

48
Q

when would you see fibrinoid pericarditis?

A

transumural infarction

49
Q

when develop scar post MI?

A

after 1 month; type 1 collagen

50
Q

hemosiderin laden macrophages within lungs

A

herat failure cells

51
Q

what do blood vessels lung do in response to hypoxemia?

A

constrict, makes it harder for heart to pump, can lead to cor pulmonale wh

52
Q

what heart defect is associated with FAS?

A

ventricle septal defect

53
Q

results of eisenmeger syndrome

A

cyanosis, clubbing, right ventircular hypertorphy

54
Q

which type of ASD is associated with down syndrome?

A

ostium primum

55
Q

congenital rubella is associated with what heart defect?

A

PDA

56
Q

machine-like murmur + lower extremity cyanosis

A

PDA; lower extermity cyanosis due to pulmonary HTN

57
Q

what to close PDA?

A

Indomethacine, gets rid of PDE

58
Q

cyanosis upon exercising + squat to relieve

A

R to L shunt, increase pressure on L side favoring blood flow to pulmonary circulation

59
Q

boot-shaped heart

A

T of F

60
Q

how to keep baby with transposition of great vessels alive?

A

keep PDA open with PGE

61
Q

maternal diabetes associated with what heart defect?

A

transposition of great vessels

62
Q

truncus arteriosus

A

persistent due to failure of division ; early cyanosis due to mixing of blood in ventricles

63
Q

tricuspid atresia

A

early cyanosis since blood can’t go to pulmonary circulation

64
Q

infantile coarctation of the aorta

A

associated with pda, between aortic arch and PDA, lower extremity cyanosis, turnery syndrome

65
Q

what heart defect is turner syndrome associated with?

A

coarctation of the aorta with lower extremity cyanosis

66
Q

adult coarctation of the aorta

A

HTN in UE and hypotension with weak pulses in LE; associated with bicuspid aortic valve

67
Q

acute rheumatic fever

A

systemic complication due to immune response to M protein (molecular mimcry) = damage to human tissues with auto-antibodies

68
Q

diagnosis of ARF

A

evidence of strep b infection with ASO or anti-DNase B titer; fever or elevated fever; J (joint, migratory polyarthralgias) O (heart, pancarditis) N (nodules, subcutaneous) E (erythema marginatum) S (sydnans chorea)

69
Q

what is long term sequelae or ARF?

A

heart - mitral valve +/- aortic, aschoff bodies and aniskoff cellls within myocardium

70
Q

what will kill patients with ARF?

A

myocarditis

71
Q

increased risk of aortic stenosis

A

bicuspid aortic valve; turner syndrome

72
Q

distinguish aortic dises of aortic stenosis from rheumatic disease

A

rheumatic disease will have fusion of valves

73
Q

early, blowing diastolic murmur

A

aortic regurgitation

74
Q

what does aortic regurgitaiton do to the pulse pressure?

A

widens it; patient will have head-bobbing, bounding pulses, pulsatile nail beds

75
Q

mid-systolic click followed by regurgitation murmur

A

mitral valve prolapse

76
Q

holosystolic blowing murmur louder with squatting and expiration

A

mitral regurgitation

77
Q

what does acute vs chronic rheumatic fever do to the mitral valve?

A

acute = regurgitaiton (holosystolic blowing murmur; chronic = aomitral stenosis with diastolic murmur

78
Q

opening snap followed by diastolic rumble

A

mitral stenosis

79
Q

small vegetations on previously damaged valves

A

low virulence s viridans

80
Q

large vegetations on tricuspid

A

highly infectious s aurea; IV drug user

81
Q

endocarditis of prosthatetic valves

A

s epidermidis

82
Q

patient is determined to have endocarditis with s bovis. what should you check next?

A

unerlying colorectal cancer

83
Q

endocarditis with negative blood cultures

A

HACEK (hemophilus, actinobacillus, cardiobacterium, eikenella, kingella); paritculalrly hard to grow on cluture

84
Q

what technique can be used to visualize valvular vegetations?

A

TEE

85
Q

libman sacks endocarditis

A

sterile vegatations on both sides of valve; usually mitral valve with regurgitaiton

86
Q

complications of dilated cardiomyopathy

A

valve regurgitation (mitral and tricuspid) + arrhytmia

87
Q

doxorubicin + late complication of coxsackie virus + alcohol + pregnancy

A

dilated cardiomyopathy

88
Q

acute vs late consequences of myocarditis

A

acute = death, later on = dilated cardiopmyopathy

89
Q

mutations in _____ most common cause of hypertrophic cardiomyopathy

A

mutations in sarcomere

90
Q

sudden death of young athlete or syncope with exercise

A

hypertrophic cardiomyopathy

91
Q

myofier hypertrophy with disarray

A

hy[pertrophic cardiomyopathy

92
Q

causes of restrictive cardiomyopathy

A

amyloidosis, sarcoidsosi, hemochromatosis, endocrdial fibroelastosis, loeffler syndrome

93
Q

low voltage EKG with diminished QRS amplitudes

A

restrictive cardiomyopathy presenting as CHF

94
Q

children + tuberous sclerosis + benign hamartoma of cardiac muscle

A

rhabdomyoma

neuro (34 decks)

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