lung 1 + 2

Question 1

What blood alcohol level is legally drunk driving in most

states?

Answer 1

80 mg/dl

Question 2

What level causes drowsiness in most people?

Answer 2

200 mg/dl

Question 3

What level causes stupor in most people?

Answer 3

300 mg/dl

Question 4

characteristics of influenza (more like 4 symptoms)

Answer 4

Influenza characteristically begins with the abrupt onset of fever, headache, myalgia, and malaise,

following an incubation period of one to four days (average two days).

Question 5

what are symptoms of influenza?(3)

Answer 5

These symptoms are accompanied by manifestations of respiratory tract illness, such as non-productive cough, sore throat, and nasal discharge.

Question 6

what is pathology of influenza?

3 elements here

Answer 6

Tracheobronchitis with lymphocytic

infiltrate, necrosis and (in repair

phase) squamous metaplasia

Acute lung injury with alveolar

edema, hyaline membranes

+/- fibrinopurulent alveolar exudate

(if bacterial infection superimposed)

Question 7

how does influenza cause superimposed bacterial pneumonia?

Answer 7

Influenza virus kills the respiratory epithelial

cells, knocking out the mucociliary escalator

for clearing bacteria from the lower

respiratory tract.

Question 8

Numerous small yeast forms, some budding.

“Coin lesions” of old __________like

this are often resected for suspected cancer.

Answer 8

Numerous small yeast forms, some budding.

“Coin lesions” of old histoplasmosis like

this are often resected for suspected cancer.

Question 9

which virus has inclsuion bodies in macrohages?

Answer 9

CMV

Question 10

Septate fungal hyphae with acute

angle branching.

Answer 10

Classic for Aspergillus species,

but NOT specific for Aspergillus.

Question 11

what are the three distict form of aspergillosis?

Answer 11

Colonizing: for example, a fungus ball

 that grows until it fills a cavity,

 then stops

2. Allergic: bronchopulmonary,

   associated with **eosinophils**

3. Invasive: in immunocompromised

** patients, starts in lung, invades blood**

vessels, causes hemorrhages + infarcts,

** disseminates, especially to brain**

Question 12

what are Conidiophores (fruiting bodies)?

Answer 12

fruiting bodies of Aspergillus

highly specific (but rarely seen in tissue b/c require contact w/air)

Question 13

“the most

common pathogenic

parasitic infection in

humans, spread by

fecally contaminated

water or food.”

Answer 13

Giardiasis:

Question 14

how can you identify Giardia in duodenal biopsy(what shape)?

are they invasive?

Answer 14

“Giardia trophozoites are

noninvasive and can be

identified in duodenal

biopsy specimens by

their characteristic pear

shape.”

Question 15

Bilateral Peripheral Nodular Infiltrates (7 things here)

Answer 15

Tuberculosis (chronic)

Histoplasmosis (chronic)

Sarcoidosis (chronic)

Staphylococcus aureus (acute)

Pneumococcus (rare manifestation)

Granulomatosis with polyangiitis

Metastases (testicular or sarcoma)

Question 16

most common parasitic worm

infection (helminthic infestation)

in the world

where do they live?

shape?

Answer 16

The most common parasitic worm

infection (helminthic infestation)

in the world

Ascaris worms generally live in the

small intestine

Ascaris are large (15-35 cm) & round

Question 17

which disease?

Eggs develop into infectious larvae

in soil, acquired hand-to-mouth,

larvae penetrate intestine, enter

portal circulation to liver, heart and

lungs, develop in lungs, ride the

mucociliary ladder up to pharynx,

follow the food down to intestine

where they mature into worms

Answer 17

Ascariasis: Life cycle

Question 18

Loeffler’s syndrome:

cough (+/- sputum [+/- blood]),

eosinophilia and transient pulmonary

infiltrates.

Intestinal obstruction, Cholangitis,

Biliary obstruction, Cholecystitis,

Liver abscess, Pancreatitis,

Appendicitis

all can be caused by??

Answer 18

Ascariasis: Syndromes

Question 19

how do you tx ascariasis?

which worms not associated with eosinophilia?

how do you tx?

Answer 19

Worms without larval migration are

not associated with eosinophilia

Diagnosis: eggs in the stool

Treatment: albendazole

                or mebendazole

Question 20

Second most common parasitic worm

infection in the world

worms generally live in the

colon

worms are 4 cm in length

and round, with attenuated whip-like

anterior portions embedded in colon

Answer 20

Trichuriasis (whipworm)

Question 21

Eggs develop into infectious larvae

in soil, acquired hand-to-mouth,

larvae dig into small intestine and

develop spear-like anterior end,

“adolescent” larvae go with the flow

down to the cecum, embed their

spears into the cecum and mature

into worms

which worm?

Answer 21

Trichuriasis (whipworm): Life cycle

Question 22

whic worm?

Light infection: constipation,

indigestion, RLQ discomfort

Heavy infection: nausea, vomiting,

diffuse abdominal pain + tenderness,

weight loss, diarrhea (frequent small

blood-streaked stools), anemia,

eosinophilia, hypoalbuminemia,

hypergammaglobulinemia

Answer 22

Trichuriasis (whipworm): Syndromes

Question 23

MC infection in central american immigrants in the USA?

Answer 23

1. Trichuris trichiuria (whipworm) 27%

Question 24

take home

Transfusing a patient with profound

but chronic anemia can precipitate

fatal heart failure, but so can not

transfusing the patient.

Question 25

take home:

Confusion may be a sign that the gain

of transfusion outweighs the risk.