lung 1 + 2 Flashcards
What blood alcohol level is legally drunk driving in most
states?
80 mg/dl
What level causes drowsiness in most people?
200 mg/dl
What level causes stupor in most people?
300 mg/dl
characteristics of influenza (more like 4 symptoms)
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).
what are symptoms of influenza?(3)
These symptoms are accompanied by manifestations of respiratory tract illness, such as non-productive cough, sore throat, and nasal discharge.
what is pathology of influenza?
3 elements here
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)
how does influenza cause superimposed bacterial pneumonia?
Influenza virus kills the respiratory epithelial
cells, knocking out the mucociliary escalator
for clearing bacteria from the lower
respiratory tract.
Numerous small yeast forms, some budding.
“Coin lesions” of old __________like
this are often resected for suspected cancer.
Numerous small yeast forms, some budding.
“Coin lesions” of old histoplasmosis like
this are often resected for suspected cancer.
which virus has inclsuion bodies in macrohages?
CMV
Septate fungal hyphae with acute
angle branching.
Classic for Aspergillus species,
but NOT specific for Aspergillus.
what are the three distict form of aspergillosis?
Colonizing: for example, a fungus ball
that grows until it fills a cavity, then stops
-
Allergic: bronchopulmonary,
associated with **eosinophils**
3. Invasive: in immunocompromised
** patients, starts in lung, invades blood**
vessels, causes hemorrhages + infarcts,
** disseminates, especially to brain**
what are Conidiophores (fruiting bodies)?
fruiting bodies of Aspergillus
highly specific (but rarely seen in tissue b/c require contact w/air)
“the most
common pathogenic
parasitic infection in
humans, spread by
fecally contaminated
water or food.”
Giardiasis:
how can you identify Giardia in duodenal biopsy(what shape)?
are they invasive?
“Giardia trophozoites are
noninvasive and can be
identified in duodenal
biopsy specimens by
their characteristic pear
shape.”
Bilateral Peripheral Nodular Infiltrates (7 things here)
Tuberculosis (chronic)
Histoplasmosis (chronic)
Sarcoidosis (chronic)
Staphylococcus aureus (acute)
Pneumococcus (rare manifestation)
Granulomatosis with polyangiitis
Metastases (testicular or sarcoma)
most common parasitic worm
infection (helminthic infestation)
in the world
where do they live?
shape?
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
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
Ascariasis: Life cycle
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??
Ascariasis: Syndromes
how do you tx ascariasis?
which worms not associated with eosinophilia?
how do you tx?
Worms without larval migration are
not associated with eosinophilia
Diagnosis: eggs in the stool
Treatment: albendazole
or mebendazole
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
Trichuriasis (whipworm)
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?
Trichuriasis (whipworm): Life cycle
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
Trichuriasis (whipworm): Syndromes
MC infection in central american immigrants in the USA?
- Trichuris trichiuria (whipworm) 27%
take home
Transfusing a patient with profound
but chronic anemia can precipitate
fatal heart failure, but so can not
transfusing the patient.
take home:
Confusion may be a sign that the gain
of transfusion outweighs the risk.
