Physiology

Question 1

effects of high altitude

Answer 1

low bicarbonate as kidneys excrete BC03 to combat metabolic alkalosis
increased erythropoeitin
increased ventillation –> resp alkalosis

Question 2

symptoms of AMS an HACE

Answer 2

acute mountain sickness - nausea, fatigue, dyspnoea
high altitude cerebral oedema - ataxia, decrease mental status, coma

Question 3

pathophysiology of carbon monoxide poisoning

Answer 3

decreases oxygen delivery to the tissues

Question 4

pathophysiology of type 1 hypersensitivity reaction

Answer 4

reversible bronchoconstriction of vasoactive amines

Question 5

what type of cells do adenocarcinomas of the lung derive from

Answer 5

mucous producing glandular cells

Question 6

what is responsible for the changes in influenza that make it highly infective

Answer 6

viral point mutations as it undergoes genetic drift and shift

Question 7

acid fast rods in sputum

Answer 7

TB

Question 8

Activates macrophages and induces the release of tumor necrosis factor-α

Answer 8

TB

Question 9

what is the main mechanism behind cardiogenic pulmonary oedema

Answer 9

increased capillary hydrostatic pressure

Question 10

what is the main mechanism behind oedema due to nephrotic syndrome and cirrhosis

Answer 10

decreased capillary oncotic pressure

Question 11

what is the main mechanism behind sepsis induced ARDS

Answer 11

neutrophil release of proteases

Question 12

does total lung capacity increase or decrease in obstructive lung disease

Answer 12

TLC increases

Question 13

mechanism of ebstein barr virus

Answer 13

infects b cells from CD 21

Question 14

what is the mechanism of the monospot test

Answer 14

heterophil antibodies detected by agglutination

Question 15

culture media used for H.influenza

Answer 15

chocolate agar

Question 16

culture media used for N. gonorrhea and n. meningitidis

Answer 16

thayer-martin

Question 17

culture media for bordetella pertusis

Answer 17

bordet gengou
(bordet for bordetella)

Question 18

culture media for diptheria

Answer 18

loffler

Question 19

culture media for mycoplasma pneumonia

Answer 19

eaton agar

Question 20

culture media for m.tuberculosis

Answer 20

lowenstein-jensen medium, middlebrook medium

Question 21

culture media for fungi

Answer 21

sabouraud agar
(sab’s a fun guy)

Question 22

culture media for bordetella, legionella, fransciella

Answer 22

charcoal yeast extract buffered with cystine and iron

Question 23

gram stain for legionella

Answer 23

silver stain

Question 24

gram stain for pneumocystitis jiroveci pneumonia

Answer 24

flourescent antibody stain

Question 25

arteries within the kisselbach plexus

Answer 25

kisselbach drives his pLEXUS with his LEGS Labial artery anterior/posterio ethmoidal arteries greater palatine artery sphenopalatine artery

Question 26

most common location of epistaxis

Answer 26

anterior segment kisselbach plexus (labial artery, anterior/posterior ethmoidal arteries, greater palatine artery, sphenopalatine artery)

Question 27

location of life threatening epistaxis

Answer 27

posterior segment sphenopalatine artery (branch of maxillary artery)

Question 28

virchows triad

Answer 28

stasis (post op, long haul flight) hypercoaguability (COCP, pregnancy, cancer, factor V leiden) endothelial damage (exposed collagen triggers clotting cascade)

Question 29

how does PE affect V/Q

Answer 29

V/Q mismatch as the alveoli are ventillated but not perfused

Question 30

what type of shock would a large PE cause

Answer 30

obstructive shock (thrombus causes large RV, prevents filling of LV)

Question 31

what are lines of Zahn on histology

Answer 31

interdigiting areas of pink (fibrin/platelets) and red (RBC) found in thrombi formed before death (PE)

Question 32

FEV1 and FVC in obstructive vs restrictive lung disease

Answer 32

obstructive - FEV1 decreased more then FVC restrictive - FEV1 and FVC proportionately decreased

Question 33

Respiratory volume (RV) change in restrictive and obstructive lung disease

Answer 33

obstructive - RV increased restrictive - RV decreased

Question 34

flow volume loop change in obstructive and restrictive lung disease

Answer 34

obstructive - shifts to the left restrictive - shifts to the right

Question 35

metasplasia associated with COPD

Answer 35

COPD leads to metaplasia of pseudostratified ciliated columnar epithelium into stratified squamous epithelium

Question 36

centriacinar and pancacinar emphysema - difference in aetiologies ?

Answer 36

centriacinar (spares distal alveoli) --> smoking panacinar (affects respiratory bronchioles and alveoli) --> alpha 1 antitrypsin deficiency

Question 37

histological feature found in asthma

Answer 37

curschmann spirals (shed epithelium form whorled mucous plugs) charcot-leyden crystals (eosinophillic, hexagonal, double pointed crystals formed from breakdown of eosinophilsin sputum)

Question 38

histological feature found in mesothelioma

Answer 38

psammoma bodies

Question 39

what part of the lung does asbestos affect

Answer 39

base (lower lobes)

Question 40

what part of the lung does silica, coal and berillium affect

Answer 40

apex (upper lobes)

Question 41

what stain is used to visualise asbetos

Answer 41

Prussian blue stain

Question 42

describe how asbestos looks on histology

Answer 42

asbestos bodies are golden-brown fusiform rods resembling dumbbells

Question 43

lights criteria for exudate pleural effusion

Answer 43

pleural fluid/serum protein > 0.5 pleural fluid/serum LDH > 0.6 pleural fluid LDH > 2/3 upper limit normal serum LDH

Question 44

exudate vs transudate

Answer 44

exudate - cloudy fluid due to infection/malignancy transfudate - clear fluid due to increased hydrostatic pressure (Na retension, HF) or decreased oncotic pressure (nephrotic syndrome, cirrhosis)

Question 45

air fluid levels in right lung - what does this indicate

Answer 45

lung abscess