Physiology

Question 1

Expected arterial blood gases in pulmonary embolism

Answer 1

⬆️ pH (alkalosis resp)
⬇️ PaO2
⬇️ PaCO2
HCO3 normal

Question 2

Physiologic responses when there’s hypoxic environment at high altitude

Answer 2

⬆️ increased pulmonary vascular resistance
⬆️ sympathetic activity = ⬆️ CO
Aldosterone suppression = ⬇️ plasma volume

Question 3

Streptococcus pneumoniae

Answer 3

Gram +, lanced shaped 
Catalase -
Alfa hemolysis 
Optochin sensitive
Bile soluble

Question 4

More common pathogens in secondary bacterial pneumonia

Answer 4

Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae

Question 5

Mention the two forces that determine the negative intrapleural pressure

Answer 5

Expanding force of the chest wall opposing collapsing force of the lungs

Question 6

What causes the formation of cold agglutinins in Mycoplasma pneumoniae infection?

Answer 6

IgM ab that bind RBC and cause clumping/agglutinations at low body temperatures

Question 7

Mention illnesses that form cold agglutinins

Answer 7

Mycoplasma pneumoniae (walking pneumonia)
Infectious mononucleosis
Certain hematologic malignancies

Question 8

Blastomyces dermatitidis shape changes with temperatures

Answer 8

37 grades: yeast form, single cells with broad based bud

25-30 grades: hyphae (environment)

Question 9

Pulmonary volumes in Obstructive lung disease

Answer 9

⬇️⬇️ FEV1
⬇️ FVC
⬇️ FEV1/FVC
⬆️ RV
⬆️ TLC
⬆️ FRC

Question 10

Pulmonary volumes in Restrictive disease

Answer 10

⬇️ FEV1
⬇️ FVC
Normal FEV1/FVC ratio
⬇️ TLC
⬇️ RV

Question 11

Principal receptor to central chemoreceptors

Answer 11

CO2

Question 12

Type of receptors found in aortic and carotid bodies

Answer 12

Chemoreceptors

Question 13

What does it stain the acid fast reaction?

Answer 13

Organisms Iike mycobacterium that have mycolic acid

Question 14

Mention the infectious agent than colonizes lung cavities

Answer 14

Aspergillus fumigatus

Question 15

Factors required for growth of Haemophilus influenzae in agar

Answer 15

Chocolate agar, X factor (hematin) and V factor (NAD+)

Question 16

Type of H. influenzae that causes disseminated disease

Answer 16

Type B, encapsulated

Question 17

Primary virulence factor of M. tuberculosis

Answer 17

Cord factor. It inhibits phagolysome acidification and leads to casseating granuomas formation

Question 18

Pathologic features of Coccidiodes immitis

Answer 18

Dimorphic: hyphae at environment and spherule at human temperature
Spherules packed with endospores 
Saburaud agar
Erythema nodosum 
Arthralgias 
South western US

Question 19

Most common pathogens found in COPD exacerbation

Answer 19

Haemophilus influenzae
Streptococcus pneumoniae 
Moraxella catarrhalis
Rhinovirus
Influenza virus
Pseudomonas aeruginosa

Question 20

Clinical features of Legionella pneumophila infection

Answer 20

Not stain with Gram, visualized in Silver stain
Contaminates water
No person to person transmission
High fever, GI and neurologic symptoms
Smokers and chronic lung disease 
Detected as urine antigen
HypoNatremia

Question 21

What gives Elastin protein its properties

Answer 21

Extensive cross-linking between monomers by lysyl oxidase. And nonpolar aa content

Question 22

Associated conditions of Allergic broncopulmonary aspergillosis

Answer 22

Asthma and cystic fibrosis

May cause bronchiectasis and eosinophilia

Question 23

Nocardiosis characteristics

Answer 23

Branching filament, gram +
Found in soil / trauma infection
Weak acid fast
Pulmonary infection in immunicompromised 
Can spread CNS