pulm Flashcards
lecthin:sphingomyelin ratio (what is considered normal (or less risk))
- indicator of lung development and surfactant production
- >2
surgery? non-small cell vs small cell cancer
surgery in NSCC, chemo in SCC
mesothelioma high risk in what population (also, what stain)
- people exposed to asbestos
- shipbuilders and plumbers
- prussian blue, hemosiderin surrounding fibers
keratin pearls and intercellular bridging
-squamous cell lung cancer
emphysema (MOA of reduced oxygenation)
- neutrophil elastase activity increased by smoking
- destruction of alveoli
- decreased ability of oxygen to diffuse across damaged walls
- obstructive lung disease
situs inversus (associated with…) (kartagener’s syndrome)
- complete reversal of organs, due to ciliary dyskinesia
- assoc with: bronchiectasis and chronic sinusitis
- sperm can’t swim!
basilar hyperlucency (associated with)
-emphysema
alpha 1 anti-trypsin (pathophys, and associated disease)
- defective protein misfolded, decreased activity leads to increase elastase activity –> destruction of alveoli
- panacinar emphysema
- hepatic cirrhosis
legionella (what does it cause, how is it transmitted, what are the symptoms, what does the gram stain look like?)
- common cause of community acquired pneumonia
- not transmitted person to person, but through water sources
- acute onset high fever and pneumonia
- neutrophils and no organisms on stain
common cold caused by what… (name 3 most common and structure (RNA, DNA, dsDNA etc)
- rhinovirus (50%), corona virus (10%), RSV (10%)
- single stranded RNA (rhino naked, corona enveloped)
drug that can induce asthma (and associated weird symptom)
- aspirin
- nasal polyp
most common cause of pink eye
- adenovirus (naked icosahedral dsDNA)
- self-limited
bordella purtussis grows on…
bordet-gengou agar
tennis racquet cells are pathognomonic for…. (and cell markers)
- langerhans cell histiocytosis
- S-100 and CD1a
name of drug given to premature babies with insufficient surfactant
-phosphatidylcholine
nuerotoxic SE of INH…
- burning/tingling in fingers, due to decreased B6
- supplemental B6 can improve symptoms
erythema nudism is an extra pulmonary manifestation of… (also in a GI condition…)
- sarcoid
- crohns
oral candidiasis in asthma due to… (fix it by…)
- inhaled corticosteroids
- rinsing mouth
pancoasts tumor
- tumor of the apex of the lung, compressing superior cervical sympathetic ganglion
- results in horner’s syndrome
- smoking is risk factor
air crescent sign (name pathogen, and physical form)
- pulmonary aspergillosis
- 45 degree branching septate hyphae, rare fruiting bodies
most common malignancy associated with exposure to asbestos? second?
- brochogenic carcinoma
- mesothelioma
what are club cells? what do they do (2 things)
- cells responsible for producing protein component of surfactant
- responsible for CYP450 dependent oxidase activity which detoxifies inhaled materials
most common cause of atypical pneumonia? what is the difficulty in identifying this organism
- mycoplasma pnuemonia
- takes weeks to culture, use cold agglutinin test
eosinophilia in sputum sample… (NAACP)
-neoplasm, allergic, asthma, collagen vascular diseases, parasites
sputum of asthma patients contains… (3 things)
- eos
- curshmanns spirals
- charcot-leyden crystals
thumbprint sign… (indicative of what condition… causative organism?)
- epiglottitis
- h.flu
hypercalcemia of malignancy is most often due to…
-squamous cell lung cancer
what is dipalmitoyl phophatidylcholine and what cell makes it?
-surfactant, type II pneumocytes
type II pneumocytes have two main jobs, name them.
- produce surfactant
- proliferation after lung damage
what cells make ADH, serotonin, calcitonin etc in the lungs?
-bronchial cells of kulchitsky
what viral illness precedes lobar pneumonia in an otherwise healthy individual? (and structure of virus)
-influenza… enveloped, segmented, single-stranded RNA
leading cause of death for CF pts
-pseudomonas
panacinar vs centriacinar emphysema
- pan: alpha-1-antitrypsin
- centri: smoking
wheezing localizing respiratory problems to….
-bronchioles
OSA causes… that leads to compensatory….
- respiratory acidosis
- increased HCO3 absorption by kidney
things are most likely to lodge in the…
right main bronchus
zeill-nielson stain
TB (and other mycobacterium)
nocardia asteroides (presents like… but can be differentiated by… tx with…)
- TB, but with more brain abscesses, typically in immunocompromised pts.
- also acid fast (but weakly), however, gram positive filaments
- tx with sulfas
which bug belongs to which medium:
- bordet-gengou
- chocolate agar with factors V and X
- tellurite
- theyer-martin
- bordet-gengou…. purtussis
- chocolate agar with factors V and X… H. influenza
- tellurite…. diphtheria
- theyer-martin…. gonorrhea
anatomy of lung… where is the horizontal fissure located
-just behind the 4th rib
lung exam: if you have decreased breath sounds, you think it could be one of two things… to distinguish those you do a tactile fremitus/egophony– what are the two main things you’re distinguishing between
- decreased breath sounds = less air… consolidation or effusion
- increased fremitus/egophony, consolidation
- no increased fremitus/egophony, effusion
genetics of CFTR (chromosome number and specific mutation), and end result
- deletion at F508 on chromosome 7
- misfolded CFTR protein, channel which is important for secreting Cl- in GI and respiratory tracts as well as reabsorbing Cl- from sweat is not transported to membrane
- thick mucous in GI and respiratory, and elevated Cl- in sweat
disease that comes in two phases, first somewhat nonspecific symptoms, second with hemorrhagic mediastinitis, bloody pleural effusions and mediastinal widening on CXR (probably a stem with a farm and sheep)
-bacillus anthracis, or ‘wool sorters disease’
smoker with large hilar mass with cavitation makes you think… which is associated with…
- squamous cell carcinoma
- PTHrP, elevated calcium in the blood
allergic rhinitis is an example of which type of immune reaction… it causes…
- type I
- angioedema due to IgE mediated release of histamine from mast cells and basophils
honeycomb pattern? name disease and common phenotype.
- desquamative interstitial pnemonia
- middle aged, smoker, gradual onset, restrictive pattern
what is a syncytium?
-a multinucleated cell formed by fusion of nearby cells, ala RSV
what is the chloride shift?
when the body gets hypercapnic, increased CO2 gets picked up by RBC’s, carbonic anhydrase converts it to bicarb which is extruded into blood for Cl-
histamine 1 vs histamine 2 receptors
- histamine 1 receptors are located in nasal and bronchial mucosa, implicated in seasonal allergies
- histamine 2 receptors are located in stomach and affect GI acid secretion
