Pulm Flashcards
A girl presents with SOB that is worse when it is cold. She should be given?
Asthma Give corticosteroids (block phospholipase A2)
A pt with recurrent infections is believed to have an immunodeficiency that results from defective PMN destruction of catalse-producing microorganisms. How would you confirm?
Chronic granulomatous dz
Defective PMN phagocytosis due to a lock of nicotinamide adenosine dinucleotide phosphate (NADPH)
Low fluorescent activity on dihydrorhodamine (DHR) flow cytometry assay (asses production of superoxide radicals)
Negative nitroblue tetrazolium
A pt with nodular sclerotic lesions and high alk phos likely has?
Metastatic neoplasia
Usually do to prostate cancer
A pt with a 50ppd history is presenting with HTN, wheezing, and cyanotic hands should not receive?
Nonselective beta blockers (nadolol, propanolol, timolol, pindolol) because it can further cause bronchoconstriction
Also contraindicated in cocaine use (unopposed alpha agonism)
Is goodpasture obstructive or restrictive?
restrictive (FEV1:FVC > 0.8)
Which drug promotes smoking cessation by reducing nicotine cravings and decrease the pleasurable effects of cigarettes
Varenicline
Partial alpha4beta2 nicotinic acetylcholine rec eptor, competes with nicotine
A pt with Pulmonary HTN will have dyspnea because they have?
Decreased lung compliance
A pt with CF has symptoms because?
They have a 3 bp deletion that leads to abnormal posttranslational processing of a transmembrane protein that will be targeted to the proteasome
a pt gets a fish bone stuck in his left piriform recess. A nerve is injured during removal. What is likely to be impaired?
Cough reflex
Superior laryngeal n. (CNX)
MHC I has which components?
Heavy chain and B2-microglobulin
MHC I is on all nucleated cells
MHC II has which components?
alpha and beta polypeptide chains
Function of MHCI
On all nucleated cells
Present to CD8+
Recognizes viruses, tumors and process Ag in cytoplasm
APC to CD8+ results in apoptosis of the presenting cell
Function of MHC II
Found on APC’s (B cell, Macrophages, DC, Langerhans)
Presents to CD4+
Recognizes bacterial Ag which are processed by lysosomes
Activation of TH cells stimulate humoral and cellular response
Sputum cultures growing budding yeast and form germ tubules at 37C
Candida
A woman is give a blood transfusion with O type packed RBCs develops facial swelling, hibes and SOB. Why?
Selective IgA deficiency
Typically have recurrent sinopulmonary and GI infections (no secretory IgA), autoimmune dz, anaphylaxis during transfusion (form IgE against IgA)
Dx - low IgA
What type of transmembrane protein is CFTR?
ATP-gated NaCl channel
M. TB can cultur in parallel chains (serpentine cords) this correlates with?
Virulence. Cord factor, a mycoside composed of two mycolic acid molecules bound to the disaccharide trehalose. Without cord factor the mycoside can’t cause dz because it inactivates PMNs, damages mitochondria, and induce TNF
Asbestos exposure is most likely to cause?
Bronchogenic carcinoma
What test should you use when you want to compare the means of two or more group?
Analysis of variance (ANOVA)
determines variability within groups as well as between boots.. Tests a null hypothesis that all groups are random samples of the same population before comparing the groups
A premature infant that was treated for ARDS presents with abn retinal vascularization that extends into the vitreous. What happened?
Neonatal oxygen supplementation
Can progress to blindness
Caused by upregulation of VEGF
After leaving the alveolar beds, capillaries have a drop in O2 saturation before entering the LA. Why?
Mixture with deoxygenated blood (1. bronchial v., 2. Small cardiac (thebesian v.))
Female with no smoking history presenting with a mass in the lower lobe of the left lung. Dx?
Adenocarcinoma
What happens in the first week following exposure to TB?
Intracellular bacterial proliferation (alveolar macrophage)
A pt with an extensive smoking history presents with hemoptysis and shoulder pain
Pancoast syndrome
Tumor at the lung apex (superior sulcus)
Causes shoulder pain, Horner syndrome (ipsi ptosis, miosis, anhydrosis), upper extremity edema, spinal cord compression