Pulm

Question 1

What is defective in cystic fibrosis?

Answer 1

CFTR: cystic fibrosis transmembrane regulator

Delta F508 is most common mutation –> abnormal protein folding

Question 2

Cause of spontaneous pneumothorax

Answer 2

Rupture of subpleural blebs (tall thin males)
COPD

Trachea deviates towards affected side

Question 3

Tension pneumothorax

Answer 3

Air enters pleural space but cannot leave

Trachea deviates away from affected side

Usually due to trauma

Question 4

Common causes of transudative effusion

Answer 4

CHF

Nephrotic syndrome

Question 5

Common causes of exudative effusion

Answer 5

Malignancy

Pneumonia

Question 6

Light’s criteria for exudate effusion

Answer 6

Plural protein/serum protein >.5
Pleural LDH/serum LDH >.6
Plural LDH > 2/3rd upper limits of normal

Question 7

Mesothelioma

Answer 7

Pleural tumor from asbestos

Pleural thickening and pleural effusion (slow onset)

Question 8

Pulmonary embolisms are caused by

Answer 8

a hypercoagulable state

Most commonly thrombi from DVT

Question 9

Increased D-dimer can point towards a diagnosis of

Answer 9

DVT/PE

Question 10

What leads to a fat embolism

Symptoms?

Answer 10

Long bone fracture

ARDS
Confusion
Petechiae

Question 11

Sarcoidosis

Answer 11

Hilar lymphadenopathy, cough, erythema nodosum, uveitis, hypercalcemia, and high ACE levels
Hallmark: non-caseating granulomas
Accumulation of TH1 CD4 cells (IL-2, IFN gamma)

Question 12

Which pulmonary cells are regenerative?

Answer 12

Type II pneumocytes

They also produce surfactant

Question 13

What should be given to a preterm infant to reduce the risk of surfactant deficiency?

Answer 13

Corticosteroids

Question 14

Highest resistance to flow

Lowest resistance to flow

Answer 14

Medium bronchi

Terminal bronchioles

Question 15

Chronic bronchitis

Answer 15

Hypertrophy of mucus glands due to smoking

Blue bloaters

Question 16

Anti-trypsin Deficiency

Answer 16

Panacinar emphysema due to destruction of elastin

Liver cirrhosis

Question 17

Bronchiectasis

Answer 17

Large airways are dilated but obstructive disease
Due to chronic inflammation
Have hemoptysis and mucus production
Seen in Kartageners syndrome and ABPA

Question 18

Low DLCO

Answer 18

Interstitial lung disease (fibrosis)
Emphysema
PE or pulm HTN

Question 19

Silicosis

Answer 19

Involves macrophages (failed phagolysosome formation)
Increased risk of TB

Question 20

Air fluid level in lungs

Answer 20

Lung abscess

Usually caused by anaerobes (Bacteroides), staph aureus, or klebsiella

Question 21

Small cell lung cancer

Answer 21

Neuroendocrine tumors

Paraneoplastic syndromes: ACTH, ADH, Lambert Eaton

Question 22

Squamous cell carcinoma

Answer 22

Keratin pearls

Can produce PTH related protein

Question 23

Adenocarcinoma

Answer 23

Most common cancer in female non smokers

Question 24

Important mediator of idiopathic pulmonary fibrosis

Answer 24

TGF-beta released from pneumocytes

Question 25

ARDS hallmark and treatment

Answer 25

Hyline membranes

Ventilation with positive end-expiratory pressure

Question 26

Paraneoplastic syndromes of small lung cell carcinoma

Answer 26

ADH
ACTH
Eaton-lambert - antibodies against calcium receptors

Question 27

Squamous cell carcinoma can produce what?

Answer 27

PTHrP –> hypercalcemia