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Q2 > Pulm MIM > Flashcards

Pulm MIM Flashcards

1
Q

Q fever
domestic farm animals/dairy farmer/partruent animals
PNEUMONIA/hepatitis/fever
chronic: (-) culture endocarditis

A

Coxiella burnetti

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2
Q

bird/bat dropping in MW (mississippi, ohio river valleys)
intracellular macs filled w/ fungus
inhaled from the environment
dimorphic fungi
T-cell mediated
PNEUMONIA, chest pain, pericarditis, systematic
Amphotericin B

A

Histoplasma capsulatum

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3
Q

risk factors for drug-resistant STREP PNEUMO in adults

A

> 65yo
b-lactam/macrolide/fluoroquinolne tx in past 3-6mo
alcoholism/medical comorbidies/ICPs
exposure to children (day care center

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4
Q

what prophylaxis drug for h. influenzae

A

rifampin

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5
Q

people who have >5mm TB positive skin test

A

HIV
live w/ TB infected person
immunocompromised/transplant
CXR has fibrotic changes

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6
Q

SHi Moraxella are causes of what (2)

A
  1. otitis media (common infection)

2. acute exacerbation of chronic bronchitis (ACEB)

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7
Q

90% viral
if bacterial: GAS, Staph aureus

GAS -> acute rheumatic fever, glomerulonephritis

A

tonsillitis, pharyngitis

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8
Q

pseudomonas
ear -> CNS

purulent otorrhea -> osteomyelitis of mastoid bone, bell’s palsy, meningitis

A

necrotizing external otitis

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9
Q

fungal
nose -> blood -> nasal
broad, nonseptate hyphae with right angle branching inside the vessel
esp in diabetes, ICPs

A

rhino-cerebral zygomycosis

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10
Q

benign polypoid vascular proliferation

adults (trauma, pregnancy) anterior nasal septum

A

pyogenic granuloma

lobular capillary hemangioma

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11
Q

benign vascular/fibrous neoplasm w/ locally destructive tissue
adolescent MALES
lateral/upper posterior nasopharynx
ANTLER-LIKE thin walled vessels w/ collagenous stroma
complete resection essential

A

Juvenile nasophrayngeal angiofibroma

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12
Q

nasal obstruction

A

Nasopharyngeal carcinoma
olfactory neuroblastoma
rhabdomyosarcoma
sinonasal inflammatory polyps/papillomas/melanoma

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13
Q

cystic fibrosis, aspirin intolerance
non-neoplasic inflammation of nasal mucosa
intact epithelium w/ stoma filled w/ eosinophils

A

sinonasal inflammatory polyps

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14
Q

benign neoplasm of sinonasal mucosa (squamous/columnal)
HPV 6,11
inverted (endophytic) harder to resect - higher mortality

A

sinonasal papilloma

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15
Q 
malignant tumor of skeletal muscle
most common sarcoma in head/neck of kids 
sarcoma botryoides "grape-like mass" 
t (2;13), t(1;13) 
tadpole cell
A

rhabdomyosarcoma

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16
Q

malignant small round blue cells (rosettes) tumor

unilateral usually in cribiform plate -> damage CN1 -> anosmia

A

olfactory neuroblastoma

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17
Q

EBV (epstein barr virus)
kids in africa
adults in asia
keratinizing (Squamous cell), non-keratinizing, undifferentiated

cervical ALD

keratinizing: not sensitive to radiation, worst prognosis

A

nansophargyngeal carcinoma

18
Q

granulomatous diseases

A

Wegener’s: necrotizing
TB: caseating
Sarcoid: non-caseating

19
Q 
non-infective vasculitis 
nose, lung, kidneys 
purulent rhinorrhea 
C-ANCA
necrotizing granuloma 
males

exam Q: sinusitis + bloody urine

A

Wegener’s granulomatosis

20
Q

EBV associated
africa
highly destructive angiocentric T cell lymphoma

A

nasopharyngeal carcinoma

extranodal NK-Tcell lymphoma (midline destruction)

21
Q

squamous cell

A 
nasophrayngeal carcinoma (malig)
laryngeal pailloma/papillomatosis (benign) 
laryngeal carcinoma (smoking)
22
Q

benign, exophytic neoplastic growth of squamous cells

adult: single lesion
kids: multiple lesion, high recurrence - HPV 6,11

A

laryngeal papilloma

23
Q

smoking, alcohol, asbestos
could’ve been progression from laryngeal papilloma
hoarseness
malignant

A

laryngeal carcinoma

24
Q 
most common autoimmune disease in F >50 yo 
destruction of lacrimal/salivary glands 
DRY eye (blurred vision) mouth (dysphagia) 
Igs agains SS-A, SS-B
A

Sjogren syndrome

25
Q

salivary gland neoplasms

A

pleomorphic adenoma (benign mixed tumor): most common, benign, epithelial + stomal tissue (myoepithelial)

Warthin Tumor: BILATERAL, LYMPHOCYTIC infilatrate, smoking

Mucoepidermoid carcinoma: most malignant, t(11;19), fusion gene MECT1-MAML2

mucocytes and epidermoid cells

26
Q

dev lesion of neck

A

branchial cleft: lateral
thyroglossal duct cyst: midline
para-ganglioma (carotid body tumor): like pheochromocytoma (perfuse sweating, etc.)

27
Q

smokers, very aggressive
centrally located
paraneopalstic syndromes (SIADH, Cushing’s, Eaton-Lambert syndrome)
poorly differentiated
small blue cells that are smudged
synaptophysin/chromogranin stain positive
metastasize to liver/kidneys/adrenal glands

A

small cell lung cancer

28
Q

central/peripheral/ENDOBRONCHIAL
young person w/ recurrent R sided pneumonia
not related to smoking
surgery is curative
well differentiated neuroendocrine cells
typical/atypical/malignant

A

Carcinoid tumors

29
Q 
most common type of lung cancer in non-smokers 
"coin" lesions periphrally located 
F smokers 
glands/mucin/GLOBET CELLS 
Erlotininb (Tarceva) EGFR inhibitor 
lobectomy + chemo (no radiation)
A

adenocarcinoma

30
Q

adenocarcinoma in situa
clara cells
looks like unresolving pneumonia b/c diffuse (no solid tumor) - ground glass opacity
spreads through the airway (not blood stream)
not related to smoking

A

bronchio-alveolar cell carcinoma

the least severe of adenocarcinoma

31
Q

poorly differentiated, prominent nucleoli
smoking
poor prognosis

A

large cell carcinoma

32
Q 
keratin pearls
intercellular bridges 
cavitation 
intravascular invasion 
most common in male smokers 
central/hilar 
parathyorid hormone-related protein (hyperCa2+) 
no Avastin
A

squamous cell carcinoma

33
Q

***Chronic bronchitis pathology (4)

A

mucous gland enlargement (goblet cells, Reid index)
chronic inflammation of the airway wall (eosinophils)
thick bronchial basement membrane
squamous metaplasia, goblet cell hyperplasia

34
Q

emphysema is central bullae

spontaneous pneumothorax: peripheral bullae

A

.

35
Q

pneumonia/erythemia multiform/bullous myringitis (fluid behind ear drum)
no cell wall (sterol in cell membrane)
cold agluttinin IgM serology

A

mycoplasma pneumoniae

36
Q

pneumonia, hoarse voice, pharyngitis, atherosclerosis

gm (-) pleomorphic
obligate intracellular
asymptomatic infection

Giemsa stain

A

chlamydia pneumonia

37
Q

young

A

sarcoidosis

38
Q

polyarthritis
erythema nodosum
hilar adenopathy
fever

acute

A

Lofgren syndrome

sarcoidosis

39
Q

insidious onset, progress relentelssely
velcro-like (coarse) crackles
PATCHY

A

.

40
Q

pulmonary embolism from DVT

A 
cancer: hypercoag state 
one leg is swollen 
sob 
CT scan should be done 
lweor lobes 
'wedge-shaped' hemorrahgic lesion cause dual blood supply

Q2 (6 decks)

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