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USMLE 1 > PULMO > Flashcards

PULMO Flashcards

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USMLE® Step 1 flashcards
1
Q

How can viruses use eukaryotic ribosomes for protein synthesis?

A

They must convert their polycistronic genome into monocis mRNA

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2
Q

How to convert poly genome into monocis mRNA?

A
  1. viral genome is already segmented 2. a transcription promotor can precede each gene 3. precursor RNA strands can undergo alternative splicing 4. viral genome can serve as a single mRNA that’s cleaved into sep proteins
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3
Q

Elastin’s ability to stretch during inspiration then recoil to original shape- explained by

A

interchain crosslinks involving lysine

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4
Q

Explain resistance to streptomycin

A

altered structure of bacterial ribosomal proteins

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5
Q

Inhibits fungal DNA and RNA synthesis

A

Flucytosine

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6
Q

Inhibits fungal cell wall

A

Caspofungin

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7
Q

Inhibits fungal cell membrane

A

ampho B and Nystatin bind ergosterol; azoles inhibit ergosterol synthesis

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8
Q

The high susceptibility of patients with silicosis to TB is best explained by

A

impaired macrophage killing

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9
Q

at peak exercise, what parameters are the same in systemic and pulmonary circulation?

A

blood flow per minute

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10
Q

Suggests diagnoses of cystic fibrosis

A

hx recurrent respi infections with Ps aeruginosa, chronic diarrhea, weight loss, death of a 9 y/o sibling d/t respi infection

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11
Q

Explain diarrhea and weight loss in CF

A

malabsorption due to obstructive fibrosis and progressive insufficiency of the exocrine pancreas

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12
Q

Improve condition of CF

A

pancreatic lipase

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13
Q

Why does the V/Q ratio decrease from the lung apex to the base?

A

bc perfusion increases significantly from the apex to the base

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14
Q

Explain antibodies involved in M pneumoniae

A

share antigens with human erythrocytes and cause RBC destruction; Ab referred to as cold agglutinins

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15
Q

at what point is total pulmonary vascular resistance lowest?

A

functional residual capacity

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16
Q

likely to cause chronic pneumonia in an immunocompetent host

A

Blastomyces dermatitidis

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17
Q

Highest O2 sat in fetal circulation is in the

A

umbilical vein, which empties directly into the IVC via the ductus venosus

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18
Q

pH lower than 7.35 signifies

A

acidosis

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19
Q

respi acidosis occurs due to

A

the retention of CO2 in the lungs; presents with low pH and high pCO2

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20
Q

chronic respi acidosis

A

is compensated, with a HCO3 level >30

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21
Q

Centriacinar emphysema

A

heavy smoker with exertional dyspnea and airspace enlargement on CT

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22
Q

Pathogenesis of centriacinar emphysema

A

involves intraalveolar release of proteases, especially elastase, from infiltratin NEUTROPHILS and from alveolar MACROPHAGES

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23
Q

In the setting of lung volume loss, the trachea deviates…

A

toward the opacified lung (atelectasis)

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24
Q

In the setting of a large pleural effusion, the trachea deviates…

A

away from the opacified lung

25
Q

Rx Mycoplasma infections

A

anti-ribosomal agents like tetracyline and erythromycin

26
Q

Frameshift mutation

A

deletion or addition of a number of base pairs which are not a multiple of three

27
Q

Most frictional airway resistance is found in the

A

large bronchi

28
Q

MCC of meconium ileus

A

cystic fibrosis

29
Q

Most likely cause of death, CF

A

pneumonia

30
Q

Three day hx of dysuria and back pain. Fever, hypotensive, tachypneic, tachycardic. Becomes hypoxic. LUNG FINDINGS?

A

fluid accumulation in alveolar spaces (ARDS; sepsis and shock are two major risk factors)

31
Q

long history of asbestos exposure

A

bronchogenic carcinoma

32
Q

Decreased FVC, lower lobe involvement, a1- antitrypsin deficiency

A

chronic panacinar emphysema

33
Q

intermittent respi sx in a patient with normal CXR, occasional sputum eosinophils, and reduced FEV1

A

asthma

34
Q

what would an elevated PCWP in a patient with pulmonary edema be suggestive for?

A

a cardiogenic cause, such as pulmonary venous hypertension

35
Q

Increased pulm capillary permeability in ARDS results in…

A

decrease in lung compliance, an increase in the work of breathing, and worsened V/Q mismatching

36
Q

non caseating granulomas in an African American

A

sarcoidosis

37
Q

Accentuated second heart sound over the upper left sternal border, pitting lower extremity edema, and hepatomegaly in a patient with atrophic skin changes and cold-induced digital vasospasm. Cause of condition

A

intimal thickening of pulmonary arterioles (scleroderma and PH)

38
Q

interstitial pneumonia in a transplant patient with intranuclear and cytoplasmic inclusion bodies. Organism is described as….

A

enveloped ds DNAV (CMV)

39
Q

Clinical features of Legionella pneum

A

high fever with relative bradycardia, headache and confusion, watery diarrhea

40
Q

lab findings in Legionella

A

hyponatremia, sputum GS showing many neutrophils but few or no organisms

41
Q

Rx Legionella

A

respi FQ or newer macrolides

42
Q

Legionella is described as a

A

G- rod

43
Q

18 y/o male w/ sudden onset right-sided chest pain and dyspnea. Tall, thin patient in acute distress. Right side of chest is hyperresonant to percussion and lack BS. MLC of condition?

A

apical subpleural blebs

44
Q

High fever, chills, and cough productive of green sputum. Crackles over right lower lung lobe. What accounts for color of sputum?

A

myeloperoxidase

45
Q

MPO

A

released from neutrophil azurophilic granules; heme-containing pigmented molecule

46
Q

MCC of SVC syndrome

A

bronchogenic carcinoma

47
Q

nkaed rna molecules induce viral protein sythesis and viral genome replication. The patient is ML infected with

A

rhinovirus (SS, positive sense RNA molecule)

48
Q

many of amphotericin b’s toxic effects are due to its binding of

A

cell membrane cholesterol

49
Q

ethambutol affects bacterial

A

carbohydrate polymerization

50
Q

diagnose CF by

A

chloride level in sweat

51
Q

columnar mucin-secreting cells that fill the alveolar spaces without invading the stroma or vessels

A

bronchioalveolar Ca

52
Q

Cheyne-Stokes describes

A

cyclic breathing in which apnea is followed by gradually increasing tidal volumes, and then gradually decreasing tidal volumes until the next apneic period

53
Q

Cheyne stokes breathing seen in

A

advanced CHF

54
Q

stimulates neutrophil migration to the site of inflammation

A

leukotriene B4

55
Q

small fibrotic focus in lower lobe of right lung, calcified LN in right lung hilus..

A

primary exposure to MTB

56
Q

several episodes of H flu OM despite immunizations.. why?

A

the strains responsible for the pt’s dse do not produce a capsule

57
Q

Pneumonia, histo: alveoli filled with exudate containing neutrophils, fibrin, and some fragmented red blood cells. Pt died during..

A

gray hepatization

58
Q

V/Q ratio highest at the

A

Apex

59
Q

Perfusion highest in the

A

Base

USMLE 1 (11 decks)

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