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Asem > resp + urine > Flashcards

resp + urine Flashcards

1
Q

Selective IgA deficiency presents? Why anaphylaxis(rxn?) during transfusion?

A

Selective IgA deficiency presents? Why anaphylaxis during transfusion? recurrent musosal infection +autoimmune disorders + anaphylasis during transfusions (rxn:hives, swelling, SOB) because react against IgA)

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2
Q

Clearance, FF, GFR equations? typically what value? GFR estimates(2), RPF estimates(1)

A

Clearance(A) = U con(A)*Urine flow /PLASMA con(A) usually FF, GFR, = 100, 20% ; Inuline & cretiinie-slightly secreted; PAH(all secreted)

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3
Q

How does b-agonist treat acute COPD excercerbation(pathogens?)?

A

How does b-agonist treat acute COPD excercerbation(pathogens?)? By GS so CAMP for sm to relax; B2 for bronchial + uterus muscle relax

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4
Q

loading(or maintenace) dose = _(or _)*Cpss/bioavailablity fraction

How does cl and vd relate?
Cpss achieved in _ half-lifes and if IV, bioavailability

A
  1. loading(or maintenace) dose = vd(or CL)*Cpss/bioavailablity fraction

half life* CL= .7*vd

Cpss achieved in 4.5 half-lifes and if IV, bioavailability =1

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5
Q

viridans produce _for virulence

A

viridans produce dextrans for virulence

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6
Q

PAh lowest in what part of nephron? Why?

A

PAh lowest in? Why? PAH is primarily secreted by prox tubule

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7
Q

streptococcus/staphlocci = _/cluster

G+ = cocili/filament/bacilli =2/2/3= staph & strep/ nocardia/ actinomyci /clostridia & listeria, corynebac
G- = diplo/cocobac/curved/bacili= 3/5/3/ rest= neiserias & moraxella/ h.infl, pertusis, (dog, cow, rabbit)
A

streptococcus/staphlocci = chain/cluster

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8
Q

GBS antibiotic given where? @ what wk?

A

GBS antibiotic given where? @ what wk? INTRAPARTUM ampicillin @ 35 wks because protectivity vanises after a mth.

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9
Q

Most microbe contaminant on expectorants?

A

Most microbe contaminant on expectorants? Candida is normal flora of GI(oral) & skin -> typic contaminant of sputum expectaranted; so a contaminant(like coag-staph & enterococci) unless if immunocompromised or vascular catheters.

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10
Q

For pyleonephritis due to UTI, NEED?

A

For pyleonephritis due to UTI, NEED? vesicoureteral reflux( anatomical or acquire-reccurent bladder infections may damage) to facilicitate accent

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11
Q

Greateast risk after asbestosis exoposure is ?

A

Greateast risk after asbestosis exoposure is ? bronchogenic greater than mesothelioma

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12
Q

all lung malignancies have paraneoplastic= squamous/ adenocarcinoma =/

A

2-sample t-test/chi-all lung malignancies have paraneoplastic= squamous/ adenocarcinoma = PThrp/ migratory thrombophlebitis

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13
Q 
VItamins
Thiamine deficiency presents? 
B2/B6
B3
Vit A/C/E/D deficiency?
B12/B9
A

Thiamine deficiency presents? Weirknekie and beriberi (dry/wet = symmetric peripheral neuropathy/ HF)
B2/B3/B6= FAD/NAD/pyroxidine)= B6 +normo anemia/pellagra/ cheilosis, glossitis, stomatitis
Vit A/C deficiency? Night blindness, xeropthalmia, infections/ gingival swelling, petechial hemorrhages, impaired wound healing

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14
Q

On frontal CXR R middle lobe is next to what part of heart? What is at R/ l border of sternum?

A

On frontal CXR R middle lobe is next to what part of heart? What is at R/ l border of sternum? R(SVC->RA->IVC) and L(Aortic knob->pulmonary artery->LA->RV + LV)

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15
Q

Supine or righ lateral decubitis hypotension syndrome due to ?

A

Supine or righ lateral decubitis hypotension syndrome due to ? Pregnancy( wk 20) presses on IVC-> dec preload

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16
Q

Enterocooci grows in two?cause endocarditis under what condition?

A

Enterocooci grows in two?cause endocarditis under what condition? (grows in hypertonic saline & bile); cause endocardities after Gu procedures

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17
Q

Cadiac muscle uses _ not camouldulin?

A

Cadiac muscle uses troponin?? Not camouldulin?

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18
Q

Asthma drugs picture=prophylaxis, treatment(1), persistent severe(1):

A

Asthma drugs picture=prophylaxis, treatment(1), persistent severe(1): omalzumab(IgE antibody)-> cromoglycales(prevent mast cell degranulation-no histamine release)/glucocorticoids( inhib PLA2) ->antihistamiens/ zileuton(inhib lox) & montelukasts(inhib receptor); glucocorticoid 1st line treat, omalzumab for persistent sever, others for prophylaxis.

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19
Q

Varenicline/ nicotine? Which one is reduces withdrawal craving and dec rewarding effects? =

A

8754Varenicline/ nicotine? Which one is reduces withdrawal craving and dec rewarding effects? = partial/full agonist so reduced/full effect. Varenicline because as partial agonist, stimulate receptor(dec withdrawal) but not to full extent(dec rewarding effects). When do you use nicotine path?

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20
Q

FEV1 physiologically _ with age( smoking _rate of decline)

A

FEV1 physiologically declines with age( smoking increases rate of decline)

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21
Q

Asbestos in what part of lung? Only pneumocociu that can happen where? What bodies ?

A

Asbestos in what part of lung? Only pneumocociu that can happen where? What bodies ? in lower lob. pleural plaques; ferroginus bodies

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22
Q

Silica presents?

Berrylliosis?

A

Silica vrs berryliosis ? Birefringent whorled collagenous nodules surrounded by dust-laden macrophages;

Nodules vrs noncasesting granulomas

increased risk for Tb vrs increased risk for lung cancer

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23
Q

consolidat/pleural effusion/pneumothtorax/ atelectasis to breath sounds, fremitus, percussion? :

A

consolidat/pleural effusion/pneumothtorax/ atelectasis to breath sounds, fremitus, percussion? : consolidation only one with increased Breath sound & tactile fremitius others decreased. Pnuemothorax only with hyperresonance others dull.

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24
Q

6564adenocacinoma / sq/small/large b cell carninoma of lung hallmark on biopsy?

A

6564adenocacinoma / sq/small/large b cell carninoma of lung hallmark on biopsy? Ducts/ intracellular bridges + keratin pearls/ small blue cells with no cytoplasm and salt& pepper/ non of the above but stain for markers to determine origin

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25
Q

ARDS on chest x-ray? causes(4)? Refractory to what? What happens to capillary wedge pressure and why?

A

ARDS on chest x-ray? causes(4)? Refractory to what? What happens to capillary wedge pressure and why? pancretitis, sepsis, trauma, pneumonia can lead to ARDS(inflammation-> bilateral opacities/hyline membranes with normal pulmonary capillary wedge pressure), refractory to 100 oxygen so give PEP

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26
Q

Obstructive lung collapse on X-ray vrs Tension pneumothorax ? Deviate?

A

2116Obstructive lung collapse on X-ray vrs Tension pneumothorax ? Deviate? Unilateral pulmonary opacification of affected side + deviation of trachea toward vrs away from opacification

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27
Q

Pulmonary edema/fibrosis/ARDS on X-ray? -

A

Pulmonary edema/fibrosis/ARDS on X-ray? - bilateral flufflly/ instertitial linging/ white out

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28
Q

central obesity is a _ lung disease

A

central obesity is a restrictive lung disease

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29
Q

CFTR mutation? What electrolyte imbalance? Why supplement with salt in CFTR?

A

CFTR mutation? What electrolyte imbalance? Why supplement with salt in CFTR? F508; hypochlo & natremia; CFTR with high osmo eccrine sweat->hypochloremia & hyponatremia so supplement with salt if exercise or do anything that makes sweat

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30
Q

Exudative vrs transudative? lights criteria?

A

Exudative vrs transudative? lights criteria? Pressure changes vrs imflammation. Exudative if fluid/serum is protein or lDH or LDH = > .5 /.6/ two- thirds upper limit of serum

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31
Q

Pulmonary exam findings for consolidation, pleural effusion, pneumothorax and atelectasis?

A

Pulmonary exam findings for consolidation, pleural effusion, pneumothorax and atelectasis? Breath sound & tactile fremitus ( dec for all except consolidation-inc) vrs percussion( dull for all except pneumothorax-hyperrosonant)

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32
Q

Thebesian veins drain _( so lA with _ po2 than pulm veins)

A

Thebesian veins drain lungs( so lA with less po2 than pulm veins)

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33
Q

Haldane/ bohr effect =

A

Haldane/ bohr effect = release CO2, Hi bind O2 /release O2 bind bicarb + h+ in lungs/tissue

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34
Q

aspiration: supine/upright =

A

aspiration: supine/upright =posterior UL & superior LL/ basilar segments

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35
Q

Ureaplasma urelyticum is a _ genus

A

Ureaplasma urelyticum is a myocoplasma genus

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36
Q

cold agglutinations?

A

cold agglutinations: infectious mono ?

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37
Q

sleep apnea: _ problem so what nerve?

A

sleep apnea: pharynx not larynx problem so hypoglossal

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38
Q

intrapleural pressures are negative!

A

intrapleural pressures are negative!

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39
Q

6 dimorphic: mold(hypehea) vrs yeast(single cells)

A

5 dimorphic: mold(hypehea) vrs yeast(single cells)

Histo, cocidio, blasto, sponthrix, paracocidio, candida

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40
Q

Insterstitual lung disease:_elastic recoil( pull of surrounding tisue on bronchiols) -> relative _ expiratory flow rate but _ lung volumes

A

Insterstitual lung disease: increaed elastic recoil( pull of surrounding tisue on bronchiols) -> relative inc expiratory flow rate but decreased lung volumes

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41
Q

panic, altitide -> _ -> hypocapnia -> _ cerebral perfusion-> altitude sickness symtoms

@ altitude hypoxemia _(O2 _ nomalzed)
@ PE acute->chronic = no metabol compenzation until _hrs later

A

panic, altitide -> hyperventilation -> hypocapnia -> low cerebral perfusion-> altitude sickness symtoms
@ altitude hypoxemia persists(O2 not nomalzed)
@ PE acute->chronic = no metabol compenzation until 24 hrs later

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42
Q

asthma/copd exacerbations= _/infections( mostly viral(3); 3 bac)

A

asthma/copd exacerbations= allergy/infections( mostly viral: rhino &parainflu, influenza; strep pnue, Moraxella, h.influ)

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43
Q

Astham or CF history -> _ with eosinophils ->bronchiectasis

A

Astham or CF history -> ABPA with eosinophils ->bronchiectasis

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44
Q

Legionella : pulmonary + _ diarrhea in ciggar smoking old men with _natremia

A

Legionella : pulmonary + watery diarrhea in ciggar smoking old men with hyponatremia

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45
Q

MUDPILES?(alch, uremia, DKA, alchol, 2_, lactic acidosis, alch, salicytales _)

HARDASS?

Respiratory acidosis( hyperventilators alt, panic, ,, salicylates _)

Acidosis/alkakolisis table?
ph->acid/alk->pco2 and bicarb->resp acid/alk=hypo/hyperventilations & metabolic acid(nomal/yes anion gap= hardass/_)->/ alk( check urine cl for saline/not saline responsive)-> compensation(metabol acid/alk = 1.5x +-8/ .7 x…..respiratory acid/alk=1,3/2,5) inaccurate?-> mixed

Saline responsive(2) and non responsive(@) causes of metabolic alkalosis?

1557Respiratory acidosis/alkalosis acute/chronic = >30 bicarb because takes kidney about 1 day to compensate. Look for others

A

MUDPILES?(alch, uremia, DKA, alchol, iron 0r inh, lactic acidosis, alch, salicytales late)

HARDASS?
( hyperalimentation, additions diease, renal tubular acidosis, diarrhea, acetolamide, spiranolactone, saline)

Respiratory acidosis( hyperventilators alt, panic, pulm emboli,tumor, salicylates early)

acidosis/alkakolisis table!!!
ph->acid/alk->pco2 and bicarb->resp acid/alk=hypo/hyperventilations & metabolic acid(nomal/yes anion gap= hardass/mudpils)->/ alk( check urine cl for saline/not saline responsive)-> compensation(metabol acid/alk = 1.5x +-8/ .7 x…..respiratory acid/alk=1,3/2,5) inaccurate?-> mixed
so anion gap and urin cl levels ->compensation.

956 Saline responsive causes of metabolic alkalosis? saline(direutics, vomit) nosaline(hyperaldosterone)

metabolic acidosis/alkalosis -> check anion gap/ check urine cloride(lo/hi = saline response-direutic or vomiting or aspiration due to volume depletion/not response-bater & gitelman syndrome & mineralocorticoid excess;

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46
Q

Pthr.p or PTH which by malignancy

A

Pthr.p not pth secreted by malignancy

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47
Q

Juxtaglomerular aparatus is 3 cells? What cells release renin?

A 
JG cells(B1 receptors, modified smooth muscle
 Cells surrounding in afferent ateriole), macula densa( part of TAL) and mesangial cells; renin is by JG cells
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48
Q

Incontinence urge/overflow/ stress? treat?

A

Spastic(overactive) bladder due to UMN lesion that dec inhibition/flaccid(unactive) bladder due to detrusor muscle hypoactivity so don’t pee fully/ outlet incompetence= can’t overcome urge/ feel like never fully empty bladder/ leak when laugh(inc abd pressures) ….Up/low neurons have inhib/ act effect on bladder! & In multiple sclerosis: urge->overflow incontinence

Urge/overflow = CN lesions(like NPH) that leads to loss of inhibition/ diabetes cause inability to sense full bladder -> incomplete emptying + night enuresis

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49
Q

Treat urge incontinence?

A

antimuscarinic

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50
Q

aut dorm/recess = present _/ _ in life= parent / = / defect

A

aut dorm/recess = present later/ early in life= parent show/does not show = cytoskeletal/enzyme defect

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51
Q

Which renal carcinoma is most common? where in kidney? On gross?

A

Which renal carcinoma is most common? Renal clear cell / oncocytoma is in proximal renal tubules/ collecting duct = grossly yellow sphere with necrosis/ brown with central stellate scar = microscopically clear cytoplasm with chicken wire vasculature/

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52
Q

Vesicoureteral reflux affects kidneys how?

A

Vesicoureteral reflux affects kidneys how? Chronic pyelonephritis with with dilated calyces in upper& lower poles of kidney….Vrs multicystic dysplastic kidney is nonhereditary

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53
Q

Interstial nephitis vrs glomerular nephritis vrs nephrotic syndrome: wbc(eosinophile)/ blood/ protein?

A

Interstial nephitis vrs glomerular nephritis vrs nephrotic syndrome: wbc(eosinophile)/ blood/ protein?

54
Q

Risk factors for rhabdomyolysis? What kidney injury? If myoglobin urine dipstick shows?

A

Risk factors for rhabdomyolysis? What kidney injury? If myoglobin urine dipstick shows? form prolong muscle activity(seizures), crush injuries & drugs ; myoglobin-not hemoglobin!- shows( + blood on urine with absence of rbc) ->ATN

55
Q

Most common cause of urinary distension-suprapublic fullness?

A

Most common cause of urinary distension-suprapublic fullness? Obstruction(PBH) especially if older man

56
Q

Glomerular pathology: divide into nephritic or nephrotic first.

General C_ deposits besides _ change

Nephrotic syndrome:
membraneous nephropathy has IgG_ antibodies against PLA2R, _tumors,

Nephritic syndrome
fibrin/Ige deposits/ basket weave = MPGN/ RPGN/ _
IgA nephropathy can be _

A

2131Nephrotic syndrome:
membraneous nephropathy has IgG4 antibodies against PLA2R
c3
Nephritic syndrome
C1/fibrin/Ige deposits/basketweave = MPGN/ RPGN/lupus neprhtitis /alport

57
Q

ach/sympathetics

A

ach/sympathetics

58
Q

Glucose is _filtered then _ so if block reabsorption it’s clearance resembleds _.

A

Glucose is freely filtered then reabsorbed so if block reabsorption it’s clearance resembleds inulin.

59
Q

acidosis stimulates renal ammoniagenesis: _->glucose releasing ammonium + bicarb

A
  1. acidosis stimulates renal ammoniagenesis: glutamine->glucose releasing ammonium + bicarb
60
Q

alanin cycle: ala->pyruvate

lactic acid cycle:

A

alanin cycle: ala->pyruvate

lactic acid cycle:

61
Q

acids secreted as_ +_

A

acids secreted as NH4 + inorganic phospahte

62
Q

Inulin & creatinie/ PAH=

A

Inulin & creatinie/ PAH= filter & both / sec = GFR/PRF

63
Q

In renal transplantation can have distal ureteral ischemia due to lack of _( of and arteries)

A
  1. In renal transplantation can have distal ureteral ischemia due to lack of anastomosis( of renal and superior vesical arteries)
64
Q

Vessicouretral reflux/ posterior urethral valves( mebrane @ junction of blad & ureter) & UP junction = _/obstructive( bilate & unilate) causes of _

A
  1. Vessicouretral reflux/ posterior urethral valves( mebrane @ junction of blad & ureter) & UP junction = non/obstructive( bilate & unilate) causes of hydronephrosis
65
Q 
.
Transplant rejection(all ischemic of bld vessels) hyperacute/acute/chronic=
A 
.
Transplant rejection(all ischemic of bld vessels) hyperacute/acute/chronic= fibrinoid necrosis + neutros/ fibrous thick + mononuclear cells/ intersitial fibrosis + atrophy
66
Q

DCT has _ osmolarity

A

DCT has lowest osmolarity

67
Q

Potters sequence is from _ anomaly(R)->oligohydro(O)->PTT

A

. Potters sequence is from renal anomaly(R)->oligohydro(O)->PTT

68
Q

Enterococci: gram pot cocci in chains, y-hemolytic( -> _ hemolysis)

A

Enterococci: gram pot cocci in chains, y-hemolytic( -> no hemolysis)
G+ -> staph/strep = calase +/- = a/b/y hemolysis

69
Q

GFR/RPF = GFR/ RBF(1-hct) is for what

A

FF = GFR/RPF = GFR/ RBF(1-hct)

excretion rates = filteration +sec -reabsorbed rate

70
Q

ureter ant to all except 2

water flows over illacs and under the bridge

A

ureter ant to all except uterine/vas artery + gonadal vesssels + renal vessels
(water flows over illacs and under the bridge)

71
Q

Most water(all?) absorption in _

A

Most water(all?) absorption in PT

72
Q

ADH/Ald @ / collecting duct because medula is _ osmolarity

A

ADH/Ald @ low/hi collecting duct because medula is higher osmolarity

73
Q

ADH also absorbes urea why?

A

ADH also absorbes urea-> hi med osmolarity-> higher water absorption

74
Q

RET is only _ mutation.

A

RET is only activating mutation.

VHL?

75
Q

!transfusion reactions( acute=chest & back pain) vrs transplant reactions

A

transfusion reactions( acute=chest & back pain) vrs transplant reactions

Transfusion rxn:
Allergic&anaphylactic/ febrile/ hemolytic/lung= plasma proteins/ Hla, wbc/ rbc/ neutro, Pulm endo ending within 2/ 1-6/1/6

76
Q

!hypersensitivity reactions(anphylaxis vrs allerrgy)

A

hypersensitivity reactions(anphylaxis vrs allerrgy)

77
Q

Airway resistance graph? resistance varies _with total cross-sectional area.

A

Airway resistance graph: resistance varies inversely with total cross-sectional area(highest @ alveoli): high in trachea, peak at med-sized bronchi(total cross-section low)-> decreases

78
Q

Problem with transplanted kidney consider ?

Calcineurin inhibitors (CT)

A 
Problem with transplanted kidney consider rejection: 
Calcineurin inhibitors (cyclosporine, tacrolimus) reduce renal blood
79
Q

ATN: _ cast ; due to_( overexertion-> myalgia, weakness, dark urine)

ATN stages: 3

A

ATN: muddy brown cast ; due to rabdomyolys( overexertion-> myalgia, weakness, dark urine)

ATN stages: initiation/maintenance/recovery= hrs/ wks/ mths = contrast dyes, toxins, ischemia/ oligouria with inc creatitnin/bun, K, metabol acidosis/ polyuria with accompanying electrolyte wasting( especially hypokal)

80
Q

Total oxygen content determined by =3

A

Total oxygen content determined by = SaO2(hg saturation) + PaO2 + hg concentration………Look for these 3 values to determine co(dec Sao2) /cn( all norm so oxygen content norm but venous oxygen content inc-> a-v o2 gradiant dec)/anemia( low hg)/polycethemia( hi hg)/altitude

81
Q

In suprapubic cystotomy bladder is_ peritoneal so shouldn’t peirce peritoneum which is of stomach

A

In suprapubic cystotomy bladder is extra peritoneal so shouldn’t peirce peritoneum which is of stomach

82
Q

Sickle cell, diabetes, NSAID nephropathy, obstructive pyelonephritis cause what renal pathology?

A

Renal pap necrosis present in disease? Sickle cell, diabetes, NSAID nephropathy, obstructive pyelonephritis

83
Q

!Stones: struvite(aka staghorn calculus cause grows rapidly to fill renal calyces and pelvis ) -> _ +organsm so that _urine allow precipitate of MgAlPhos

A

Stones: struvite(aka staghorn calculus cause grows rapidly to fill renal calyces and pelvis ) -> urea + organsm so that alk urine allow precipitate of MgAlPhos

Staghorn calculi cause by UTI from urease + organisim(proteus and klebsiella)

Cal oxalate: hypercalceuria

84
Q

SIADH have _ hyponatremia

A

SIADH have euvolemia hyponatremia

85
Q

In emphysema diffusion capacity _?

A

In emphysema diffusion capacity decreased because loose alveoli Surface area

86
Q

Difference between minute and alveola ventilation?

A

Difference between minute and alveola ventilation? deadspace. Minute ventilation= Vtidal * RR Alvelar Ventilation = (Vtidal-Dead space)* RR

87
Q

Hyperaldosteronism present with _ due to aldosterone escape. Aldosterone escape?

A

Aldosterone escape? Hypokalemia & alkalosis but no hypernatremia and volume overload in hyperaldosterone

88
Q

Aspiration pneumonia vrs pulmonary pneumonia? /

A

Aspiration pneumonia vrs pulmonary pneumonia? Cellular/acelluar

89
Q

What maintains GFR after hypovolemia?

A

What maintains GFR after hypovolemia? Hypovol-> lo GRF->eff constrict -> in FF( in GFR relative to RPF)

90
Q

Why is supplemental O2 adminstration in person with COPD bad?

A

Why is supplemental O2 adminstration in person with COPD bad? Reverses hypoxic pulm vasoconstriction -> blood shunted from original well-ventilated alveoli -> v/Q mismatch( with more deadspace) inc blood CO2 (aka, oxygen induced hypercapnia)-> patient presents with confusion

91
Q

Chronic lung transplant rejection occurs at what anatormic part?

A

Chronic lung transplant rejection occurs at what anatormic part? small airways->bronchiolitis oblierans

92
Q

Unilateral renal stenois: 2 things happens to contralateral kidney and I to ispilate

A

Low bld flow to affected kidney-> hih renin->ang2-> hypertension.. so unaffected kidney feels hypertension (hyperplastic, hylination of arteries, nephrosclerosis) so decreases renal sodium absorption and affected kidney improves his GFR.

93
Q

Hypovolumia(ie diuretic) labs

_bun/creatine( 20:1) ration and _urine sodium

A

Hypovolumia(ie diuretic) labs

Hi bun/creatine( 20:1) ration and low urine sodium

94
Q

PRA(plasma renin activity = amount of Ag1 per unit time) _ prop to low na, antihypertensives

_ prop to sympathetic inhibitors

A

PRA(plasma renin activity = amount of Ag1 per unit time) direct/inverse prop to low na, antihypertensives/ sympathetic inhibitors

95
Q

RCC on histo:? produce hormones, EPO, PTrpt so may present with _ _, _ to lung, bone, liver

A

RCC on histo: clear or yellow cytoplasm, produce hormones, EPO, PTrpt so may present with polycethmia, hypercalcemia, metastise to lung, bone, liver

96
Q

Fatty/waxy & hyaline/ WBC =

A

Fatty/waxy & hyaline/ WBC = fatty nephrotic/TH protein nonspecific & degenerated hyaline CKD / interstitial nephritis

97
Q

Sacoidosis presents with _and _ granulomas on biopsy?

A

Sacoidosis presents with dyspnea and noncaseating granulomas on biopsy

98
Q

CKD: hi _ chelate ca-> low ca -> hi FBGR23( dec calcitriol production & intestinal ca absorption) & hi PTH

(alb( in setting of diabetes) only affects _( so total ca levels) not ionized ca levels)

A

CKD: hi phos chelate ca-> low ca -> hi FBGR23( dec calcitriol production & intestinal ca absorption) & hi PTH (alb( in setting of diabetes) only affects bound( so total ca levels) not ionized ca levels)

99
Q

Risk factors for adeno/sq cell carcionoma of eso: o_&_ &; nitroso/ alch

A

Risk factors for adeno/sq cell carcionoma of eso: obesicty & smoke & nitroso/ alch

100
Q

Small cell carcinomas express_markers since neuroendocrine

A

Small cell carcinomas express neural markers since neuroendocrine

101
Q

Ethylen glycol & methanol poisoning present with metabolic acidosis _ gap. Treated with fomepizole. Ethylen glycol/ methanol metabolite -> acute _ injury/ _

A

Ethylen glycol & methanol poisoning present with metabolic acidosis anion gap. Treated with fomepizole. Ethylen glycol/ methanol metabolite -> acute kidney injury/ blindness

102
Q

Abcess sputum? on CT looks like? Caused by so treat?

A

Abcess sputum? on CT looks like? Caused by so treat? Foul smelling and CT with air-fluid levels; Cause by anaerobes so clindamycin is best.

103
Q

14870 PCP pneumonia present in what immunodifficiency? Stain? Looks like?

A

14870 PCP pneumonia present in what immunodifficiency? Stain? Looks like? specifically cell-mediated immunity( ie HIV), silver

104
Q

HSP presents? Similar and difference with PSGN?

A

HSP presents? Similar and difference with PSGN? IgA hypersensitty vasculitis that leads abdominal pain, joint pain, purpura, hematuria (berger disease); HSP and PSG both after upper respiratory infection but HSP earlier.

105
Q

Sclc + female cancers(3) can cause neurologic disease?) via automune antibodies(?).

A

Sclc + female cancers(3) can cause neurologic disease?) via automune antibodies(?). Subacute cerebellar degeneration is a Neurologic Paraneoplastic syndrome? Etiology of neurologics are typically autoimmune. Sclc & female cancers(breast,oveary,uterine) produces anti yo, p/q and hu antibodies that cause SCD

106
Q

Mesothelimas presents as_ pleural _ ; On histo as _ cells with long, slender _i with abundant _filaments and +
_ &; _ stain

A

Mesothelimas presents as unilateral pleural thickening ; On histo as spindle cells with long, slender microvilli with abundant tonofilaments and + calretinin & cytokeratins stain

107
Q

Treat cyclo/ifosfamide hemorrhagic cystitis with? _ which binds toxic metabol _ (prophylaxix hydration, irrigation)

A

Treat cyclo/ifosfamide hemorrhagic cystitis with? mesna which binds toxic metabol arolein (prophylaxix hydration, irrigation)

108
Q

Uric acid preciptates under what conditions: _ environments of _ducts that why treat with _ and _

A

Uric acid preciptates under what conditions: acidic environments of distal & collecting ducts that why treat with alkalinization and hydration.

109
Q

lateral renal artery stenosis how affect other kidney if hypertensive?
.

A

lateral renal artery stenosis how affect other kidney if hypertensive?
if hypertensive: affected kidney protected from effect so well perfused shows changes of hypertensive nephropathy. Atrophied tubules appears crowded.

110
Q

_ and Cushing both cause hypertension + hypokal ? difference? What is aldosterone escape? Difference?

A

_ and Cushing both cause hypertension + hypokal ? difference? What is aldosterone escape?
Hyperaldosteronism(hypertension leads to reflexive in in GFR->NA excrete); cushings with weight gain.

111
Q

ATN clincal course for most? If assoc with multiorgan failure

A

ATN clincal course for most? If assoc with multiorgan failure
Initiation/ maintenance/ recovery: slight oligouria/ oligouria, & electrolyte abnormal/ reepithelization of tubules with transient polyuria & loss of electrolytes.; if assoc with multiorgan failure, may be permanent injury so may see scaring.

112
Q

IgA berger disease(1) vrs psgn nephropathies(2)?

A

IgA berger disease vrs psgn nephropathies?

days/ weeks after Upper respiratory infection = mesangial igA/ igG + C3

113
Q

What is chloride shift?

High Co2 in _ rbc -> CA changes to bicarb -> band _protein exchange of bicarb/cl out/into rbc cell-> co2 eliminated, cl inside cell.

A

What is chloride shift? High Co2 in venous rbc -> CA changes to bicarb -> band 3 protein exchange of bicarb/cl out/into rbc cell-> co2 eliminated, cl inside cell.

114
Q

Urothelia bladder cancer present? Gross hematuria(glomerular nephritis will be microscopic) in elderly Exposure? Rubber _, aromatic amine _, textile _, smoke

A

Urothelia bladder cancer present? Gross hematuria(glomerular nephritis will be microscopic) in elderly Exposure? Rubber plastic, aromatic amine dyes, textile leather, smoke

115
Q

1412CFTR is what type of mutation?_mutation changes DNA lenthg(hence RNA as well), (others do not but nonsense changes RNA lenght). What type of mutation changes DNA length(2):

A

1412CFTR is what type of mutation? Frameshift mutation changes DNA lenthg(hence RNA as well), (others do not but nonsense changes RNA lenght). What type of mutation changes DNA length(2): frameshift & TN repeates.

116
Q

I.Pulm fibrosis on CT? what happens to alveoli cells? vrs emphysema ?

A

I.Pulm fibrosis on CT? what happens to alveoli cells? honeycomb @ edges. Loss typ1, hyperplasia type 2(but not differentiate) emphysema losse both?

117
Q

Nephrotic syndrome induced RVT presents? Gross _ , new onset & f pain; Why happens? Nephrotic syndrome patients are (4)

A

Nephrotic syndrome induced RVT presents? Gross hematuria , new onset variocele & flank pain; Why happens? Nephrotic syndrome patients are hypercoagulable( + hi lipids, edema, infections) cause loose antithrombin( + lipases, alb, Ig)

118
Q

In CFTR why give pancreatic lipase?

A

In CFTR why give pancreatic lipase? Pancreatic insufficiency so can treat with pancreatic enzymes supplementation so no malabsorption and can gain weight.

119
Q

Influenza(what class of virus?) epidermic & pandemics cause by?

A

Influenza(what class of virus?) epidermic & pandemics cause by? Orthomyoxovirus. Antigenic shift aka Reasortment ( drift is HIV)

120
Q

In exercise what happens to T SVC? Why?

A

In exercise what happens to T SVC? Why? Although sympathetic, Dec because of muscle vessels vasodilation

121
Q

Lupus associated with what kidney syndromes? (2) DP and Membrano nephro which are nephritic/nephrotic presents? Wire-loop depoits/ spike and dorm subepi. !!!!

A

Lupus associated with what kidney syndromes? DP and Membrano prolif which are nephritic/nephrotic presents? Wire-loop deposits/ spike and dorm gbm. !!!!

122
Q

Kidney stones present with RBC _ ? RBC cast/ cells from kidney?

A

Kidney stones present with RBC _ ? RBC cast/ cells from kidney( ie glomerulonephritis)/disruption of ureteral epithemlum( Kidney stones)

123
Q 
acid base
compensation:  metabol acidosis/alk(inc) =1.5(bicarb) + 8/ .7(per bicarb)
resp acid(inc)/alk(dec) = 1(per 10 paco2) -> 4( per 10 pco2)/  2(per 10 paco2) ->5 (per 10 pco2)
A 
acid base
compensation:  metabol acidosis/alk(inc) =1.5(bicarb) + 8/ .7(per bicarb)
resp acid(inc)/alk(dec) = 1(per 10 paco2) -> 4( per 10 pco2)/  2(per 10 paco2) ->5 (per 10 pco2)
124
Q

Uric acid kidney stones precipitate in _ environment

A

Uric acid kidney stones precipitate in _ environment

Acidic

125
Q

Dexamethasone suppression test
Low dose is for _( if does not suppress means _)
hi dose = + for _

A

Dexamethasone suppression test
Low does for screnning if does not supress means acth problem
hi dose = -/+ for CRH induced cushings

126
Q 
lobar bacterial(2) pnuemonia is _
broncopnue(5)
intersitial(6 via pop)
A

. lobar bacterial(SK) pnuemonia is neutophilic
broncopnue(SHMPL)
intersitial(youngs(clam & myoplasma), child(RSV), transplant(CMV), elderly(flu), famer(Q))

127
Q

Goodpasture vrs We”C”ner granulomatosis? _ANCA is against neutrophils proteinase 3.

A

Goodpasture vrs We”C”ner granulomatosis= lower only vrs low + upper respiratory tract. cANCA is against neutrophils proteinase 3.

128
Q

Lupus(RASH or PAIN) vrs RA: ?)

A

Lupus(RASH or PAIN) vrs RA: rash vrs joint swelling(aka pannus)

129
Q

lupus is _complementemia

A

lupus is hypocomplementemia

130
Q

_syndrome is is anti-centromere antibody.

A

CREST syndrome is is anti-centromere antibody.

131
Q

Bleeding problem during CKD: U

A

A

Bleeding problem during CKD: Uremia leads to a QUALITATIVe platelet disfunction so normal platelet count

Asem (9 decks)

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