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)
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)
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
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
- 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
5
Q
viridans produce _for virulence
A
viridans produce dextrans for virulence
6
Q
PAh lowest in what part of nephron? Why?
A
PAh lowest in? Why? PAH is primarily secreted by prox tubule
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
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.
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.
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
11
Q
Greateast risk after asbestosis exoposure is ?
A
Greateast risk after asbestosis exoposure is ? bronchogenic greater than mesothelioma
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
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
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)
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
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
17
Q
Cadiac muscle uses _ not camouldulin?
A
Cadiac muscle uses troponin?? Not camouldulin?
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.
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?
20
Q
FEV1 physiologically _ with age( smoking _rate of decline)
A
FEV1 physiologically declines with age( smoking increases rate of decline)
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
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
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.
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
25
ARDS on chest x-ray? causes(4)? Refractory to what? What happens to capillary wedge pressure and why?
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
26
Obstructive lung collapse on X-ray vrs Tension pneumothorax ? Deviate?
2116Obstructive lung collapse on X-ray vrs Tension pneumothorax ? Deviate? Unilateral pulmonary opacification of affected side + deviation of trachea toward vrs away from opacification
27
Pulmonary edema/fibrosis/ARDS on X-ray? -
Pulmonary edema/fibrosis/ARDS on X-ray? - bilateral flufflly/ instertitial linging/ white out
28
central obesity is a _ lung disease
central obesity is a restrictive lung disease
29
CFTR mutation? What electrolyte imbalance? Why supplement with salt in CFTR?
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
30
Exudative vrs transudative? lights criteria?
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
31
Pulmonary exam findings for consolidation, pleural effusion, pneumothorax and atelectasis?
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)
32
Thebesian veins drain _( so lA with _ po2 than pulm veins)
Thebesian veins drain lungs( so lA with less po2 than pulm veins)
33
Haldane/ bohr effect =
Haldane/ bohr effect = release CO2, Hi bind O2 /release O2 bind bicarb + h+ in lungs/tissue
34
aspiration: supine/upright =
aspiration: supine/upright =posterior UL & superior LL/ basilar segments
35
Ureaplasma urelyticum is a _ genus
Ureaplasma urelyticum is a myocoplasma genus
36
cold agglutinations?
cold agglutinations: infectious mono ?
37
sleep apnea: _ problem so what nerve?
sleep apnea: pharynx not larynx problem so hypoglossal
38
intrapleural pressures are negative!
intrapleural pressures are negative!
39
6 dimorphic: mold(hypehea) vrs yeast(single cells)
5 dimorphic: mold(hypehea) vrs yeast(single cells)
| Histo, cocidio, blasto, sponthrix, paracocidio, candida
40
Insterstitual lung disease:_elastic recoil( pull of surrounding tisue on bronchiols) -> relative _ expiratory flow rate but _ lung volumes
Insterstitual lung disease: increaed elastic recoil( pull of surrounding tisue on bronchiols) -> relative inc expiratory flow rate but decreased lung volumes
41
panic, altitide -> _ -> hypocapnia -> _ cerebral perfusion-> altitude sickness symtoms
@ altitude hypoxemia _(O2 _ nomalzed)
@ PE acute->chronic = no metabol compenzation until _hrs later
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
42
asthma/copd exacerbations= _/infections( mostly viral(3); 3 bac)
asthma/copd exacerbations= allergy/infections( mostly viral: rhino ¶influ, influenza; strep pnue, Moraxella, h.influ)
43
Astham or CF history -> _ with eosinophils ->bronchiectasis
Astham or CF history -> ABPA with eosinophils ->bronchiectasis
44
Legionella : pulmonary + _ diarrhea in ciggar smoking old men with _natremia
Legionella : pulmonary + watery diarrhea in ciggar smoking old men with hyponatremia
45
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
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;
46
Pthr.p or PTH which by malignancy
Pthr.p not pth secreted by malignancy
47
Juxtaglomerular aparatus is 3 cells? What cells release renin?
```
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
```
48
Incontinence urge/overflow/ stress? treat?
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
49
Treat urge incontinence?
antimuscarinic
50
aut dorm/recess = present _/ _ in life= parent _/_ = _/_ defect
aut dorm/recess = present later/ early in life= parent show/does not show = cytoskeletal/enzyme defect
51
Which renal carcinoma is most common? where in kidney? On gross?
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/
52
Vesicoureteral reflux affects kidneys how?
Vesicoureteral reflux affects kidneys how? Chronic pyelonephritis with with dilated calyces in upper& lower poles of kidney….Vrs multicystic dysplastic kidney is nonhereditary
53
Interstial nephitis vrs glomerular nephritis vrs nephrotic syndrome: wbc(eosinophile)/ blood/ protein?
Interstial nephitis vrs glomerular nephritis vrs nephrotic syndrome: wbc(eosinophile)/ blood/ protein?
54
Risk factors for rhabdomyolysis? What kidney injury? If myoglobin urine dipstick shows?
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
Most common cause of urinary distension-suprapublic fullness?
Most common cause of urinary distension-suprapublic fullness? Obstruction(PBH) especially if older man
56
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 _
2131Nephrotic syndrome:
membraneous nephropathy has IgG4 antibodies against PLA2R
c3
Nephritic syndrome
C1/fibrin/Ige deposits/basketweave = MPGN/ RPGN/lupus neprhtitis /alport
57
ach/sympathetics
ach/sympathetics
58
Glucose is _filtered then _ so if block reabsorption it’s clearance resembleds _.
Glucose is freely filtered then reabsorbed so if block reabsorption it’s clearance resembleds inulin.
59
acidosis stimulates renal ammoniagenesis: _->glucose releasing ammonium + bicarb
2. acidosis stimulates renal ammoniagenesis: glutamine->glucose releasing ammonium + bicarb
60
alanin cycle: ala->pyruvate
| lactic acid cycle:
alanin cycle: ala->pyruvate
| lactic acid cycle:
61
acids secreted as_ +_
acids secreted as NH4 + inorganic phospahte
62
Inulin & creatinie/ PAH=
Inulin & creatinie/ PAH= filter & both / sec = GFR/PRF
63
In renal transplantation can have distal ureteral ischemia due to lack of _( of _and_ arteries)
4. In renal transplantation can have distal ureteral ischemia due to lack of anastomosis( of renal and superior vesical arteries)
64
Vessicouretral reflux/ posterior urethral valves( mebrane @ junction of blad & ureter) & UP junction = _/obstructive( bilate & unilate) causes of _
5. Vessicouretral reflux/ posterior urethral valves( mebrane @ junction of blad & ureter) & UP junction = non/obstructive( bilate & unilate) causes of hydronephrosis
65
```
.
Transplant rejection(all ischemic of bld vessels) hyperacute/acute/chronic=
```
```
.
Transplant rejection(all ischemic of bld vessels) hyperacute/acute/chronic= fibrinoid necrosis + neutros/ fibrous thick + mononuclear cells/ intersitial fibrosis + atrophy
```
66
DCT has _ osmolarity
DCT has lowest osmolarity
67
Potters sequence is from _ anomaly(R)->oligohydro(O)->PTT
. Potters sequence is from renal anomaly(R)->oligohydro(O)->PTT
68
Enterococci: gram pot cocci in chains, y-hemolytic( -> _ hemolysis)
Enterococci: gram pot cocci in chains, y-hemolytic( -> no hemolysis)
G+ -> staph/strep = calase +/- = a/b/y hemolysis
69
GFR/RPF = GFR/ RBF(1-hct) is for what
FF = GFR/RPF = GFR/ RBF(1-hct)
| excretion rates = filteration +sec -reabsorbed rate
70
ureter ant to all except 2
| water flows over illacs and under the bridge
ureter ant to all except uterine/vas artery + gonadal vesssels + renal vessels
(water flows over illacs and under the bridge)
71
Most water(all?) absorption in _
Most water(all?) absorption in PT
72
ADH/Ald @ _/_ collecting duct because medula is _ osmolarity
ADH/Ald @ low/hi collecting duct because medula is higher osmolarity
73
ADH also absorbes urea why?
ADH also absorbes urea-> hi med osmolarity-> higher water absorption
74
RET is only _ mutation.
RET is only activating mutation.
| VHL?
75
!transfusion reactions( acute=chest & back pain) vrs transplant reactions
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
!hypersensitivity reactions(anphylaxis vrs allerrgy)
hypersensitivity reactions(anphylaxis vrs allerrgy)
77
Airway resistance graph? resistance varies _with total cross-sectional area.
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
Problem with transplanted kidney consider ?
Calcineurin inhibitors (CT)
```
Problem with transplanted kidney consider rejection:
Calcineurin inhibitors (cyclosporine, tacrolimus) reduce renal blood
```
79
ATN: _ cast ; due to_( overexertion-> myalgia, weakness, dark urine)
ATN stages: 3
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
Total oxygen content determined by =3
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
In suprapubic cystotomy bladder is_ peritoneal so shouldn’t peirce peritoneum which is of stomach
In suprapubic cystotomy bladder is extra peritoneal so shouldn’t peirce peritoneum which is of stomach
82
Sickle cell, diabetes, NSAID nephropathy, obstructive pyelonephritis cause what renal pathology?
Renal pap necrosis present in disease? Sickle cell, diabetes, NSAID nephropathy, obstructive pyelonephritis
83
!Stones: struvite(aka staghorn calculus cause grows rapidly to fill renal calyces and pelvis ) -> _ +organsm so that _urine allow precipitate of MgAlPhos
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
SIADH have _ hyponatremia
SIADH have euvolemia hyponatremia
85
In emphysema diffusion capacity _?
In emphysema diffusion capacity decreased because loose alveoli Surface area
86
Difference between minute and alveola ventilation?
Difference between minute and alveola ventilation? deadspace. Minute ventilation= Vtidal * RR Alvelar Ventilation = (Vtidal-Dead space)* RR
87
Hyperaldosteronism present with _ due to aldosterone escape. Aldosterone escape?
Aldosterone escape? Hypokalemia & alkalosis but no hypernatremia and volume overload in hyperaldosterone
88
Aspiration pneumonia vrs pulmonary pneumonia? _/_
Aspiration pneumonia vrs pulmonary pneumonia? Cellular/acelluar
89
What maintains GFR after hypovolemia?
What maintains GFR after hypovolemia? Hypovol-> lo GRF->eff constrict -> in FF( in GFR relative to RPF)
90
Why is supplemental O2 adminstration in person with COPD bad?
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
Chronic lung transplant rejection occurs at what anatormic part?
Chronic lung transplant rejection occurs at what anatormic part? small airways->bronchiolitis oblierans
92
Unilateral renal stenois: 2 things happens to contralateral kidney and I to ispilate
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
Hypovolumia(ie diuretic) labs
| _bun/creatine( 20:1) ration and _urine sodium
Hypovolumia(ie diuretic) labs
| Hi bun/creatine( 20:1) ration and low urine sodium
94
PRA(plasma renin activity = amount of Ag1 per unit time) _ prop to low na, antihypertensives
_ prop to sympathetic inhibitors
PRA(plasma renin activity = amount of Ag1 per unit time) direct/inverse prop to low na, antihypertensives/ sympathetic inhibitors
95
RCC on histo:? produce hormones, EPO, PTrpt so may present with _ _, _ to lung, bone, liver
RCC on histo: clear or yellow cytoplasm, produce hormones, EPO, PTrpt so may present with polycethmia, hypercalcemia, metastise to lung, bone, liver
96
Fatty/waxy & hyaline/ WBC =
Fatty/waxy & hyaline/ WBC = fatty nephrotic/TH protein nonspecific & degenerated hyaline CKD / interstitial nephritis
97
Sacoidosis presents with _and _ granulomas on biopsy?
Sacoidosis presents with dyspnea and noncaseating granulomas on biopsy
98
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)
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
Risk factors for adeno/sq cell carcionoma of eso: o_&_ &; nitroso/ alch
Risk factors for adeno/sq cell carcionoma of eso: obesicty & smoke & nitroso/ alch
100
Small cell carcinomas express_markers since neuroendocrine
Small cell carcinomas express neural markers since neuroendocrine
101
Ethylen glycol & methanol poisoning present with metabolic acidosis _ gap. Treated with fomepizole. Ethylen glycol/ methanol metabolite -> acute _ injury/ _
Ethylen glycol & methanol poisoning present with metabolic acidosis anion gap. Treated with fomepizole. Ethylen glycol/ methanol metabolite -> acute kidney injury/ blindness
102
Abcess sputum? on CT looks like? Caused by so treat?
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
14870 PCP pneumonia present in what immunodifficiency? Stain? Looks like?
14870 PCP pneumonia present in what immunodifficiency? Stain? Looks like? specifically cell-mediated immunity( ie HIV), silver
104
HSP presents? Similar and difference with PSGN?
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
Sclc + female cancers(3) can cause neurologic disease?) via automune antibodies(?).
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
Mesothelimas presents as_ pleural _ ; On histo as _ cells with long, slender _i with abundant _filaments and +
_ &; _ stain
Mesothelimas presents as unilateral pleural thickening ; On histo as spindle cells with long, slender microvilli with abundant tonofilaments and + calretinin & cytokeratins stain
107
Treat cyclo/ifosfamide hemorrhagic cystitis with? _ which binds toxic metabol _ (prophylaxix hydration, irrigation)
Treat cyclo/ifosfamide hemorrhagic cystitis with? mesna which binds toxic metabol arolein (prophylaxix hydration, irrigation)
108
Uric acid preciptates under what conditions: _ environments of _ducts that why treat with _ and _
Uric acid preciptates under what conditions: acidic environments of distal & collecting ducts that why treat with alkalinization and hydration.
109
lateral renal artery stenosis how affect other kidney if hypertensive?
.
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
_ and Cushing both cause hypertension + hypokal ? difference? What is aldosterone escape? Difference?
_ 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
ATN clincal course for most? If assoc with multiorgan failure
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
IgA berger disease(1) vrs psgn nephropathies(2)?
IgA berger disease vrs psgn nephropathies?
| days/ weeks after Upper respiratory infection = mesangial igA/ igG + C3
113
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.
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
Urothelia bladder cancer present? Gross hematuria(glomerular nephritis will be microscopic) in elderly Exposure? Rubber _, aromatic amine _, textile _, smoke
Urothelia bladder cancer present? Gross hematuria(glomerular nephritis will be microscopic) in elderly Exposure? Rubber plastic, aromatic amine dyes, textile leather, smoke
115
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):
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
I.Pulm fibrosis on CT? what happens to alveoli cells? vrs emphysema ?
I.Pulm fibrosis on CT? what happens to alveoli cells? honeycomb @ edges. Loss typ1, hyperplasia type 2(but not differentiate) emphysema losse both?
117
Nephrotic syndrome induced RVT presents? Gross _ , new onset _& f_ pain; Why happens? Nephrotic syndrome patients are (4)
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
In CFTR why give pancreatic lipase?
In CFTR why give pancreatic lipase? Pancreatic insufficiency so can treat with pancreatic enzymes supplementation so no malabsorption and can gain weight.
119
Influenza(what class of virus?) epidermic & pandemics cause by?
Influenza(what class of virus?) epidermic & pandemics cause by? Orthomyoxovirus. Antigenic shift aka Reasortment ( drift is HIV)
120
In exercise what happens to T SVC? Why?
In exercise what happens to T SVC? Why? Although sympathetic, Dec because of muscle vessels vasodilation
121
Lupus associated with what kidney syndromes? (2) DP and Membrano nephro which are nephritic/nephrotic presents? Wire-loop depoits/ spike and dorm subepi. !!!!
Lupus associated with what kidney syndromes? DP and Membrano prolif which are nephritic/nephrotic presents? Wire-loop deposits/ spike and dorm gbm. !!!!
122
Kidney stones present with RBC _ ? RBC cast/ cells from kidney?
Kidney stones present with RBC _ ? RBC cast/ cells from kidney( ie glomerulonephritis)/disruption of ureteral epithemlum( Kidney stones)
123
```
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)
```
```
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
Uric acid kidney stones precipitate in _ environment
Uric acid kidney stones precipitate in _ environment
| Acidic
125
Dexamethasone suppression test
Low dose is for _( if does not suppress means _)
hi dose = + for _
Dexamethasone suppression test
Low does for screnning if does not supress means acth problem
hi dose = -/+ for CRH induced cushings
126
```
lobar bacterial(2) pnuemonia is _
broncopnue(5)
intersitial(6 via pop)
```
. lobar bacterial(SK) pnuemonia is neutophilic
broncopnue(SHMPL)
intersitial(youngs(clam & myoplasma), child(RSV), transplant(CMV), elderly(flu), famer(Q))
127
Goodpasture vrs We”C”ner granulomatosis? _ANCA is against neutrophils proteinase 3.
Goodpasture vrs We”C”ner granulomatosis= lower only vrs low + upper respiratory tract. cANCA is against neutrophils proteinase 3.
128
Lupus(RASH or PAIN) vrs RA: ?)
Lupus(RASH or PAIN) vrs RA: rash vrs joint swelling(aka pannus)
129
lupus is _complementemia
lupus is hypocomplementemia
130
_syndrome is is anti-centromere antibody.
CREST syndrome is is anti-centromere antibody.
131
Bleeding problem during CKD: U
A
| Bleeding problem during CKD: Uremia leads to a QUALITATIVe platelet disfunction so normal platelet count
