Respiratory Flashcards
What are the symptoms of a tension pneumothorax?
low bp, fast pulse, respiratory effort, hypoxia, hyperresonance to percussion, and absence of breath sounds
What inhibits neutrophil elastase?macrophage?
serum alpha1 antitrypsin
tissue inhibitors of metalloproteinases
What are the primary cell lines in stable COPD?
Neutrophil, macrophages, and CD8+ T cells- These cells release proteases that damage lung tissue and have impaired phagocytic activity
Where does S. Aureus colonize?
Anterior Nares
Describe the symptoms seen with SCID
SCID encompasses many mutations that lead to T and B cell deficiencies, leading to severe viral and bacterial infections, candidiasis, persistent diarrhea, failure to thrive, and thymic aplasia
Describe CVID
hypogammaglobulinemia with B and T cell dysfunction that is not as severe as SCID
What is the histopathology of Mesothelioma?
Nodular or smooth plerual thickening and pleural effusions
Abundant tonofilaments and long, slender microvilli
What is the most common cause of croup?
parainfluenza virus
Where in the respiratory tree is airway resistance greatest?
In the medium sized bronchi (generations 2-5)
How can you differentiate between MAC and M TB?
MAC grows well at 41 C
What is deficient in CGD? How is it tested?
Deficiency in NADPH Oxidase
Tested by dihydrorhodamine flow cytometry and nitroblue tetrazolium test
What is the treatment for oral thrush in an immunocompetent patient?
Nystatin, a topical antifungal
What are the labs in Allergic bronchopulmonary aspergillus (fumigatus)?
Hypersensitivity reaction- high IgE, eosinophilia, and IgE + IgG antibodies to aspergillus. Reccurent can lead to transient pulm infiltrates and proximal bronchiectasis
What is the formula for distending pressure?
P=2T/r
What is the respiratory issue associated with pancreatitis?
ARDS
What is the role of eosinophils against parasites?
antibody-dependent cell-mediated toxicity
IL-5 from mast cells or Th2 causes eosinophils to proliferate
Symptoms associated with obstructive sleep apnea
Morning headaches, daytime sleepiness, obesity, high blood pressure. Can lead to PAH and right heart failure
What does M. Pneumo need to grow?
cholesterol
What pathogen likes to invade old lung cavities?
Aspergillus fumigatus- forms aspergilloma, a radiopaque structure that shifts when the patient changes position
What are the symptoms of lingual thyroid?
dysphagia, dysphonia, dyspnea
What is the mechanism of action of Cromoglycates?
Inhibit mast cell degranulation
What is the mechanism of action of Montelukast/Zafirlukast?
Leukotriene D4 receptor antagonist
What is the MOA of Zileuton?
Lipoxygenase inhibitor
What is the MOA of Omalizumab
Antibody to IgE Fc portion
What does carbolfuchsin stain for?
Acid-fast stain for mycolic acid in nocardia and mycobacteria
What neuroendocrine markers can be positive in small cell carcinoma?
neuron-specific enolase, chromogranin, and synaptophysin
What causes the CFTR channel to open?
binding of 2 ATP
Which catalase positive organisms most commonly cause infection in patients with CGD?
S. Aureus, Burkholder Cepacia, Serratia Marsescen, Nocardia, Aspergillus (BANASS)
What causes oxygen induced hypercapnea?
- Hyperoxia (to high oxygen content) reverses vasoconstriction and increases dead space
- Increased arterial O2 leads to decreased Hgb affinity for CO2–> CO2 offloading and increased serum levels
- High flow O2 leads to decreased chemoreceptor signaling–> decrease respiratory rate and minute ventilation
What is the hallmark of asbestos exposure on chest imaging?
pleural thickening with calcifications (especially between the 6th and 9th ribs. (calcified lesions, pleural plaques)
What part of the lung is most affected by chronic lung transplant rejection?
The small airways–> bronchiolitis obliterans- inflammation and fibrosis of the bronchiolar walls leads to narrowing and obstruction of the bronchioli.
What is the clinical triad of fat embolism syndrome?
neurological abnormalities, petechial rash, and hypoxia
What keeps gram positive organisms from being destroyed by variations in tonicity?
peptidoglycan wall
What are the symptoms of selective IgA deficiency?
Airway and Gi infections, Autoimmune disease, Atopy, Anaphylaxis to blood transfusions
What are the symptoms of superior vena cava syndrome?
dyspnea, cough, and swelling of the face, neck, and UE. Dilated collateral veins may be seen in upper torso. Lung cancer, non-hodgkin lymphoma
What is the major virulence factor for H Flu?
The capsule, which is composed of the polymer polyribosylribitol phosphate- binds factor H and prevents phagocytosis and complement mediated lysis
