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UWORLD > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What are the symptoms of a tension pneumothorax?

A

low bp, fast pulse, respiratory effort, hypoxia, hyperresonance to percussion, and absence of breath sounds

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2
Q

What inhibits neutrophil elastase?macrophage?

A

serum alpha1 antitrypsin

tissue inhibitors of metalloproteinases

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3
Q

What are the primary cell lines in stable COPD?

A

Neutrophil, macrophages, and CD8+ T cells- These cells release proteases that damage lung tissue and have impaired phagocytic activity

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4
Q

Where does S. Aureus colonize?

A

Anterior Nares

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5
Q

Describe the symptoms seen with SCID

A

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

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6
Q

Describe CVID

A

hypogammaglobulinemia with B and T cell dysfunction that is not as severe as SCID

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7
Q

What is the histopathology of Mesothelioma?

A

Nodular or smooth plerual thickening and pleural effusions

Abundant tonofilaments and long, slender microvilli

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8
Q

What is the most common cause of croup?

A

parainfluenza virus

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9
Q

Where in the respiratory tree is airway resistance greatest?

A

In the medium sized bronchi (generations 2-5)

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10
Q

How can you differentiate between MAC and M TB?

A

MAC grows well at 41 C

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11
Q

What is deficient in CGD? How is it tested?

A

Deficiency in NADPH Oxidase

Tested by dihydrorhodamine flow cytometry and nitroblue tetrazolium test

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12
Q

What is the treatment for oral thrush in an immunocompetent patient?

A

Nystatin, a topical antifungal

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13
Q

What are the labs in Allergic bronchopulmonary aspergillus (fumigatus)?

A

Hypersensitivity reaction- high IgE, eosinophilia, and IgE + IgG antibodies to aspergillus. Reccurent can lead to transient pulm infiltrates and proximal bronchiectasis

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14
Q

What is the formula for distending pressure?

A

P=2T/r

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15
Q

What is the respiratory issue associated with pancreatitis?

A

ARDS

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16
Q

What is the role of eosinophils against parasites?

A

antibody-dependent cell-mediated toxicity

IL-5 from mast cells or Th2 causes eosinophils to proliferate

17
Q

Symptoms associated with obstructive sleep apnea

A

Morning headaches, daytime sleepiness, obesity, high blood pressure. Can lead to PAH and right heart failure

18
Q

What does M. Pneumo need to grow?

A

cholesterol

19
Q

What pathogen likes to invade old lung cavities?

A

Aspergillus fumigatus- forms aspergilloma, a radiopaque structure that shifts when the patient changes position

20
Q

What are the symptoms of lingual thyroid?

A

dysphagia, dysphonia, dyspnea

21
Q

What is the mechanism of action of Cromoglycates?

A

Inhibit mast cell degranulation

22
Q

What is the mechanism of action of Montelukast/Zafirlukast?

A

Leukotriene D4 receptor antagonist

23
Q

What is the MOA of Zileuton?

A

Lipoxygenase inhibitor

24
Q

What is the MOA of Omalizumab

A

Antibody to IgE Fc portion

25
Q

What does carbolfuchsin stain for?

A

Acid-fast stain for mycolic acid in nocardia and mycobacteria

26
Q

What neuroendocrine markers can be positive in small cell carcinoma?

A

neuron-specific enolase, chromogranin, and synaptophysin

27
Q

What causes the CFTR channel to open?

A

binding of 2 ATP

28
Q

Which catalase positive organisms most commonly cause infection in patients with CGD?

A

S. Aureus, Burkholder Cepacia, Serratia Marsescen, Nocardia, Aspergillus (BANASS)

29
Q

What causes oxygen induced hypercapnea?

A
  1. Hyperoxia (to high oxygen content) reverses vasoconstriction and increases dead space
  2. Increased arterial O2 leads to decreased Hgb affinity for CO2–> CO2 offloading and increased serum levels
  3. High flow O2 leads to decreased chemoreceptor signaling–> decrease respiratory rate and minute ventilation
30
Q

What is the hallmark of asbestos exposure on chest imaging?

A

pleural thickening with calcifications (especially between the 6th and 9th ribs. (calcified lesions, pleural plaques)

31
Q

What part of the lung is most affected by chronic lung transplant rejection?

A

The small airways–> bronchiolitis obliterans- inflammation and fibrosis of the bronchiolar walls leads to narrowing and obstruction of the bronchioli.

32
Q

What is the clinical triad of fat embolism syndrome?

A

neurological abnormalities, petechial rash, and hypoxia

33
Q

What keeps gram positive organisms from being destroyed by variations in tonicity?

A

peptidoglycan wall

34
Q

What are the symptoms of selective IgA deficiency?

A

Airway and Gi infections, Autoimmune disease, Atopy, Anaphylaxis to blood transfusions

35
Q

What are the symptoms of superior vena cava syndrome?

A

dyspnea, cough, and swelling of the face, neck, and UE. Dilated collateral veins may be seen in upper torso. Lung cancer, non-hodgkin lymphoma

36
Q

What is the major virulence factor for H Flu?

A

The capsule, which is composed of the polymer polyribosylribitol phosphate- binds factor H and prevents phagocytosis and complement mediated lysis

UWORLD (9 decks)

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