RESPIRATORY: 602 - 603 Flashcards

1
Q

Describe the pathophysiology of rhinosinusitis.

A

Obstruction of sinus drainage into the nasal cavity leads to inflammation and pain over the affected area

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2
Q

Which sinus is most commonly affected in rhinosinusitis in adults?

A

Maxillary

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3
Q

What is the most common acute cause of rhinosinusitis?

A

Viral URI (in particular adenovirus)

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4
Q

What can often be superimposed on top of rhinosinusitis?

A

Bacterial infection

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5
Q

What are common bacteria that cause a superimposed infection on rhinosinusitis?

A

S. pneumoniae, H. influenzae, M. catarrhalis

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6
Q

What type of hypersensitivity reaction is allergic rhinitis?

A

Type I

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7
Q

What are two associations with allergic rhinitis?

A

Asthma and eczema

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8
Q

What do you see histologically with allergic rhinitis?

A

Inflammatory infiltrate with eosinophils

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9
Q

What is Virchow’s triad for deep venous thrombosis?

A
  1. Stasis
  2. Hypercoagulability (e.g. defect in coagulation cascade proteins)
  3. Endothelial damage (exposed collagen triggers clotting cascade)
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10
Q

What is the most common defect in coagulation cascade proteins?

A

Factor V Leiden

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11
Q

Where do 95% of pulmonary emboli arise from?

A

Deep leg veins

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12
Q

What is Homan sign and what does it check for?

A

Checks for DVT

When dorsiflexion of the foot causes calf pain

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13
Q

What medication can you give to prevent DVT/for acute management?

A

Heparin

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14
Q

What medication can you give for long-term prevention of DVT recurrence?

A

Warfarin

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15
Q

What are the different types of emboli?

A

Mnemonic: FAT BAT

Fat
Air
Thrombus
Bacteria
Amniotic
Tumor
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16
Q

How does a pulmonary embolus present?

A

Sudden-onset dyspnea, chest pain, tachypnea

May also present as sudden death

17
Q

How does pulmonary emboli lead to respiratory alkalosis?

A

Pulmonary emboli –> V/Q mismatch –> hypoxemia –> respiratory alkalosis

18
Q

What are fat emboli often associated with?

A

Long bone fractures and liposuction

19
Q

What is the classic triad of fat emboli?

A

Hypoxemia, neurologic abnormalities, petechial rash

20
Q

What is a major complication of amniotic fluid emboli?

A

DIC - especially postpartum

21
Q

When do gas emboli originate?

A

Nitrogen bubbles precipitate in ascending divers

22
Q

How do you treat gas emboli?

A

Hyperbaric oxygen

23
Q

What is the ideal imaging test to check for pulmonary emboli?

A

CT pulmonary angiography - look for filling defects