respiratory Flashcards
alpha 1 antitrypsin deficiency is due to
mutation of Pi gene on chromosome 14
exposure to asbestos fibers causes which one of the following X ray findings?
A. pleural blebs
B. Diffuse interstitial pulmonary fibrosis w/ irregular or linear opacities at the bases of the lungs
B
pt hx of working in shipyards or manufacturing insulation
this is pathognomoic for exposure to?
asbestos
pt has hx silicosis exposure and has silicotic nodules of varying sizes scattered throughout the lungs
now presents with FEVER.
what should you do?
PPD test for TB
TX if + = isonizid
if pt has negative sputum culture and negative chest xray then give isonizid for 9 months.
construction
stone masonry
mining
sandblasting
**ceramics
all increase risk of
silicosis
usual interstitial pneumonia
is also called?
idiopathic pulmonary fibrosis
its the most common and lethal usual interstitial pneumonia
- dypnea, cough,
no hx of infection, drugs or occupational exposure
coarse crackles and rales
whats the pathology of restrictive lung disease caused by
sarcoidosis
exaggerated immune response w/ accumulation of lymphocytes and macrophages
on the boards
breath sounds –> bronchial
percussion note –> dull
tactile fremitus –> increased
diagnosis?
lobar pneumonia
on boards
pt with typical pneumonia
in the right lower lobe.
now complaining of shoulder pain with coughing
what is the cause of these symptoms
pneumonia involving the diaphragmatic pleura
tx of streptococcus pnenumonia
doxycycline,
or
azithromycin
or
clarithromycin
if pt has typical pneumonia caused by streptococcus pneumoniae
and has a comorbidity
how do you tx
admit (inpatient
levofloxacin IV
or
ceftriaxone + azithromycin
pneumonia caused by legionella pneumophila
is diagnosed by
urinary antgen (radioimmunoassay)
aspiration of endogenous oropharyngeal flora polymorphic gram + organism
aspriation pneumonia
a pt with a clenched fist injury
(pt hit someone else in the mouth)
what microbe could be infected his hand
peptostreptococcus
pneumonia clues for the boards
nursing home
klebsiella
pneumonia clues for the boards
COPD pt
moraxella
or
H influ
pneumonia clues for the boards
cattle, sheep, farmer
Q fever
pneumonia clues for the boards
Birds
C. Psittacosis
pneumonia clues for the boards
hunter
tularemia
pneumonia clues for the boards
bat caves in mississippi, ohio river valleys
histoplasmosis
pneumonia clues for the boards
California, arizona
Coccidiomycosis
(sarcoid like)*
pneumonia clues for the boards
Chicago
(bone lesions)
blastomycosis
pneumonia clues for the boards
Homosexual
P jiroveci P
pneumonia clues for the boards
headache, diarrhea, and delirium confusion
legionella
(water cocolers, CXR worse
pneumonia clues for the boards
acute infection with HIV results in Reactivation of what latent infection
TB
on boards
what do these presentations represent?
pt with severe injury to the chest wall or illegal abortion in underserved area. that now has emboli
air embolism
due to bubbling of air into the circulation
pts with hereditary pulmonary htn with
mutations of bone morphogenetic protein receptor type II (BMPR-II)
what is the cause of the pulm htn
BMPR-II function to inhibit proliferation of vascular smooth muscle tissue doesnt work anymore
bronchoalveolar carcinoma
arises from
clara cells
how does large cell carcinoma of the lung cause
gynecomastia
excessive secretion no B - HCG –> high levels of estrogen and painful gynecomastia (breast enlargement) in males
pt long hx of smoking, pt in ER brought by family bc he is confused
his Na is 118. (normal 140)
whats the cause
SIADH –> hyponatremia –> confusion
(hes not losing Na - remember Na level on the electrolyte panel is not telling you about the Na in body but its telling you about how much water is in body. if high Na = pt dehydrated, if na is low = overhydrated)
in small cell carcinoma.
on boards
ataxia in pt with long hx of smoking
what is your diagnosis
small cell carcinoma
(paraneoplastic syndrome)
causing cerebellar (purkinje cell) degeneration/ subacute cerebeller degeneration due to autoimmune.
