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Clinical Medicine LAB - Professor Sample > Respiratory Exam 4 > Flashcards

Respiratory Exam 4 Flashcards

1
Q

preferred study for PE and pulmonary nodules

A

Spiral (Helical ) CT

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2
Q

Iv contrat for?

A

vasculature

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3
Q

oral contrast for?

A

GI or esophageal

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4
Q

how long is the dye allergic reaction delayed?

A

2-6 hrs

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5
Q

Air Bronchograms

A

bronchi become visible due to increased opacity of surrounding lung

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6
Q

Bronchiectasis CT finding?

A

abnormal dilation of bronchial tree

lack of tapering of the bronchi

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7
Q

PE CT finding?

A

90 % sensitive for PE

well defined hypotenuse area in the pulmonary artery

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8
Q

GG opacities CT finding?

A

lower density opacities rather than thick opacities

low density lung opacity not sufficient to obscure pulm. vessels

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9
Q

Permanent enlargement of the air spaces DISTAL to the bronchioles

destruction of alveolar septum/wall

A

Emphysema

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10
Q

Size of pulmonary nodules ?

A

<3 cm

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11
Q

malignant pulmonary nodules?

A

speculated

multiple

changing in size

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12
Q

Benign Pulmonayr nodule?

A 
unchnaged
small
calcified
smooth 
solitary
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13
Q

Septated nodules?

A

suspect primary lung malignancy

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14
Q

Circumscribed nodules?

A

suspect lung mets

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15
Q

Halo sign?

A

surrounded by ground glass - suspect malignancy

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16
Q

how big should the heart be?

A

half the width of the chest cavity

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17
Q

Left heart border (left ventricle)? Silhouettes and there adjacent structures

A

Lingula

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18
Q

Right heart border (right atrium) Silhouettes and there adjacent structures

A

Right middle lobe

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19
Q

Left hemidiaphragm? Silhouettes and there adjacent structures

A

left lower lobe

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20
Q

Right hemidiaphragm? Silhouettes and there adjacent structures

A

right lower lobe

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21
Q

Aortic knuckle ? Silhouettes and there adjacent structures

A

left upper lobe/middle mediastinum

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22
Q

Descending aorta? Silhouettes and there adjacent structures

A

left lower lobe

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23
Q

Right paratracheal stripe? Silhouettes and there adjacent structures

A

right upper lobe / anterior mediastinum

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24
Q

Paraspinal lines ? Silhouettes and there adjacent structures

A

medial lung / posterior mediastinum

25
Q

pathology of atelectasis?

A

Volume loss of some portion of the lung

Shows linear, curvilinear or wedge shaped opacities

More diffuse in presentation

Compensatory hyperinflation of adjacent lobes

26
Q

CFTR gene is expressed in:

A

epithelial cells in a variety of organs including

the lung, sinuses, pancreas, sweat gland, intestine, liver, and vas deferens

27
Q

CF is the most common inherited life-shortening disease of __________ in the US

A

caucasions

28
Q

CF lung disease is characterized by:

A

mucociliary clearance

chronic polymicrobial infection of the airways

exaggerated inflammatory response

29
Q

Sweat Chloride Test indication?

A

To diagnose CF:

Recurrent respiratory infections

Late passage of meconium stool

Failure to thrive - not progressing like they should

Chronic cough

Malabsorption syndromes - greasy fatty smelly stools

30
Q

Pathophysiology of CF?

A

Abnl mutation in the CFTR (CF transmembrane conductance regulator gene)

Gene encodes a synthesis of a protein that serves as a channel through which chloride enters and leaves the cells.

Sweat near the base of the gland has a high sodium and chloride concentration ( deposits at base)

In patients with CF transport does not occur.

31
Q

during the CF sweat chloride test… Sweating is induced by mild electrical current called?

A

(pilocarpine iontophoresis

Sodium and chloride content of sweat is measured

32
Q

During the CF sweat chloride test the + electrode is ? current flow 5-12 min

A

pilocarpine hydrochloride

33
Q

During the CF sweat chloride test the - electrode is ? current flow 5-12 min

A

bicarbonate solution

34
Q

During the CF sweat chloride test the aper discs are placed on the arm and covered with ________ for air tight seal for one hour

A

paraffin

35
Q

Normal SCT results ?

A

Normal: <50 meq/L

36
Q

Equivocal SCT results?

A

Equivocal: -60 meq/L

37
Q

Abnormal SCT results?

A

Abnormal: >60 meq/L

38
Q

Interferring factors with swat chloride test?

A

Not reliable within the first few weeks of life

Not reliable for pubertal adolescents

Dehydration can reduce volume of sweat
don’t do test after a marathon

Cold room can reduce sweating
because we sweat in hot environments

39
Q

Most common mutation in the CFTR gene? and what chromosome?

A

Delta AF508

chromosome 7

40
Q

Procedures for CFTR mutation analysis ?

A

Serum
Chorionic villus sampling
Amniocentesis - cells

Uses PCR to amplify the locus for the mutation

41
Q

Mutation and chromosome for Alpha-1 Antitrypsin?

A

autosomal recessive disease caused by mutations in the SERPINA1 gene on chromosome 14, which encodes the protease inhibitor alpha-1 antitrypsin (AAT)

42
Q

where do you see Alpha-1 Antitrypsin deficiency ?

A

emphysema and COPD

43
Q

Pathophysiology of Alpha-1 Antitrypsin?

A

AAT inactivates endoproteases that can breakdown elastic fibers and collagen in the lungs

A deficiency causes a build-up of those endoproteases

44
Q

Testing for the ____ and __ alleles

A

S, Z

45
Q

Normal AAT?

A

85-213 mg/dL or 0.85-2.13 g/L (SI Units)

46
Q

Gold standard for PE

A

CT

47
Q

D-dimer is a __________________ product made through the lysis of fibrin when plasmin acts on the fibrin polymer clot

A

fibrin degradition

48
Q

what can give you a false positive for D-Dimer?

A

inflammation and pregnancy, being old, having CA

49
Q

D-Dimer is very sensitive but not specific? T or F

A

T

50
Q

D-Dimer normal result?

A

<0.4 mcg/ml

51
Q

When will we have a increased D-Dimer?

A

DVT

PE

52
Q

what detects and monitors the course of sarcoidosis as well as other granulomatous disease (Differentiate between active and dormant sarcoid disease
)

A

Angiotensin converting enzyme (ACE)

53
Q

where does ACE come from and what does it activate?

A

comes from the lungs(Found in pulmonary epithelial cells) and it turns Angiotension 1 into Angiotension 2

54
Q

__________ ACE levels are found in sarcoidosis pts.

A

elevated

55
Q

ACE test has somewhat low sensitivity and specificity. T or F

A

T

56
Q

Elevated levels of ACE are reported in ___ of patients with acute disease and only ___ of patients with chronic disease.

A

60%

20%

57
Q

Normal ACE result?

A

<40 units/L

58
Q

When will we see an increase in ACE levels?

A

Sarcoidosis (more severe= higher level)

Gaucher disease - sphingolipids are not broken down correctly and distributed all over the body
TB
Leprosy
Alcoholic cirrhosis
Hodgkin disease
amyloidosis
59
Q

Interfering factors of ACE?

A

False decreased levels:

Hemolysis - cause decrease levels
Drugs
ACE inhibitors (duh)

Clinical Medicine LAB - Professor Sample (36 decks)

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