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CPR II Week 4/5/6 > Robbins Ch 15 Part II > Flashcards

Robbins Ch 15 Part II Flashcards

1
Q

Spectrum of immunologically-mediated interstitial disorders due to inhaled organic antigens is known as?

A

Hypersensitivity pneumonitis

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2
Q

Pigeon-breeder lung is a type of hypersensitivity pneumonitis from?

Farmer’s lung?

Hot tub lung?

A

1) Protein in bird feces
2) Actinomycetes spores in hay
3) Mycobacterium avium complex and Legionella

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3
Q

What does the Pulmonary Function Tests indicate for hypersensitivity pneumonitis?

A

Restrictive lung disease (FEV1:FVC ratio is normal)

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4
Q

What interleukin is increased with pulmonary eosinophilia?

A

IL-5

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5
Q

What improves the symptoms associated with respiratory bronchiolitis-associated Interstitial Lung Disease?

A

Smoking cessation

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6
Q

Pulmonary Langerhans Cell Histiocytosis is a rare disease of what population?

Most cases resolve with?

A

1) Young adult smokers

2) Smoking cessation

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7
Q

What condition is characterized by surfactant accumulation in alveoli and bronchioles?

The defects are related to?

What is it positive for?

How does it present clinically?

A

1) Pulmonary Alveolar Proteinosis
2) GM-CSF dysfunction
3) Periodic Acid-Schiff
4) Cough with abundant sputum containing chunks of gelatinous material

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8
Q

Hereditary Pulmonary Alveolar Proteinosis occurs in what population?

What is its prognosis?

A

1) Neonates

2) Rapidly fatal

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9
Q

What are characteristic of ante-mortem pulmonary embolism?

A

Lines of Zahn

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10
Q

DVTs are diagnosed by?

A

Duplex ultrasound

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11
Q

Bone Morphogenetic Protein Receptor Type 2 (BMPR2) mutation is associated with?

A

Familial Pulmonary HTN

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12
Q

Pulmonary HTN is defined by pulmonary artery pressure (PAP) greater than?

A

25 mmHg

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13
Q

What morphologic finding is highly associated with pulmonary HTN?

A

Plexiform lesions

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14
Q

Idiopathic pulmonary HTN is most common in what population?

A

Women 20-40 years old

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15
Q

Goodpasture syndrome has autoantibodies against?

It is most common in what population?

What does immunofluorescence show?

A

1) Basement Membrane
2) Male teens to late 20s
3) Linear Ig deposition along BM

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16
Q

What disease of children is similar to Goodpasture syndrome but there are no anti-basement membrane antibodies detected in serum?

A

Idiopathic Pulmonary Hemosiderosis

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17
Q

What is Polyangiitis with Granulomatosis (Wegner’s) positive for?

How does it compare to sarcoidosis?

A

1) PR3-ANCA/ c-ANCA

2) Scattered, poorly formed granulomas compared to the well defined granulomas of sarcoidosis

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18
Q

What is the most common cause of deaths in influenza epidemics?

A

Superimposed bacterial pneumonia

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19
Q

What is the most common cause of community acquired pneumonia?

What is its distribution of inflammation in the lung?

What is found on gram stained sputum?

A

1) Streptococcus pneumoniae
2) Lobar
3) Gram positive, lancet shaped diplococci that are encapsulated

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20
Q

What is the most common bacterial cause of acute exacerbation of COPD?

Which type was the vaccine made for?

What population does it have a high mortality rate with because it causes pneumonia?

A

1) Haemophilus influenzae
2) Type B
3) Children

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21
Q

What is the second most common bacterial cause of COPD exacerbation?

What does it cause in the elderly?

In children?

A

1) Moraxella catarrhalis
2) Pneumonia
3) Otitis media

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22
Q

What are the three most common causes of otitis media in children?

A

1) Streptococcus Pneumoniae
2) Haemophilus Influenzae
3) Moraxella Catarrhalis

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23
Q

What is the most frequent cause of gram (-) bacterial pneumonia?

What population is it most common in?

How is the sputum described?

A

1) Klebsiella pneumoniae
2) Chronic alcoholics
3) Currant jelly sputum

24
Q

Legionella pneumophila pneumonia is seen particularly in?

How is it diagnosed?

A

1) Organ transplant recipients

2) Antigens in urine

25
Q

What part of the influenza virus attaches to cells?

What part allows release of replicated virus from cells?

Which part does tamiflu act against?

A

1) Hemagglutinin
2) Neuraminidase
3) Neuraminidase

26
Q

Human Metapneumovirus and human respiratory syncytial virus fall under what category?

A

Paramyxovirus

27
Q

What infects the lower respiratory tree and spreads systemically causing Severe Acute Respiratory Syndrome (SARS)?

A

Coronavirus

28
Q

What correlates with a poorer outcome in COVID patients due to the thrombotic complications?

A

D-dimer

29
Q

What cell type may be identified in the circulation due to COVID?

A

Megakaryocytes

30
Q

Hospital acquired pneumonia is most commonly caused by what gram positive cocci?

What gram negative rods?

Ventilator associated pneumonia is most commonly caused by?

A

1) Staphylococcus Aureus and Streptococcus Pneumonia
2) Enterobacteriaceae and Pseudomonas
3) Gram negative bacilli

31
Q

What are very characteristic of lung abscess?

A

Air-fluid levels

32
Q

Aspiration based abscesses are more common on the?

Pneumonia based abscesses are typically located?

A

1) Right main bronchus

2) Basally

33
Q

What are intracellular pathogen of phagocytes, endemic to Ohio and Mississippi river valleys (midwest)?

What can it cause in immunocompromised patients?

The characteristic yeast form shows what morphology?

A

1) Histoplasma capsulatum
2) Fulminant disseminated histoplasmosis
3) Pumpkin seed

34
Q

What are soil dwelling, dimorphic fungus that occurs in central and southeast USA (Florida)?

The characteristic yeast forms show what morphology?

A

1) Blastomyces dermatitidis

2) Broad Based Budding

35
Q

What is endemic in southwestern U.S. and mexico and causes a granulomatous response with eosinophils in the lungs?

What characteristic morphology does it show?

A

1) Coccidioidomycosis

2) Non-budding spherules

36
Q

What opportunistic fungal infection is an AIDS-defining illness?

The characteristic yeast forms show what morphology?

A

1) Pneumocystis jiroveci

2) Cup-shaped

37
Q

Which sex has increased susceptibility to the associated carcinogens of tobacco smoking?

A

Females

38
Q

What is characterized by loss of tumor suppressor genes due to tobacco smoke exposure such as CDKN2A and TP53?

A

Squamous cell carcinoma

39
Q

Which carcinoma has the strongest association with smoking?

Which is the most common lung cancer associated with smoking?

A

1) Small cell carcinoma

2) Squamous cell carcinoma

40
Q

Gain-of-function of GF receptor signaling pathways is characteristic of?

A

Adenocarcinoma

41
Q

What is the most common form of lung cancer in the absence of smoking?

Where in the lung is it most common?

Majority express what transcription factor?

A

1) Adenocarcinoma
2) Peripheral lung
3) Thyroid transcription factor 1

42
Q

What are composed entirely of dysplastic cells growing along preexisting alveolar septae?

A

Adenocarcinoma in situ

43
Q

Orange cytoplasm and keratin pearls is diagnostic of?

A

Squamous cell carcinoma

44
Q

What paraneoplastic syndrome does squamous carcinoma lead to?

Small cell carcinoma?

A

1) Hypercalcemia

2) SIADH and Cushing’s

45
Q

What happens when carcinomas invades neural structures near trachea?

What tumors are associated with this?

A

1) Horner syndrome:
a) Partial Ptosis
b) Anhidrosis
c) Miosis
d) Arm weakness

2) Pancoast tumors

46
Q

Lung cancer has a worse prognosis if there is what mutation?

A

KRAS mutation

47
Q

What syndrome can carcinoid tumors cause?

A

Flushing, diarrhea, cyanosis

48
Q

Radio-opacity ‘coin lesion’ on routine CXR is diagnostic of?

A

Lung hamartoma

49
Q

What population does Lymphangioleiomyomatosis present in?

It is associated with loss of function of what tumor suppressor?

A

1) Young women

2) TSC2

50
Q

Suppurative Pleuritis (Empyema) is more common on which side?

A

Right side

51
Q

Exfoliated tumor cells is characteristic of?

A

Hemorrhagic Pleuritis

52
Q

What is the most common cause of hydrothorax?

A

Cardiac failure

53
Q

What occurs during tension pneumothorax?

A

Air enters during inspiration but is not released during expiration

54
Q

Solitary fibrous tumors are positive for?

What fusion gene is virtually unique to solitary fibrous tumor?

A

1) CD34

2) NAB2-STAT6

55
Q

90% of malignant mesothelioma cases are related to?

What is it positive for?

A

1) Asbestos exposure

2) Cytokeratin and calretinin

56
Q

Small cell carcinoma causes what histological feature to be present?

A

Neuroendocrine differentiation

57
Q

Large cells with intranuclear and cytoplasmic inclusions describes?

Hyphal forms without septations describes?

Caseating granulomata with acid fast organisms describes?

A

1) Cytomegalovirus
2) Mucormycosis
3) Mycobacteria

CPR II Week 4/5/6 (18 decks)

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