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uworld > Set 8 (Pulmonary) > Flashcards

Set 8 (Pulmonary) Flashcards

1
Q

Alcoholic

Currant jelly sputum

A

Klebsiella pneumoniae

MAC

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2
Q

Chocolate agar

Factor X and Factor V required

A

H. influenzae

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3
Q

Requires L-cystine-supplemented agar

A

Legionella pneumophila

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4
Q

“Ground glass infiltrate” on x-ray

Silver stain

A

Pneumocystis jiroveci

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5
Q

Animal hides
Spores
Obligate intracellular

A

Coxiella burnetti

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6
Q 
Lymphoid hyperplasia (large tonsils, LN)
Recurrent sinopulmonary infections
Cannot undergo class-switching
A

Hyper-IgM syndrome

m/c problem: CD-40 T-lymphocyte ligand

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7
Q

IgA class switching induced by?

A

TGF-Beta

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8
Q

IgE class switching induced by?

A

IL-13, together with IL-4

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9
Q

Cilia are present til where in the respiratory tree?

A

Respiratory bronchioles

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10
Q

Neutrophils fail to turn blue upon nitroblue tetrazolium test

A

CGD

X-linked, NADPH oxidase deficiency

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11
Q

Lecithinase

Alpha toxin or Phospholipase C

A

C. perfringens

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12
Q

UNABLE to kill catalase producing organisms

S. aureus, Serratia, E. coli

A

CGD

x-linked

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13
Q

Tender

Small, red-blue lesion UNDER nail bed

A

Benign glomus tumor (glomangioma)

modifed smooth muscle cells; thermoregulatory

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14
Q

Innervation of mediastinal/diaphragmatic parietal pleura

A

Phrenic nerve (C3, 4, 5)

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15
Q

Very high fever in a smoker
Diarrhea, confusion, cough
Gram stain reveals NO organisms

A

Legionella

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16
Q

B cell surface markers

A

CD19, CD20, CD21

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17
Q

Cell marker for Reed-Stergnberg cells and neutrophils

Marker useful in diagnosis of Hodgkin lymphoma

A

CD15

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18
Q

CD16

A

NK

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19
Q

Recurrent respiratory infection
Persistent diarrhea
Persistent Giardia infection
ALL immunoglobulin are LOW

A

X-linked agammaglobuinemia

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20
Q

Promote B-cell IgA synthesis

Eosinophil activation

A

IL-5

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21
Q

CFTR protein

A

Transmembrane ATP-gated chloride channel

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22
Q

cGMP-gated Na+ channel: role in?

A

Vision

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23
Q

Resistance to this drug is via decreased catalase-peroxidase activity

A

Isoniazid (requires this enzyme to be ACTIVATED)

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24
Q

CFTR mutations affect exocrine glands by?

A

Reduce luminal chloride secretion

Increase sodium ABSORPTION

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25
Q

CFTR mutation affect SWEAT gland by?

A

Reduce luminal chloride secretion

DECREASE sodium absorption (lots of sodium in sweat)

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26
Q

Inhibit synthesis of mycolic acid

A

Isoniazid

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27
Q

Ipratropium

A

Anti-muscarinic agent (M3 receptor antagonist)

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28
Q

Allergic asthma: clear therapeutic benefit w?

A

Leukotriene receptor antagonist (LTC4, D4, E4)

Acetylcholine receptor antagonist

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29
Q

NON-selective BB: a/e

A

Bronchoconstriction
Peripheral vasospasm
Predispose patients to HYPOglycemia (decrease glucagon secretion)

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30
Q

HYPOnatremia

Sputum culture: neutrophil, NO organism

A

Legionella

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31
Q

Exploring caves
Bird, bat droppins
Think of?

A

Histoplasma capsulatum

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32
Q

Spherules packed w/ endospores

A

Coccidioides immitis

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33
Q

Budding yeast w/ thick capsule

A

Cryptococcus neoformans

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34
Q

Yeast that form pseudohyphae

Blastoconidia

A

Candida

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35
Q

Septate hyphae + V-shaped branching

A

Aspergillus fumigatus

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36
Q

Dimorphic

Ovoid cells w/i macrophages

A

Histoplasma capsulatum

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37
Q

Chronic rejection after lung transplantation

A

Bronchiolitis obliterans

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38
Q

Polyribosyl-ribitol-phosphate

A

H. influenzae type b

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39
Q

Malignant pustule

A

PainLESS ulcer w/ black eschar and local edema

B. anthracis, capsule = D-glutamate

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40
Q

Haemophilus vaccine

A

PRP conjungated w/ diptheria or tetanus toxoid

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41
Q

Emphysema: PFTs

A

Increased TLC
Decreased FEV1/FVC ratio
DECREASED diffusion capacity

42
Q

Asthma: increased or decreased diffusion capacity?

A

INCREASED

increased pulmonary blood volume

43
Q

Dystrophin mutation associated with?

A

Duchenne and Becker muscular dystrophy

Dilated CM

44
Q

Dilated CM: genetic

A

1/3
AD mutation of myocyte cytoskeletal protein (dystrophin)
OR
Mitochondrial enzymes

45
Q

Mitochondrial vacuolization

A

Sign of IRREVERSIBLE cell injury

46
Q

Pulmonary insufficiency
Diffuse neurological impairment
Thrombocytopenia
Anemia

A

Fat embolism syndrome

47
Q

TB vs. sarcoidosis

A

TB: caseating granuloma.
Sarcodosis: NON-caseating granuloma.

48
Q

Most frequent complication of varicose veins

A

Venous stasis ulcers

49
Q

Aminoglycoside: A/E

A

Nephrotoxicity (ATN)
Ototoxicity
NMJ blocking (flaccid paralysis)

50
Q

Chloramphenicol
Dapsone
TMP-SMX
CBC to monitor for?

A

Chloramphenicol: aplastic anemia.
Dapsone: agranulocytosis.
TMP-SMX: megaloblastic anemia.

51
Q

Optic neuritis (–> color blindness, central scotoma, decreased visual acuity)

A

Ethambutol

52
Q

Acid fast organism that is NOT mycobacterium

A

Nocardia

weakly

53
Q

Theophyline

A

Bronchodilator

PDE inhibitor –> increased cAMP

54
Q

Elastin’s ability to recoil upon release of tension is attributable to?

A

Desmosine x-linking between 4 different lysine residues on four different elastin chains.

55
Q

B1 receptors are found on?

A 
Heart (increase HR and contractility)
Juxtaglomerular cells (increase renin secretion)
56
Q

Adenosine: A/E

A

Chest burning (bronchoSPASM)
Flushing
High grade blocks

57
Q

DOC for PSVT

A

Adenosine

slow conduction through AV node via HYPERpolarizing pacemaker and conducting cells

58
Q

Photodermatitis
Blue/grey skin discoloration
Pulmonary fibrosis
Hyper/Hypothyroidism

A

Amiodarone

59
Q

Constipation
Gingival hyperplasia
Anti-arrhythmic agent

A

Verapamil

60
Q

Dipalmitoyl phosphatidylcholine

A

Lecithin

production sharply increase after 30wks gestation

61
Q

Clara cells

A

NON-ciliated, secretory constituents of terminal respiratory epithelium
(Secrete CCSP: inhibit neutrophil recruitment/activation)

62
Q

Piriform recess: what nerve?

A

Internal laryngeal nerve (branch of SUPERIOR laryngeal n.)

Cough reflex; vagus!

63
Q

Gag reflex mediated by?

A

Afferent via CN9 (glossopharyngeal)

Efferent via CN10 (vagus)

64
Q

Cough reflex mediated by?

A

Vagus

afferent= internal laryngeal n.

65
Q

Work of breathing: to minimize

Pulmonary fibrosis vs. COPD

A

Pulmonary fibrosis: fast, shallow breath

COPD: slow, deep breath

66
Q

Recurrent sinopulmonary and GI infections

Anaphylaxis rxn to transfused blood products

A

Selective IgA deficiency

IgG against IgA in transfused blood

67
Q

C1 complement component deficiency

A

SLE

68
Q

Leukocyte adhesion deficiency: defect in formation of?

A

CD18 (component in integrins)

69
Q

GBS + in pregnant women, what to do?

A

INTRAPARTUM antibiotics

penicillin or ampicillin

70
Q

Gram+ cocci in CHAINS
Beta hemolytic
Bacitracin resistant

A

GBS

GAS and GBS are beta-hemolytic, GAS=susceptible

71
Q

Effect modification

A

When effect of main exposure on outcome is MODIFED by presence of ANOTHER VARIABLE.
NOT a bias.

72
Q

Congestion
Red hepatization
Gray hepatization
Elimination

A

Streptococcus pneumoniae infection

73
Q

Metabolic alkalosis: to determine cause

A

Urinary chloride cc

Volume status

74
Q

Urinary chloride low

Metabolic alkalosis

A

Saline-responsive

a/w VOLUME loss: vomiting/nasogastric suction

75
Q

Urinary chloride high

Metabolic alkalosis

A

Chloride-responsive
(a/w CONTRACTION alkalosis: thiazide/diuretic leading o Na+ loss)

or
Saline-resistant
(a/w primary HYPERaldosteronism)

76
Q

Sarcoidosis immunological abnormality

A

HIGH CD4:CD8 ratio

77
Q

Major site of opsonizing antibody production?

Major site of complement production?

A

Opsonizing: spleen.
Complement: liver.

78
Q

HIV virus

A

Enveloped
SS+
RNA

79
Q

Rhinovirus

A

Naked
SS+
RNA

80
Q

RSV virus

A

SS- RNA

81
Q

Influenza A vrisu

A

SS- RNA

82
Q

Lowers BP in HTN emergency med
Increases renal perfusion
Increase sodium and water excretion

A

Fenoldopam

selective D1 receptor agonist –>AC –> cAMP –> vasodilation of MOST arterial beds

83
Q

Hypertensive patient + renal insufficiency

A

Fenoldopam!

84
Q

Theophylline cause bronchoDILATION by?

A

PDE-inhibitor –> increased cAMP

85
Q

Which statin to use when:

patient is on agent that inhibits CYP450 3A4?

A

Pravastatin

86
Q

First line anti-TB drug that works best at acidic pH (intracellular)

A

Pyrazinamide

87
Q

Quellung reaction

A

Capsule well when specific anti-capsular antibodies are added (Strep pneumo!)

88
Q

Interfere w/ binding of aminoacyl-tRNA to A site

A

Tetracycline

89
Q

Inhibit peptidyltransferase enzyme

A

Chloramphenicol

90
Q

Inhibit translocation

A

Clindamycin, Erythromycin

91
Q

Headache
Facial plethora (edema)
Visibly dilated veins of neck and upper torso

A

SVC syndrome

small cell lung carcinoma

92
Q

Severe pain in shoulder
Arm weakness/atrophy
Horner’s syndrome
Spinal cord compression/paraplegia

A 
Pancoast tumor (superior sulcus tumor)
(Bronchogenic carcinoma)
93
Q

PTHrP secretion and Hypercalcemia

A

Squamous cell carcinoma

94
Q

Cushing syndrome

SIADH

A

Small cell carcinoma

95
Q

PO2 (Alveolar)

A

150-(arterial CO2/0.8)

normally: ~100mmHg

96
Q

COPD: compliance or elasticity
Fibrosis: compliance or elasticity

A

COPD: problem w/ air OUT (elasticity defect, compliance increased)

Fibrosis: problem w/ air IN (decreased compliance, STIFF lung!)

97
Q

Infantile coaractation of aorta

A

Coarctation is PRE-ductal

thus: pulmonary –> aorta NOT affected, R –L shunt

98
Q

Decreased lung compliance = hallmark for?

A

Pulmonary fibrosis

99
Q

VLDL: think of?

A

TG

100
Q

m/c/c of SVC syndrome

A

Lung cancer

non-HL

101
Q

Dullness to percussion

Diminished breath sounds

A

Pleural effusion

uworld (17 decks)

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