Set 8 (Pulmonary) Flashcards
1
Q
Alcoholic
Currant jelly sputum
A
Klebsiella pneumoniae
MAC
2
Q
Chocolate agar
Factor X and Factor V required
A
H. influenzae
3
Q
Requires L-cystine-supplemented agar
A
Legionella pneumophila
4
Q
“Ground glass infiltrate” on x-ray
Silver stain
A
Pneumocystis jiroveci
5
Q
Animal hides
Spores
Obligate intracellular
A
Coxiella burnetti
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
7
Q
IgA class switching induced by?
A
TGF-Beta
8
Q
IgE class switching induced by?
A
IL-13, together with IL-4
9
Q
Cilia are present til where in the respiratory tree?
A
Respiratory bronchioles
10
Q
Neutrophils fail to turn blue upon nitroblue tetrazolium test
A
CGD
X-linked, NADPH oxidase deficiency
11
Q
Lecithinase
Alpha toxin or Phospholipase C
A
C. perfringens
12
Q
UNABLE to kill catalase producing organisms
S. aureus, Serratia, E. coli
A
CGD
x-linked
13
Q
Tender
Small, red-blue lesion UNDER nail bed
A
Benign glomus tumor (glomangioma)
modifed smooth muscle cells; thermoregulatory
14
Q
Innervation of mediastinal/diaphragmatic parietal pleura
A
Phrenic nerve (C3, 4, 5)
15
Q
Very high fever in a smoker
Diarrhea, confusion, cough
Gram stain reveals NO organisms
A
Legionella
16
Q
B cell surface markers
A
CD19, CD20, CD21
17
Q
Cell marker for Reed-Stergnberg cells and neutrophils
Marker useful in diagnosis of Hodgkin lymphoma
A
CD15
18
Q
CD16
A
NK
19
Q
Recurrent respiratory infection
Persistent diarrhea
Persistent Giardia infection
ALL immunoglobulin are LOW
A
X-linked agammaglobuinemia
20
Q
Promote B-cell IgA synthesis
Eosinophil activation
A
IL-5
21
Q
CFTR protein
A
Transmembrane ATP-gated chloride channel
22
Q
cGMP-gated Na+ channel: role in?
A
Vision
23
Q
Resistance to this drug is via decreased catalase-peroxidase activity
A
Isoniazid (requires this enzyme to be ACTIVATED)
24
Q
CFTR mutations affect exocrine glands by?
A
Reduce luminal chloride secretion
Increase sodium ABSORPTION
25
CFTR mutation affect SWEAT gland by?
Reduce luminal chloride secretion
| DECREASE sodium absorption (lots of sodium in sweat)
26
Inhibit synthesis of mycolic acid
Isoniazid
27
Ipratropium
Anti-muscarinic agent (M3 receptor antagonist)
28
Allergic asthma: clear therapeutic benefit w?
Leukotriene receptor antagonist (LTC4, D4, E4)
| Acetylcholine receptor antagonist
29
NON-selective BB: a/e
Bronchoconstriction
Peripheral vasospasm
Predispose patients to HYPOglycemia (decrease glucagon secretion)
30
HYPOnatremia
| Sputum culture: neutrophil, NO organism
Legionella
31
Exploring caves
Bird, bat droppins
Think of?
Histoplasma capsulatum
32
Spherules packed w/ endospores
Coccidioides immitis
33
Budding yeast w/ thick capsule
Cryptococcus neoformans
34
Yeast that form pseudohyphae
| Blastoconidia
Candida
35
Septate hyphae + V-shaped branching
Aspergillus fumigatus
36
Dimorphic
| Ovoid cells w/i macrophages
Histoplasma capsulatum
37
Chronic rejection after lung transplantation
Bronchiolitis obliterans
38
Polyribosyl-ribitol-phosphate
H. influenzae type b
39
Malignant pustule
PainLESS ulcer w/ black eschar and local edema
| B. anthracis, capsule = D-glutamate
40
Haemophilus vaccine
PRP conjungated w/ diptheria or tetanus toxoid
41
Emphysema: PFTs
Increased TLC
Decreased FEV1/FVC ratio
DECREASED diffusion capacity
42
Asthma: increased or decreased diffusion capacity?
INCREASED
| increased pulmonary blood volume
43
Dystrophin mutation associated with?
Duchenne and Becker muscular dystrophy
| Dilated CM
44
Dilated CM: genetic
1/3
AD mutation of myocyte cytoskeletal protein (dystrophin)
OR
Mitochondrial enzymes
45
Mitochondrial vacuolization
Sign of IRREVERSIBLE cell injury
46
Pulmonary insufficiency
Diffuse neurological impairment
Thrombocytopenia
Anemia
Fat embolism syndrome
47
TB vs. sarcoidosis
TB: caseating granuloma.
Sarcodosis: NON-caseating granuloma.
48
Most frequent complication of varicose veins
Venous stasis ulcers
49
Aminoglycoside: A/E
Nephrotoxicity (ATN)
Ototoxicity
NMJ blocking (flaccid paralysis)
50
Chloramphenicol
Dapsone
TMP-SMX
CBC to monitor for?
Chloramphenicol: aplastic anemia.
Dapsone: agranulocytosis.
TMP-SMX: megaloblastic anemia.
51
Optic neuritis (--> color blindness, central scotoma, decreased visual acuity)
Ethambutol
52
Acid fast organism that is NOT mycobacterium
Nocardia
| weakly
53
Theophyline
Bronchodilator
| PDE inhibitor --> increased cAMP
54
Elastin's ability to recoil upon release of tension is attributable to?
Desmosine x-linking between 4 different lysine residues on four different elastin chains.
55
B1 receptors are found on?
```
Heart (increase HR and contractility)
Juxtaglomerular cells (increase renin secretion)
```
56
Adenosine: A/E
Chest burning (bronchoSPASM)
Flushing
High grade blocks
57
DOC for PSVT
Adenosine
| slow conduction through AV node via HYPERpolarizing pacemaker and conducting cells
58
Photodermatitis
Blue/grey skin discoloration
Pulmonary fibrosis
Hyper/Hypothyroidism
Amiodarone
59
Constipation
Gingival hyperplasia
Anti-arrhythmic agent
Verapamil
60
Dipalmitoyl phosphatidylcholine
Lecithin
| production sharply increase after 30wks gestation
61
Clara cells
NON-ciliated, secretory constituents of terminal respiratory epithelium
(Secrete CCSP: inhibit neutrophil recruitment/activation)
62
Piriform recess: what nerve?
Internal laryngeal nerve (branch of SUPERIOR laryngeal n.)
| Cough reflex; vagus!
63
Gag reflex mediated by?
Afferent via CN9 (glossopharyngeal)
| Efferent via CN10 (vagus)
64
Cough reflex mediated by?
Vagus
| afferent= internal laryngeal n.
65
Work of breathing: to minimize
| Pulmonary fibrosis vs. COPD
Pulmonary fibrosis: fast, shallow breath
| COPD: slow, deep breath
66
Recurrent sinopulmonary and GI infections
| Anaphylaxis rxn to transfused blood products
Selective IgA deficiency
| IgG against IgA in transfused blood
67
C1 complement component deficiency
SLE
68
Leukocyte adhesion deficiency: defect in formation of?
CD18 (component in integrins)
69
GBS + in pregnant women, what to do?
INTRAPARTUM antibiotics
| penicillin or ampicillin
70
Gram+ cocci in CHAINS
Beta hemolytic
Bacitracin resistant
GBS
| GAS and GBS are beta-hemolytic, GAS=susceptible
71
Effect modification
When effect of main exposure on outcome is MODIFED by presence of ANOTHER VARIABLE.
NOT a bias.
72
Congestion
Red hepatization
Gray hepatization
Elimination
Streptococcus pneumoniae infection
73
Metabolic alkalosis: to determine cause
Urinary chloride cc
| Volume status
74
Urinary chloride low
| Metabolic alkalosis
Saline-responsive
| a/w VOLUME loss: vomiting/nasogastric suction
75
Urinary chloride high
| Metabolic alkalosis
Chloride-responsive
(a/w CONTRACTION alkalosis: thiazide/diuretic leading o Na+ loss)
or
Saline-resistant
(a/w primary HYPERaldosteronism)
76
Sarcoidosis immunological abnormality
HIGH CD4:CD8 ratio
77
Major site of opsonizing antibody production?
| Major site of complement production?
Opsonizing: spleen.
Complement: liver.
78
HIV virus
Enveloped
SS+
RNA
79
Rhinovirus
Naked
SS+
RNA
80
RSV virus
SS- RNA
81
Influenza A vrisu
SS- RNA
82
Lowers BP in HTN emergency med
Increases renal perfusion
Increase sodium and water excretion
Fenoldopam
| selective D1 receptor agonist -->AC --> cAMP --> vasodilation of MOST arterial beds
83
Hypertensive patient + renal insufficiency
Fenoldopam!
84
Theophylline cause bronchoDILATION by?
PDE-inhibitor --> increased cAMP
85
Which statin to use when:
| patient is on agent that inhibits CYP450 3A4?
Pravastatin
86
First line anti-TB drug that works best at acidic pH (intracellular)
Pyrazinamide
87
Quellung reaction
Capsule well when specific anti-capsular antibodies are added (Strep pneumo!)
88
Interfere w/ binding of aminoacyl-tRNA to A site
Tetracycline
89
Inhibit peptidyltransferase enzyme
Chloramphenicol
90
Inhibit translocation
Clindamycin, Erythromycin
91
Headache
Facial plethora (edema)
Visibly dilated veins of neck and upper torso
SVC syndrome
| small cell lung carcinoma
92
Severe pain in shoulder
Arm weakness/atrophy
Horner's syndrome
Spinal cord compression/paraplegia
```
Pancoast tumor (superior sulcus tumor)
(Bronchogenic carcinoma)
```
93
PTHrP secretion and Hypercalcemia
Squamous cell carcinoma
94
Cushing syndrome
| SIADH
Small cell carcinoma
95
PO2 (Alveolar)
150-(arterial CO2/0.8)
| normally: ~100mmHg
96
COPD: compliance or elasticity
Fibrosis: compliance or elasticity
COPD: problem w/ air OUT (elasticity defect, compliance increased)
Fibrosis: problem w/ air IN (decreased compliance, STIFF lung!)
97
Infantile coaractation of aorta
Coarctation is PRE-ductal
| thus: pulmonary --> aorta NOT affected, R --L shunt
98
Decreased lung compliance = hallmark for?
Pulmonary fibrosis
99
VLDL: think of?
TG
100
m/c/c of SVC syndrome
Lung cancer
| non-HL
101
Dullness to percussion
| Diminished breath sounds
Pleural effusion
