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Set 9 (Pulmonary) Flashcards

1
Q

Macrophages that form giant cells are activated by?

A

CD4+ Th1 cells (INF-gamma)

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2
Q

Cheyne-Stokes respiration

A

Cyclic breathing

Apnea followed by gradual increasing then decreasing TV until next apnea period.

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3
Q

Cheyne-Stokes respiration seen in?

A

Advanced CHF

Neurologic dz

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4
Q

Kussmaul breathing

A

Deep and labored breathing pattern a/w SEVERE metabolic ACIDosis (esp: DKA)

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5
Q

VitD toxicity can result from?

A 
Ingestion
Granulomatous dz (sarcoidosis, TB, HL, Non-HL)
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6
Q

Sarcoidosis and VitD

A

Increased intestinal calcium ABSOPRTION

Increased bone RESORPTION 2/2 high serum calcitriol

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7
Q

Carcinoid syndrome and vitamin

A

DECREASED level of niacin (B3)

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8
Q

Common complication of CREST syndrome

A

Pulmonary HTN (–>RH failure)

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9
Q

Polycythemia w/ normal RBC mass

A

Plasma volume CONTRACTION

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10
Q

Primary erythrocytosis

A

LOW EPO levels.

Myeloproliferative dz.

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11
Q

Resistance in parallel

A

1/T = 1/R (of individual)i

Good estimate of total body circulation

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12
Q

Series arrangement of BV is good for estimating?

A

Blood flow in individual ORGAN

T= R1 + R2 + R3 + …

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13
Q

Isoniazid-induced neuropathy is due to?

A

Vitamin Deficiency (B6-pyridoxine)

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14
Q

Stimulates T helper secretion if INF-gamma

A

IL-12

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15
Q

Caspofungin most active against?

A

Candida and Aspergillus
(NOT active aginst Cryptococcus)
(Limited aginst Mucor/Rhizopus)

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16
Q

Block glucan synthesis in fungi

A

Echinocandins

caspofungin, micafungin

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17
Q

Mycolic acid

A

Long branched chain saturated FA

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18
Q

1st line tx of Legionella

A

Macrolides

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19
Q

1st line tx of Mycoplasma (mycoplasma pneumoniae, ureaplasma urealyticum)

A

Tetracycline

Macrolide

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20
Q

Digoxin used in arrythmia b/c?

A

Increase parasympathetic tone –> decreased AV node conduction

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21
Q

Digoxin toxicity can lead to ventricular tachycardia and death b/c?

A

Delayed AFTER-depolarization

hyperexcitability due to increased intracellular calcium

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22
Q

A/E of oxygen therapy in neonate in respiratory distress

A

Retinal damage

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23
Q

Terbutaline

A

B-mimetic tocolytic drug (delay labor and delivery)

A/E neonatal intraventricular hemorrhage, HYPOglycemia/calcemia, ileus

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24
Q

Laryngeal vestibule and false vocal cords: epithelium

A

Ciliated, pseudostratified, columnar, mucous secreting epithelium

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25
``` True vocal cords Laryngopharynx Anterior epiglottis Superior half of posterior epiglottis: Epithelium? ```
Stratified squamous epithelium
26
Round, cigar-shaped budding yeasts
Sporothrix schenckii
27
Green discoloration of sputum/pus is a/w?
Myeloperoxidase | Neutrophil azurophilic granule
28
Lipoprotein lipase
Release TG from chylomicrons
29
LPL deficiency results in increase of?
CHYLOMICRONS
30
Marked hyperLIPIDemia Pancreatitis Lipemia retinalis Eruptive skin xanthomas (extensor surfaces of extremities)
``` LPL deficiency (Familial hyperCHYLOMICRONemia) ```
31
Defect in LDL receptor leads to increase of?
CHOLESTEROL | Accelerated AS
32
Accelerated coronary artery disease/atherosclerosis seen with which deficiency?
LDL receptor defect (increased cholesterol) | Familial hyperCHOLESTEROLemia
33
Tubular/Tendon xanthomas Xanthelasma Arcus cornea
``` Familial hyperCHOLESTEROLemia (LDL receptor defect) ```
34
Hallmark of familial hyperCHOLESTEROLemia
Tendon xanthomas
35
Acute pancreatitis a/w what familial hyperlipidemias?
Familial hyperCHYLOMICRONemia (hyperTG)
36
Frataxin gene
Mitochondrial protein important in iron homoeostasis and respiratory fxn
37
MHC Class I molecule
Heavy chain + B2-microglobulin
38
MHC Class II molecule
Alpha and Beta chain
39
Claudication is the result of?
Atherosclerosis of larger ARTERIES
40
Class III antiarrhythmics
Amiodarone Sotalol Ibutilide, dofetilide
41
Class IA: cardiac muscle potential
Prolong Phase 0 depolarization | Prolong Phase 3 repolarization
42
Class IB: cardiac muscle potential
SHORTEN phase 3 repolarization | SHORTEN entire AP
43
Class IC: cardiac muscle potential
Prolong Phase 0 depolarization
44
Cavernous hemangiomas of brains and viscera a/w?
VHL disease
45
Pigeon droppins
Cryptococcus neoformans
46
Bird and bat droppings
Histoplasma capsulatum
47
Potter syndrome
Bilateral renal agenesis --> oligohydroamnios | pulmonary hypoplasia, limb deformity, characteristic facies
48
Thoracentesis: upper or lower border of rib?
Perform along UPPER border | lower border =van
49
Thoracentesis should be performed?
Midclavicular: above 7th Midaxillary: above 9th Paravertebral: above 11th
50
Granuloma: Th1 or Th2
Th1 type CD4+!!!!!! | IL-2, INF-gamma
51
IL-4 | IL-5
4: IgE antibody production 5: Production and activation of eosinophil, synthesis of IgA
52
CD4< 50
Prophylactic to prevent MAC infection | Azithromycin
53
CD4< 100
Prophylactic to prevent Toxoplasma gondii infection | TMP-SMX
54
CD4< 200
Prophylactic to prevent Pneumocystis jiroveci infection | TMP-SMX
55
CD4< 150
Prophylactic to prevent Histoplasma | Itraconazole
56
PVR is lowest at?
FRC
57
Decrease LV chamber apex2base dimension Sigmoid-shaped ventricular septum Myocyte atrophy w/ interstitial fibrosis Accumulation of lipofuscin pigment
NORMAL morphological changes in aging heart
58
Stimulation of vagus nerve that supply the lung
Bronchoconstriction and increased mucus production | increase airway resistance and work of breathing
59
Bosentan
Competitive antagonist of endothelin receptors | Tx of primary pulmonary arterial HTN
60
Ethambutol
Inhibit arabinosyl transferase (for tx of TB) (a/e: optic neuritis, color blindness, central scotoma)
61
Cytokines that mediate SYSTEMIC inflammatory response (and stimulate hepatic secretion of acute phase reactants)
IL-1 IL-6 TNF-alpha
62
Localized pleural thickening w/ calcification | parietal pleura of PL mid-lung zones and diaphragm
HALLMARK of asbestosis
63
Nodular densities and eggshell calcifications of hilar nodes
Pulmonary silicosis
64
Pneumoconiosis: upper vs. lower lobes
Upper: anthracosis, silicosis Lower: asbestosis
65
``` Erythema nodosum Arthralgias Hilar LAD Elevated serum ACE Liver: scattered noncaseating granuloma ```
Sarcoidosis
66
Transplant patient | Intranuclear and cytoplasmic inclusions
CMV | enveloped, double-stranded DNA virus
67
Loss of infectivity after ether exposure
Characteristic feature of ENVELOPED viruses
68
Pulmonary arterial HTN: what gene mutation?
BMPR2 gene
69
Preferred prophylaxis for N. meningitidis exposure
Rifampin
70
Neutrophil infiltrates Mucous gland enlargement Patchy squamous metaplasia of bronchial mucosa
Chronic bronchitis
71
Meconium ileus
Cystic fibrosis
72
T and B cell functioning impaired (low IgM) Throbocytopenic purpura Eczema
Wiskott-Aldrich syndrome
73
Mucormycosis is strongly a/w?
Diabetes mellitus | Diabetic ketoacidosis
74
Immune complex vasculitis a/w IgA and C3 deposition
Henoch-Schonlein purpura | palpable purpura, colicky abdominal pain, polyarthalgia, acute GN is complication
75
Westermark sign | Hampton's hump
Pulmonary embolism
76
``` Adult onset asthma Eosinophilia History of allergy, mono/polyneuropathy Migratory/transient pulmonary infiltrates Paranasal sinus abnormalities ```
Churg-Strauss vasculitis
77
Panacinar emphysema Centriacinar emphysema LOCATION
Panacinar: preferentially localize to LOWER lobe Centriacinar: UPPER lobe distribution
78
Phentolamine
Alpha1 and Alpha2 antagonist
79
Most sensitive provocative diagnostic test for coronary vasospasm?
Ergonovine | Stimulate alpha and serotonergic receptor

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