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UWorld > Set 9 (Pulmonary) > Flashcards

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
Q 
True vocal cords
Laryngopharynx
Anterior epiglottis
Superior half of posterior epiglottis:
Epithelium?
A

Stratified squamous epithelium

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26
Q

Round, cigar-shaped budding yeasts

A

Sporothrix schenckii

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27
Q

Green discoloration of sputum/pus is a/w?

A

Myeloperoxidase

Neutrophil azurophilic granule

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28
Q

Lipoprotein lipase

A

Release TG from chylomicrons

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29
Q

LPL deficiency results in increase of?

A

CHYLOMICRONS

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30
Q

Marked hyperLIPIDemia
Pancreatitis
Lipemia retinalis
Eruptive skin xanthomas (extensor surfaces of extremities)

A 
LPL deficiency
(Familial hyperCHYLOMICRONemia)
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31
Q

Defect in LDL receptor leads to increase of?

A

CHOLESTEROL

Accelerated AS

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32
Q

Accelerated coronary artery disease/atherosclerosis seen with which deficiency?

A

LDL receptor defect (increased cholesterol)

Familial hyperCHOLESTEROLemia

33
Q

Tubular/Tendon xanthomas
Xanthelasma
Arcus cornea

A 
Familial hyperCHOLESTEROLemia
(LDL receptor defect)
34
Q

Hallmark of familial hyperCHOLESTEROLemia

A

Tendon xanthomas

35
Q

Acute pancreatitis a/w what familial hyperlipidemias?

A

Familial hyperCHYLOMICRONemia (hyperTG)

36
Q

Frataxin gene

A

Mitochondrial protein important in iron homoeostasis and respiratory fxn

37
Q

MHC Class I molecule

A

Heavy chain
+
B2-microglobulin

38
Q

MHC Class II molecule

A

Alpha and Beta chain

39
Q

Claudication is the result of?

A

Atherosclerosis of larger ARTERIES

40
Q

Class III antiarrhythmics

A

Amiodarone
Sotalol
Ibutilide, dofetilide

41
Q

Class IA: cardiac muscle potential

A

Prolong Phase 0 depolarization

Prolong Phase 3 repolarization

42
Q

Class IB: cardiac muscle potential

A

SHORTEN phase 3 repolarization

SHORTEN entire AP

43
Q

Class IC: cardiac muscle potential

A

Prolong Phase 0 depolarization

44
Q

Cavernous hemangiomas of brains and viscera a/w?

A

VHL disease

45
Q

Pigeon droppins

A

Cryptococcus neoformans

46
Q

Bird and bat droppings

A

Histoplasma capsulatum

47
Q

Potter syndrome

A

Bilateral renal agenesis –> oligohydroamnios

pulmonary hypoplasia, limb deformity, characteristic facies

48
Q

Thoracentesis: upper or lower border of rib?

A

Perform along UPPER border

lower border =van

49
Q

Thoracentesis should be performed?

A

Midclavicular: above 7th
Midaxillary: above 9th
Paravertebral: above 11th

50
Q

Granuloma: Th1 or Th2

A

Th1 type CD4+!!!!!!

IL-2, INF-gamma

51
Q

IL-4

IL-5

A

4: IgE antibody production
5: Production and activation of eosinophil, synthesis of IgA

52
Q

CD4< 50

A

Prophylactic to prevent MAC infection

Azithromycin

53
Q

CD4< 100

A

Prophylactic to prevent Toxoplasma gondii infection

TMP-SMX

54
Q

CD4< 200

A

Prophylactic to prevent Pneumocystis jiroveci infection

TMP-SMX

55
Q

CD4< 150

A

Prophylactic to prevent Histoplasma

Itraconazole

56
Q

PVR is lowest at?

A

FRC

57
Q

Decrease LV chamber apex2base dimension
Sigmoid-shaped ventricular septum
Myocyte atrophy w/ interstitial fibrosis
Accumulation of lipofuscin pigment

A

NORMAL morphological changes in aging heart

58
Q

Stimulation of vagus nerve that supply the lung

A

Bronchoconstriction and increased mucus production

increase airway resistance and work of breathing

59
Q

Bosentan

A

Competitive antagonist of endothelin receptors

Tx of primary pulmonary arterial HTN

60
Q

Ethambutol

A

Inhibit arabinosyl transferase
(for tx of TB)
(a/e: optic neuritis, color blindness, central scotoma)

61
Q

Cytokines that mediate SYSTEMIC inflammatory response (and stimulate hepatic secretion of acute phase reactants)

A

IL-1
IL-6
TNF-alpha

62
Q

Localized pleural thickening w/ calcification

parietal pleura of PL mid-lung zones and diaphragm

A

HALLMARK of asbestosis

63
Q

Nodular densities and eggshell calcifications of hilar nodes

A

Pulmonary silicosis

64
Q

Pneumoconiosis: upper vs. lower lobes

A

Upper: anthracosis, silicosis
Lower: asbestosis

65
Q 
Erythema nodosum
Arthralgias
Hilar LAD
Elevated serum ACE
Liver: scattered noncaseating granuloma
A

Sarcoidosis

66
Q

Transplant patient

Intranuclear and cytoplasmic inclusions

A

CMV

enveloped, double-stranded DNA virus

67
Q

Loss of infectivity after ether exposure

A

Characteristic feature of ENVELOPED viruses

68
Q

Pulmonary arterial HTN: what gene mutation?

A

BMPR2 gene

69
Q

Preferred prophylaxis for N. meningitidis exposure

A

Rifampin

70
Q

Neutrophil infiltrates
Mucous gland enlargement
Patchy squamous metaplasia of bronchial mucosa

A

Chronic bronchitis

71
Q

Meconium ileus

A

Cystic fibrosis

72
Q

T and B cell functioning impaired (low IgM)
Throbocytopenic purpura
Eczema

A

Wiskott-Aldrich syndrome

73
Q

Mucormycosis is strongly a/w?

A

Diabetes mellitus

Diabetic ketoacidosis

74
Q

Immune complex vasculitis a/w IgA and C3 deposition

A

Henoch-Schonlein purpura

palpable purpura, colicky abdominal pain, polyarthalgia, acute GN is complication

75
Q

Westermark sign

Hampton’s hump

A

Pulmonary embolism

76
Q 
Adult onset asthma
Eosinophilia
History of allergy, mono/polyneuropathy
Migratory/transient pulmonary infiltrates
Paranasal sinus abnormalities
A

Churg-Strauss vasculitis

77
Q

Panacinar emphysema
Centriacinar emphysema
LOCATION

A

Panacinar: preferentially localize to LOWER lobe
Centriacinar: UPPER lobe distribution

78
Q

Phentolamine

A

Alpha1 and Alpha2 antagonist

79
Q

Most sensitive provocative diagnostic test for coronary vasospasm?

A

Ergonovine

Stimulate alpha and serotonergic receptor

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