USMLE Respirology Flashcards
What drugs are used for treating TB?
RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol)
What do you have to check for when someone is taking Ethambutol?
Visual acuity
Dad has 1/30 chance of being a carrier for CF. Mom has a 1/100 chance of being a carrier for CF. What’s the chance that their kid will have CF?
Independent events - likelihood dad is a carrier and will pass carrier allele to kid is 1/30 x 1/2. For mom, likelihood is 1/100 x 1/2. Multiply the two together = 1/12,000
Which lung regions are most likely to be affected by an aspiration pneumonia acquired while lying down?
Posterior segment of right upper lobe or superior segment of right inferior lobe.
Stimulation by what mechanism forms Langhans giant cells?
CD4+ T cell stimulation
What is the indication for rifampin monotherapy?
Meningococcal exposure - eliminates carrier state in those exposed.
An alcoholic gets an aspiration pneumonia. What drug do you use to treat and why?
Clindamycin for aerobic and anaerobic coverage (greater tendency in alcoholics for these pneumoniae)
What are examples of antibacterial drugs that disrupt wall synthesis?
Vancomycin and cefuroxime
What conditions might you see Cheyne-Stokes breathing (apnea followed by rising and falling tidal volumes) in?
CHF and neurological disease (TBI, stroke, brain tumour)
Chinese adult with cervical LN enlargement, pleomorphic keratin +ve cells in background of lymphocytes - dx?
Nasopharyngeal carcinoma
What patient population is at higher risk for Klebsiella pneumoniae pneumonia and what are common signs?
Alcoholics and elderly - b/c of increased aspiration risk. Currant jelly sputum and abscess formation
What cells are critical in regeneration after lobar pneumonia?
Type 2 pneumocytes
What is the differential for coin lesions on CXR?
Lung cancer, granuloma, bronchial hamartoma?
What are bronchial hamartomas composed of?
Lung tissue + cartilage
What is the next step after finding a pneumonic coin lesion on CXR?
Compare to prior XRays
What is one of the main carcinogenic components of cigarette smoke?
Polycyclic aromatic hydrocarbons
TH2 induction produces what markers that do what to encourage asthma?
IL-4 - allows IgE production
IL-5 - calls eosinophils
IL-10 - promotes TH2, blocks TH1
How does N-acetylcysteine benefit people with CF?
Breaks disulfide bridges to achieve mucolysis
CF exhibits what physiologic changes to the respiratory mucosa?
Increased Na absorption, decreased Cl excretion
How does high altitude affect blood pH, PaO2, PaCO2, and plasma HCO3?
Increase, decrease, decrease, increase
African American female with pulmonary infiltrates and hilar lymphadenopathy. Dx?
Sarcoidosis
How do you distinguish between an acute respiratory acidosis and a chronic respiratory acidosis?
HCO3 compensation. If 30, then chronic.
If you pierce the piriform recess, what nerve will you hit and what reflex will you lose?
Superior laryngeal nerve of vagus. Cough.
What cells respond in the lungs for sarcoidosis?
CD4+ lymphocytes
TB with low catalase-peroxidase activity means which TB drug will be ineffective?
Isoniazid
What do nasal polyps make you think of?
Aspirin intolerant asthma
Child with CF
Recurrent rhinitis
What happens to radial traction on airways in restrictive lung disease?
It increases, pulling the airway open
If a lung bug stains red in mucicarmine, what is it?
Cryptococcus neoformans
Infection by cryptococcus neoformans most commonly manifests as:
Meningitis
Mycobacterium that grows in “serpentine changes” most likely has what quality?
Virulence - presence of cord factor
