USMLE Respirology Flashcards

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1
Q

What drugs are used for treating TB?

A

RIPE (Rifampin, Isoniazid, Pyrazinamide, Ethambutol)

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2
Q

What do you have to check for when someone is taking Ethambutol?

A

Visual acuity

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3
Q

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?

A

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

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4
Q

Which lung regions are most likely to be affected by an aspiration pneumonia acquired while lying down?

A

Posterior segment of right upper lobe or superior segment of right inferior lobe.

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5
Q

Stimulation by what mechanism forms Langhans giant cells?

A

CD4+ T cell stimulation

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6
Q

What is the indication for rifampin monotherapy?

A

Meningococcal exposure - eliminates carrier state in those exposed.

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7
Q

An alcoholic gets an aspiration pneumonia. What drug do you use to treat and why?

A

Clindamycin for aerobic and anaerobic coverage (greater tendency in alcoholics for these pneumoniae)

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8
Q

What are examples of antibacterial drugs that disrupt wall synthesis?

A

Vancomycin and cefuroxime

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9
Q

What conditions might you see Cheyne-Stokes breathing (apnea followed by rising and falling tidal volumes) in?

A

CHF and neurological disease (TBI, stroke, brain tumour)

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10
Q

Chinese adult with cervical LN enlargement, pleomorphic keratin +ve cells in background of lymphocytes - dx?

A

Nasopharyngeal carcinoma

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11
Q

What patient population is at higher risk for Klebsiella pneumoniae pneumonia and what are common signs?

A

Alcoholics and elderly - b/c of increased aspiration risk. Currant jelly sputum and abscess formation

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12
Q

What cells are critical in regeneration after lobar pneumonia?

A

Type 2 pneumocytes

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13
Q

What is the differential for coin lesions on CXR?

A

Lung cancer, granuloma, bronchial hamartoma?

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14
Q

What are bronchial hamartomas composed of?

A

Lung tissue + cartilage

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15
Q

What is the next step after finding a pneumonic coin lesion on CXR?

A

Compare to prior XRays

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16
Q

What is one of the main carcinogenic components of cigarette smoke?

A

Polycyclic aromatic hydrocarbons

17
Q

TH2 induction produces what markers that do what to encourage asthma?

A

IL-4 - allows IgE production
IL-5 - calls eosinophils
IL-10 - promotes TH2, blocks TH1

18
Q

How does N-acetylcysteine benefit people with CF?

A

Breaks disulfide bridges to achieve mucolysis

19
Q

CF exhibits what physiologic changes to the respiratory mucosa?

A

Increased Na absorption, decreased Cl excretion

20
Q

How does high altitude affect blood pH, PaO2, PaCO2, and plasma HCO3?

A

Increase, decrease, decrease, increase

21
Q

African American female with pulmonary infiltrates and hilar lymphadenopathy. Dx?

A

Sarcoidosis

22
Q

How do you distinguish between an acute respiratory acidosis and a chronic respiratory acidosis?

A

HCO3 compensation. If 30, then chronic.

23
Q

If you pierce the piriform recess, what nerve will you hit and what reflex will you lose?

A

Superior laryngeal nerve of vagus. Cough.

24
Q

What cells respond in the lungs for sarcoidosis?

A

CD4+ lymphocytes

25
Q

TB with low catalase-peroxidase activity means which TB drug will be ineffective?

A

Isoniazid

26
Q

What do nasal polyps make you think of?

A

Aspirin intolerant asthma
Child with CF
Recurrent rhinitis

27
Q

What happens to radial traction on airways in restrictive lung disease?

A

It increases, pulling the airway open

28
Q

If a lung bug stains red in mucicarmine, what is it?

A

Cryptococcus neoformans

29
Q

Infection by cryptococcus neoformans most commonly manifests as:

A

Meningitis

30
Q

Mycobacterium that grows in “serpentine changes” most likely has what quality?

A

Virulence - presence of cord factor