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TxPlan/MedComplex/SpecNeeds > MedComplex-Exam 2 Part 2 (TB, DentalAllergy,PUD) > Flashcards

MedComplex-Exam 2 Part 2 (TB, DentalAllergy,PUD) Flashcards

1
Q

Freakin tricky: what is the genus and species of TB?

A

MYCO-BACTERIUM Tuberculosis

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2
Q

Myco-bacterium tuberculosis is a _______-shaped bacterium with a _____ capsule….

A

rod-shaped….waxy

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3
Q

Is TB aerobic or anaerobic? What is the complex lipid in its cell wall?

A

Mycolic Acid

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4
Q

TB is transmitted from person to person by _________ and the initial site of infection is in the _____….What is a secondary portal of entry for TB?

A

respiratory aerosols…lungs….secondary: GI tract (i don’t know how)

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5
Q

What is the name of the stain used for TB since it does not stain gram negative nor positive?

A

acid fast

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6
Q

Does TB attract acute inflammatory cells?

A

No, PMNs are not attracted.

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7
Q

What type of inflammatory cells go after TB? What is the transformation process?

A

macrophages transform into multi-nucleated giant cells

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8
Q

What are the components of a GHON COMPLEX?

A

1.Peripheral Parenchymal Granuloma 2. Mediastinal (hilar) lymph node

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9
Q

Yikes. This is hard to remember- In TB: what is the name for a peripheral parenchymal granuloma PLUS a mediastinal (hilar) lymph node?

A

a GOHN Complex

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10
Q

Where are Ghon Complexes usually found in the lungs?

A

the LOWER lobes

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11
Q

In TB: Grossly, the healed, _______ (supra or sub pleural?) Ghon nodule is well ________ with ________ necrosis. In later stages, the lesion is fibrotic and calcified.

A

sub pleural…. circumscribed…. central

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12
Q

What is a unilateral CERVICAL adenitis that presents with swollen non-tender nodes in pt’s experiencing miliary TB?

A

SCRO-FULA

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13
Q

What is the name for VERTEBRAL osteoarthritis after military spread of TB?

A

POTTS disease

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14
Q

What are the two groups of people most at risk for spread of TB to other parts of the lungs? What is this called?

A

ImmunoCompromised and children…called “Progressive Primary Tuberculosis”

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15
Q

In miliary TB, granulomas can go to the brain/spinal chord and cause meningitis…what is the name for a granuloma in this area?

A

A Tuberculoma

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16
Q

What area of the body are Tuberculoma’s found in miliary spread of TB?

A

the Brainstem

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17
Q

How long does it take to culture a TB sample? What is the name of the special media needed to culture it?

A

6-8 weeks (rather slow)…Lowenstein-JJ Jensen Agar

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18
Q

Which STAGE of TB do we see a GHON complex?

A

PRIMARY (not secondary, not miliary)

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19
Q

What is it called when a primary granuloma in TB can is calcified and can be seen on a chest X ray?

A

coin lesion

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20
Q

What is the sign of a positive PPD TB test? What is the name of the TB vaccine that can yield an ALMOST positive TB test?

A

10cm…BCG vaccine (5-9cm induration)

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21
Q

TB in the oral cavity is relatively _____ and usually secondary to lung involvement, usually affecting what type of people??

A

rare…elderly people

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22
Q

ORAL TB Lesions are usually seen as superficial ulcers or patches, although marked swelling of the ______ may also be seen.

A

GINGIVA

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23
Q

What is another name for an allergy to latex?

A

NRL “Natural Rubber Latex” protein allergy

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24
Q

What is the most common cause of latex allergy?

A

Direct Contact

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25
Q

What are the 4 major risk factors/groups of people for Latex allergy?

A
  1. Kids with Spina Bifida 2. ppl w/ food allergies 3.family hoof allergies 4.health care workers
26
Q

About what percent of people with spina bifida are going to have a latex allergy?

A

about 50%!

27
Q

Interesting! What group of people are most likely to have a latex allergy?

A

Children with spina bifida

28
Q

What type of reaction is a NRL protein allergy? Which antibody is associated with it???

A

Type I (immediate) hypersensitivity…IgE

29
Q

While the NRL Protein allergy was more common in the 90’s it has gone down to about what % of health care workers affected?

A

less than 10% (down from 12-17%)

30
Q

What are the three types of Reactions to Latex and what type of immune mediated response occurs for each?

A

1.NRL protein allergy-Type I 2.ACD (Allergic Contact Dermatitis) - Type IV 3. ICD (Irritant Contact Dermatitis) - NO immune response

31
Q

RememberTHATFor an ACD rxn what is the specific immune cell that is activated?

A

T-cell lymphocyte

32
Q

What is the role of Gluteraldehyde in the dental practice?

A

disinfectant

33
Q

What are the 3 main chemicals that cause ACD in a dental practice?

A

1.Gluteraldehyde 2.Methacrylate 3.Metals

34
Q

What are the two types of allergic reactions associated with Gluteraldehyde?

A

1.ACD 2.ICD

35
Q

What is the cause of a hiatal hernia MOST OF THE TIME?

A

Hiatal Hernia

36
Q

What are the two basic types of hiatal hernias? What % of the time are each?

A

1.Sliding (95%) 2.Paraesophageal (5%)

37
Q

Sliding Hernia: An enlargement of the diaphragmatic hiatus and laxity of the of the _________ connective tissue allows a cap of gastric cardia to move upward to a position above the diaphragm.

A

circumferential

38
Q

Sliding Hernia: Must be hard to Dx because its _________ in the large majority of patients and only 5% of patients diagnosed _________ complain of symptoms referable to gastroesophageal reflux.

A

asymptomatic… radiographically

39
Q

Paraesophageal hernia: This form is characterized by herniation of a portion of the gastric ______ alongside the esophagus through a defect in the diaphragmatic connective tissue membrane that defines the esophageal hiatus.

A

fundus

40
Q

WOAH in extreme cases of _________ hernias most of the stomach herniates into the thorax!!

A

Paraesophageal

41
Q

BOOM. TEST QUESTION. _______ hernias are often treated medically, whereas __________ should be tx. surgically.

A

Sliding=medically…Paraesophageal=surgically

42
Q

What is replacement of squamous epithelium of the esophagus by columnar epithelium as a result of chronic GE reflux?

A

Barretts Esophagus

43
Q

In Barretts Esophagus what is the type of metaplasia going on? (what cell type to what cell type?)

A

Stratified Squamous TO Columnar epi

44
Q

Barretts Esophagus occurs in the ______ third of the esophagus, particularly among _____ men.

A

lower…white

45
Q

Barretts Esophagus has a greater than twofold increased risk among ______.

A

smokers

46
Q

What type of cancer is a person with Barrett’s esophagus at greater risk for?

A

Adenocarcinoma (not SCC since there was metaplasia)

47
Q

Cool aside: What is the end product of the urease secreted that buffers H. Pylori in the stomach acid?

A

ammonia

48
Q

The common factor that unites both GASTIC and DUODENAL ulcers is secretion of ________.

A

HydroChloric Acid….HCl

49
Q

Gastric vs. Duodenal: peak incidence between 30 and 60 years old

A

duodenal ulcer disease

50
Q

Gastric vs. Duodenal: affects more males than females

A

dude-odinal ulcers :) LOL

51
Q

Gastric vs. Duodenal: affect middle aged and elderly more than young

A

gastric ulcer disease

52
Q

Gastric vs. Duodenal: affects men and women equally

A

gastric (grandma)

53
Q

Gastric vs. Duodenal: In the U.S., the incidence for _______ ulcers is the same for blacks and whites, but in Africa, they are RARE among blacks. In the western urban setting, all racial and ethnic groups are susceptible.

A

duodenal

54
Q

The common stereotype of the patient with a peptic ulcer is that of a highly motivated executive operating in a ________ environment.

A

STRESSFUL

55
Q

PUD: Environmental Factors: High amounts of ______ and cirrhosis of the liver are associated with PUD. _______ as well as NSAID’s and high-dose _______ have all been incriminated in the production of peptic ulcers. _______ is also a risk for PUD, particularly gastric ulcers, although the mechanism is controversial.

A

Alcohol… Aspirin… Corticosteroids… smoking

56
Q

Gastric vs. Duodenal: genetic susceptibility

A

duodenal (no increase c/o genetics in gastric ulcers)

57
Q

Gastric vs. Duodenal: Type O blood

A

duOdenal (no assoc. with gastric)

58
Q

Gastric vs. Duodenal: Kissing ulcers

A

duodenal

59
Q

The classic case of _______ ulcer is characterized by burning epigastric pain that is experienced 1-3 hours after a meal or that awakens the patient at night.

A

duodenal

60
Q

Gastric vs. Duodenal: perforations

A

duodenal

61
Q

Gastric vs. Duodenal: need BIOPSY

A

gastric (duodenal does not need biopsy-no known cases of malignancy)

TxPlan/MedComplex/SpecNeeds (21 decks)

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