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board review > respiratory > Flashcards

respiratory Flashcards

1
Q

alpha 1 antitrypsin deficiency is due to

A

mutation of Pi gene on chromosome 14

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2
Q

exposure to asbestos fibers causes which one of the following X ray findings?

A. pleural blebs

B. Diffuse interstitial pulmonary fibrosis w/ irregular or linear opacities at the bases of the lungs

A

B

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3
Q

pt hx of working in shipyards or manufacturing insulation

this is pathognomoic for exposure to?

A

asbestos

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4
Q

pt has hx silicosis exposure and has silicotic nodules of varying sizes scattered throughout the lungs

now presents with FEVER.

what should you do?

A

PPD test for TB

TX if + = isonizid

if pt has negative sputum culture and negative chest xray then give isonizid for 9 months.

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5
Q

construction

stone masonry

mining

sandblasting

**ceramics

all increase risk of

A

silicosis

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6
Q

usual interstitial pneumonia

is also called?

A

idiopathic pulmonary fibrosis

its the most common and lethal usual interstitial pneumonia

  • dypnea, cough,

no hx of infection, drugs or occupational exposure

coarse crackles and rales

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7
Q

whats the pathology of restrictive lung disease caused by

sarcoidosis

A

exaggerated immune response w/ accumulation of lymphocytes and macrophages

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8
Q

on the boards

breath sounds –> bronchial

percussion note –> dull

tactile fremitus –> increased

diagnosis?

A

lobar pneumonia

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9
Q

on boards

pt with typical pneumonia

in the right lower lobe.

now complaining of shoulder pain with coughing

what is the cause of these symptoms

A

pneumonia involving the diaphragmatic pleura

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10
Q

tx of streptococcus pnenumonia

A

doxycycline,

or

azithromycin

or

clarithromycin

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11
Q

if pt has typical pneumonia caused by streptococcus pneumoniae

and has a comorbidity

how do you tx

A

admit (inpatient

levofloxacin IV

or

ceftriaxone + azithromycin

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12
Q

pneumonia caused by legionella pneumophila

is diagnosed by

A

urinary antgen (radioimmunoassay)

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13
Q

aspiration of endogenous oropharyngeal flora polymorphic gram + organism

A

aspriation pneumonia

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14
Q

a pt with a clenched fist injury

(pt hit someone else in the mouth)

what microbe could be infected his hand

A

peptostreptococcus

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15
Q

pneumonia clues for the boards

nursing home

A

klebsiella

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16
Q

pneumonia clues for the boards

COPD pt

A

moraxella

or

H influ

17
Q

pneumonia clues for the boards

cattle, sheep, farmer

A

Q fever

18
Q

pneumonia clues for the boards

Birds

A

C. Psittacosis

19
Q

pneumonia clues for the boards

hunter

A

tularemia

20
Q

pneumonia clues for the boards

bat caves in mississippi, ohio river valleys

A

histoplasmosis

21
Q

pneumonia clues for the boards

California, arizona

A

Coccidiomycosis

(sarcoid like)*

22
Q

pneumonia clues for the boards

Chicago

(bone lesions)

A

blastomycosis

23
Q

pneumonia clues for the boards

Homosexual

A

P jiroveci P

24
Q

pneumonia clues for the boards

headache, diarrhea, and delirium confusion

A

legionella

(water cocolers, CXR worse

25
Q

pneumonia clues for the boards

acute infection with HIV results in Reactivation of what latent infection

A

TB

26
Q

on boards

what do these presentations represent?

pt with severe injury to the chest wall or illegal abortion in underserved area. that now has emboli

A

air embolism

due to bubbling of air into the circulation

27
Q

pts with hereditary pulmonary htn with

mutations of bone morphogenetic protein receptor type II (BMPR-II)

what is the cause of the pulm htn

A

BMPR-II function to inhibit proliferation of vascular smooth muscle tissue doesnt work anymore

28
Q

bronchoalveolar carcinoma

arises from

A

clara cells

29
Q

how does large cell carcinoma of the lung cause

gynecomastia

A

excessive secretion no B - HCG –> high levels of estrogen and painful gynecomastia (breast enlargement) in males

30
Q

pt long hx of smoking, pt in ER brought by family bc he is confused

his Na is 118. (normal 140)

whats the cause

A

SIADH –> hyponatremia –> confusion

(hes not losing Na - remember Na level on the electrolyte panel is not telling you about the Na in body but its telling you about how much water is in body. if high Na = pt dehydrated, if na is low = overhydrated)

in small cell carcinoma.

31
Q

on boards

ataxia in pt with long hx of smoking

what is your diagnosis

A

small cell carcinoma

(paraneoplastic syndrome)

causing cerebellar (purkinje cell) degeneration/ subacute cerebeller degeneration due to autoimmune.

board review (20 decks)

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