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HY - pulm + cardiac Flashcards

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1
Q

two organisms of lobar pneumonia

A

streptococcus penumoniae + klebsiella pneumoniae

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2
Q

lung CA of non-smoker + periphery

A

adenocarcinoma

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3
Q

four phases of lobar pneumonia

A

congestion, red hepaization, grey hepatization, resolution

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4
Q

common cause of secondary pneumonia + complicated by abscess or empyema

A

staph aureus

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5
Q

atypical/interstitial penumoniae

A

mycoplasma pneumoniae, chlamydia pneumoniae, RSV, CMV, influenza virus, coxiella burnettie

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6
Q

not visible on gram stain

A

mycoplasma pneumoiae; lack of cell wall, similar to eukaryotes with cholesterol components

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7
Q

aspiration pneumonia + right lower lobe abscess

A

bacterioides, fusobacterium, peptococcus

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8
Q

AFB stain + caseating granuloma

A

mycobacterium

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9
Q

caseating granulomase + meningites at base of brain

A

systemic tb

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10
Q

arsenic + polycyclic hydrocarbons

A

particularly carcinogenic features of smoking

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11
Q

benign coin lesions

A

granulomas + broncial hamartoma (disorganized tissue with lung tissue + cartilage)

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12
Q

keratin pearls + intercellular bridges

A

squamous cell carcinoma

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13
Q

center tumor + ADH, ACTH or eaton-lambert syndrome

A

small cell carcinoma

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14
Q

central tumor + keratin pears and intercellular bridge + PTHrP (hypercalcemia)

A

squamous cell carcinoma

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15
Q

chromogranin positive + polyp-like mass in lung

A

neuroendocrine tumor; carcinoid syndrome

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16
Q

metastasis to lung

A

breast and colon CA

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17
Q

where does lung metastasize to?

A

adrenal gland

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18
Q

lung tumor in apex

A

compresses sympathetic chain; horner syndrome - ptosis, miosis, anhydriosis

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19
Q

exertional dyspnea in a young woman

A

primary pulmonary HTN; inactivating BMPR2 mutation

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20
Q

BMPR2 inactivating mutation + plexiform lesions + atherosclerosis of pulmonary arter

A

pulmonary HTN

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21
Q

pink hyaline membranes

A

ARDS; develop hypoxemia + diffuse collapse of lungs

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22
Q

neutrophil mediated damaged to type 1 and 2 pneumocytes by proteases and FR

A

ARDS

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23
Q

complications of NRDS

A

persistence of PDA, necrotizing enteroclitis; supplemental oxygen increase risk of free radical injury (damage to retina causing blindness, bronchopulminary dysplasia)

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24
Q

centri-acinar emphysema + upper lobes

A

smoker emphysema

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25
PAS + liver in someone with emphysema
A1AT deficiency with buildup in liver
26
prolonged expiration with pursed lips
emphysema; back pressure keeps airways open
27
barrel chest
emphysema; lose elastic recoil
28
lose elastic recoil
emphysema
29
increase elastic recoil
pulmonary fibrosis
30
main cytokines from TH2
IL 4 (class-switching), IL5 (recruit eos), IL10 (promote overall reaciton, + TH1 and X TH2)
31
charcot-leyden crystals
eosinophil dervied in sputum of asthmatic
32
SAA and AA
secondary amyloidosis
33
fibrosis mediator in IPF
TGF-b
34
secondary causes of pulmonary fibrosis
radiation, bleomycin, amiodarone
35
coal workers lung + RA
Caplan syndrome
36
anthracosis
collections of carbon-laden macrophages
37
pneumoconioses that increases risk of TB
silicosis; impairs phagolysosomes formation by macrophages
38
non-caseating granulomas in lung, hilar lymph nodes + systemic organs + aeorospace worker
berylliosis; doen't confuse with sarcoidosis
39
iron ferruginous bodies
asbestosis
40
epithelioid histiocytes
defining cell of granuloma
41
asterioid body
sarcoidosis
42
non-caseating granuloma disease that can mimic sjogrens disease
sarcoidosis
43
elevated serum ACE + hypercalcemia (1-a hydroxylase activity) + non-caseating granulomas
sarcoidosis
44
hypercalcemia in non-caseating granulomas
high levels of 1-a hydroxylase
45
blood supply to papillary muscle
RCA; can rupture following ischemia with occlusion of this vessel day 4-7
46
pericarditis several weeks following MI
Dressler syndrome; auto-antibodies against pericardium
47
coagulative necrosis following MI
4-34 hrs, no inflammation cells
48
when would you see fibrinoid pericarditis?
transumural infarction
49
when develop scar post MI?
after 1 month; type 1 collagen
50
hemosiderin laden macrophages within lungs
herat failure cells
51
what do blood vessels lung do in response to hypoxemia?
constrict, makes it harder for heart to pump, can lead to cor pulmonale wh
52
what heart defect is associated with FAS?
ventricle septal defect
53
results of eisenmeger syndrome
cyanosis, clubbing, right ventircular hypertorphy
54
which type of ASD is associated with down syndrome?
ostium primum
55
congenital rubella is associated with what heart defect?
PDA
56
machine-like murmur + lower extremity cyanosis
PDA; lower extermity cyanosis due to pulmonary HTN
57
what to close PDA?
Indomethacine, gets rid of PDE
58
cyanosis upon exercising + squat to relieve
R to L shunt, increase pressure on L side favoring blood flow to pulmonary circulation
59
boot-shaped heart
T of F
60
how to keep baby with transposition of great vessels alive?
keep PDA open with PGE
61
maternal diabetes associated with what heart defect?
transposition of great vessels
62
truncus arteriosus
persistent due to failure of division ; early cyanosis due to mixing of blood in ventricles
63
tricuspid atresia
early cyanosis since blood can't go to pulmonary circulation
64
infantile coarctation of the aorta
associated with pda, between aortic arch and PDA, lower extremity cyanosis, turnery syndrome
65
what heart defect is turner syndrome associated with?
coarctation of the aorta with lower extremity cyanosis
66
adult coarctation of the aorta
HTN in UE and hypotension with weak pulses in LE; associated with bicuspid aortic valve
67
acute rheumatic fever
systemic complication due to immune response to M protein (molecular mimcry) = damage to human tissues with auto-antibodies
68
diagnosis of ARF
evidence of strep b infection with ASO or anti-DNase B titer; fever or elevated fever; J (joint, migratory polyarthralgias) O (heart, pancarditis) N (nodules, subcutaneous) E (erythema marginatum) S (sydnans chorea)
69
what is long term sequelae or ARF?
heart - mitral valve +/- aortic, aschoff bodies and aniskoff cellls within myocardium
70
what will kill patients with ARF?
myocarditis
71
increased risk of aortic stenosis
bicuspid aortic valve; turner syndrome
72
distinguish aortic dises of aortic stenosis from rheumatic disease
rheumatic disease will have fusion of valves
73
early, blowing diastolic murmur
aortic regurgitation
74
what does aortic regurgitaiton do to the pulse pressure?
widens it; patient will have head-bobbing, bounding pulses, pulsatile nail beds
75
mid-systolic click followed by regurgitation murmur
mitral valve prolapse
76
holosystolic blowing murmur louder with squatting and expiration
mitral regurgitation
77
what does acute vs chronic rheumatic fever do to the mitral valve?
acute = regurgitaiton (holosystolic blowing murmur; chronic = aomitral stenosis with diastolic murmur
78
opening snap followed by diastolic rumble
mitral stenosis
79
small vegetations on previously damaged valves
low virulence s viridans
80
large vegetations on tricuspid
highly infectious s aurea; IV drug user
81
endocarditis of prosthatetic valves
s epidermidis
82
patient is determined to have endocarditis with s bovis. what should you check next?
unerlying colorectal cancer
83
endocarditis with negative blood cultures
HACEK (hemophilus, actinobacillus, cardiobacterium, eikenella, kingella); paritculalrly hard to grow on cluture
84
what technique can be used to visualize valvular vegetations?
TEE
85
libman sacks endocarditis
sterile vegatations on both sides of valve; usually mitral valve with regurgitaiton
86
complications of dilated cardiomyopathy
valve regurgitation (mitral and tricuspid) + arrhytmia
87
doxorubicin + late complication of coxsackie virus + alcohol + pregnancy
dilated cardiomyopathy
88
acute vs late consequences of myocarditis
acute = death, later on = dilated cardiopmyopathy
89
mutations in _____ most common cause of hypertrophic cardiomyopathy
mutations in sarcomere
90
sudden death of young athlete or syncope with exercise
hypertrophic cardiomyopathy
91
myofier hypertrophy with disarray
hy[pertrophic cardiomyopathy
92
causes of restrictive cardiomyopathy
amyloidosis, sarcoidsosi, hemochromatosis, endocrdial fibroelastosis, loeffler syndrome
93
low voltage EKG with diminished QRS amplitudes
restrictive cardiomyopathy presenting as CHF
94
children + tuberous sclerosis + benign hamartoma of cardiac muscle
rhabdomyoma

neuro (34 decks)

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