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6th year subjects > Internal common topics > Flashcards

Internal common topics Flashcards

(49 cards)

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1
Q

Define obstructive lung disease?

A

Increased resistance to airflow caused by narrowing of airways

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2
Q

Etiology of obstructive lung disease (OLD)

A

COPD
Bronchial asthma
Bronchiectasis
Cystic fibrosis
Laryngeal tumors
Vocal cord palsy

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3
Q

A-a gradient in obstructive lung disease

A

Difference between the pO2 in the alveoli (A) and the arteries (a).

Normal range is 5-10 mmHg, and varies with age, altitude, and the concentration of inhaled oxygen.

In diseased states, A-a gradient increases with a ventilation-perfusion mismatch and/or impaired gas diffusion across the alveoli.

In OLB it INCREASES

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4
Q

Imaging finding in OLD

A
  1. Hyperlucency of lung tissue
  2. Horizontal ribs and widened intercostal spaces
  3. Increased AP diameter
  4. Diaphragm pushed down and flattened
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5
Q

Physiological lung volumes

A

(TLC) Total lung capacity
(IRV) Inspiratory reserve volume
(FRC) Functional residual capacity
(IRC) Inspiratory reserve capacity
(ERV) Expiratory reserve volumes
(RV) Residual volume
(VC) Vital capacity

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6
Q

Lung volume flow loop in OLD

A

The top graph is a normal flow-volume loop and a time-volume curve used to determine the FEV1.

Obstructive lung diseases result in a concave flow-volume loop due to increased resistance. Absolute FEV1, as well as FEV1 relative to vital capacity (FEV1/FVC), is diminished.

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7
Q

FEV 1

A

The ratio of FEV₁ (maximum volume of air that can be forcefully expired within 1 second after maximal inspiration

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8
Q

FEV1/FCV

A

FEV₁/FVC ratio is decreased in obstructive lung disease.
In restrictive lung diseases, FEV₁/FVC ratio may be normal or increased

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9
Q

Pulmo testing results

A
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10
Q

How can you test the lung function?

A

Spirometry
Plethysmograph
DLco

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11
Q

Spirometri findings in OLD

A
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12
Q

Plethysmograph findings in OLD

A
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13
Q

what is measured in anemia?

A

Hematorcrit
Hemoglobin

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14
Q

Hct in Anemia

A

M: < 40%
F: < 35%

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15
Q

Hb in anemia

A

M: < 14
F: < 12

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16
Q

Anemia severity

A

Mind 10-11
Moderate 8-10
Severe 7-8

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17
Q

Classification of anemia

A

MCV < 80: Microcytic anemia- Small RBC
MCV 80-100: Normocytic anemia Normal-sized RBC
MCV > 100: Macrocytic anemia- Larger RBC

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18
Q

what to check in Microcytic anemia?

A

Ferritiin (high/low)
TIBC (high/low)

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19
Q

Etiology of microcytic anemia?

A

Iron deficiency anemia
Anemia of chronic disease
B-thallasemia
Bart disease
Sideroblastic anemia

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20
Q

Etiology of normocytic anemia? What do you look for?

Study These Flashcards
A

Reticulocytes high/ low
EPO high/low
Signs of hemolysis?

  • CKD
  • Aplastic anemia
  • Blood loss
  • Hemolytic anemia
21
Q

Signs of hemolysis?

Study These Flashcards
A

High LDH
High Indirect billi
Low Haptoglobin

22
Q

what to look for in Macrocytic anemia

Study These Flashcards
A

Are there megaloblast or not?
Yes: megaloblastic anemia
No: Non-megaloblastic anemia

23
Q

Causes of Macrocytic anemia?

Study These Flashcards
A

Megaloblasts:
Reticulocytosis
Liver disease
Drugs (methotrexate)
Hypothyroidism
Multiple myeloma
Myeloproliferative diaseases

Non-megaloblast
Vitamin b12 def
Folate def

24
Q

what is TIBC

Study These Flashcards
A

TIBC (Total Iron Binding Capacity) differentiates between Iron deficiency anemia and Anemia of chronic disease

25
Mentzer Index in anemia
is calculated to find out if it is Thalassemia MCV/RBC Index <13 → suggests a thalassemia trait Index >13 → suggests that the patient has an IDA or ACD
26
what are reticulocytes?
immature RBC produced by BM, predicts how fast red blood cells are made by the and released into the blood. Normal range 0.5-1.5% Hypo-proliferative: <2% Hyper-proliferative: >2%
27
what are megaloblasts?
Megaloblast cells are large non-nucleated red cells.
28
Majour cause if IDA
Decreased intake (diet) Increased utilization (During pregnancy, the growth years) Excessive loss of iron (blood loss, menstruation) Incomplete absorption (diarrhea, gastric sleve)
29
If a gastroenterological evaluation fails to disclose a likely cause of IDA in a patent refractory to oral iron treatment what do you screen for?
Celiac disease, autoimmune gastritis, and Helicobacter pylori is recommended. 20% of patients with unexplained IDA have autoimmune gastritis, 50% have evidence of active H. pylori infection 4% have celiac disease
30
medication causin macrocytic anemia
Phenytoin Sulfa drugs Trimethoprim Hydroxyurea MTX 6-mercaptopurin
31
Characterization of hemolytic anemia
By the cause and by the location:: Intrinsic hemolytic anemia: abnormalities in RBCs (hemoglobin, RBC membrane, or intracellular enzymes), Extrinsic hemolytic anemia external causes (immune-mediated or mechanical damage), which is called extrinsic hemolytic anemia. Intravascular Extravascular
32
Etiology of intravascular hemolytic anemia?
1. Toxins 2. G6PD deficiency 3. Anti-body mediated 4. Macroangiopathic anemia 5. Microangiopathic anemia
33
Etiology of extravascular anemia
1. RBC defects (sickle cell disease, spherocytosis, PKD deficiency) 2. Anti-b mediated hemolysis (warm and cold agglutinin disease)
34
signs of anemia
* Pallor * Fatigue * Exertional dyspnea * In severe cases: tachycardia, angina pectoris, leg ulcers
35
Test that can be done in hemolytic anemia?
Coombs tets with Ab for immune proteins that mediate hemolysis, agglutination is a positive test
36
clinical symptoms of hodgkin lymphoma
Painless lymphadenopathy B symptoms in the classical Pel-Ebstein fever, rare but specific (2w fever 2w no fever) Alcohol-induced pain in lymph nodes. Rar but specific Pruritus (focal or generalized)
37
classification in Hodgkin lymphoma
Lugado classification
38
chemo in Hodgkin lymphoma
ABVD: adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine Stanford V: doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, prednisone BEACOPP: bleomycin, etoposide, adriamycin (doxorubicin), cyclophosphamide, oncovin (vincristine), procarbazine, prednisone
39
two classifications of Hodgkin lymphoma
Classical HL (4 types) (95%) Non-lymphocyte predominant HL (5%)
40
difference between classical Hl and non-lymphocyte predominant HL?
Classical has CD 15 + 30 Non LPHL has CD 45 + 20
41
which HL has the worst prognosis?
Lymphocyte depleted classical HL
42
which HL has the best prognosis?
Lymphocyte rich classical HL
43
Etiology of non-Hodgkin lymphoma
Chromosomal translocations: most commonly t(14;18) EBV, HIV Helicobacter pylori: MALT lymphoma, DLBCL Autoimmune diseases: Hashimoto thyroiditis, RA
44
Grades of Non HL
Low grade - Follicular lymphoma - Hairy cell leukemia - Marginal zone B-cell lymphomas - Mantle cell lymphoma - Diffuse large B-cell lymphoma Aggressive - Burkitts
45
Symptoms of non-HL
Painless lymphadenopathy associated with fatigue B symptoms Hepatosplenomegaly
46
Non-HL diagnosis
Histopathological studies are required to diagnose lymphoma. - B-cell lymphomas: CD20 positive - T-cell lymphomas: CD3 positiv
47
Chemo in non-HL
Systemic chemotherapy: (R-CHOP) Rituximab Cyclophosphamide Hydroxydaunorubicin Oncovin/vincristine Prednisolone
48
Define Non-Hodgkin lymphoma
Lymphomas are malignancies that arise from lymphocytes and are classified as either Hodgkin lymphomas (characterized by Reed-Sternberg cells) or non-Hodgkin lymphomas (NHLs), which comprise all other types of lymphoma. NHLs are further classified according to cell type
49

6th year subjects (10 decks)

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