March 30 - Pulm Flashcards Preview

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Flashcards in March 30 - Pulm Deck (21):
1

Thoracocentesis

Parietal pleura extends 2 ribs below visceral pleura/inferior lung border. To avoid injuring lung, do between 6th and 8th ribs at midclavicular line, between 8th and 10th ris at midaxillary line, and between 10th and 12th ribs at paravertebral line. Still risk of penetrating abdominal structures

2

White out on CXR

Seen in both ARDS and HF. Distinguish by PCWP (normal in ARDS, increased in HF)

3

Culturing legionella

Buffered charcoal yeast extract agar supplemented with iron, cysteine and antibioitics

4

Accentuated second heart sound

Seen in PAH

5

Scleroderma pathogenesis

Excess of TGF-beta results in collagen deposition in tissues

6

Bosentan

MOA: endothelin-receptor antagonist
Use: blocks effects of endothelin

7

Coccidioides

Causes lung disease in immunocompetant; disseminated disease in immunocompromised. Thick walled spherules packed with endospores. Occurs in SW US

8

Histoplasmosis

Occurs in ohio and mississippi river valleys, associated with caving. Yeast is ingested by macrophages in which it multiplies so on biopsy, macrophages are filled with yeast cells

9

Blastomycosis

Occurs in ohio and mississippi river valleys. Unlike histo, extrapulmonary disease very common, esp in skin and bone. Broad based budding yeast

10

Paracoccidiomycosis

Seen in south and central america. On path "pilot's wheel" with mother cell budding off multiple daughter yeast

11

Allergic bronchopulmonary aspergillosis

Increased Th2 cells produce more IL-4 and IL-5. LEads to eosinophilia and elevated serum IgE

12

Cryptococcus sulture and diagnosis

Cultured on Sabourad's agar.
On india ink, clear unstained zone surrounds the yeast. Mucicarmine stains the capsule red. Latex agglutination test can be used to detect capsular antigen

13

Mucormycosis

Seen in diabetics, esp those with DKA. Angioinvasive. Forms broad hyphae that branch irregularly with rare septations

14

ESR

Inflammation causes release of TNF-alpha, IL-1, and IL-6 which lead to increased production of acute phase reactants. The acute phase reactant fibrinogen causes red cells to form stacks.

15

Silicosis

Calcification of rim of hilar nodes + nodular densities on x-ray
Birefringent silica particles surrounded by fibrous tissue on biopsy.
Increased risk of TB due to impaired macropage function

16

Neuroendocrine tumor markers (4)

NCAM (neural cell adhesion molecule, also called CD56), enolase, chromagranin, synaptophysin

17

Vimentin

intermediate filament found in mesenchymal cells. Used in diagnosis of sarcoma

18

Reid index

Used to determine severity of chronic bronchitis. Thickness of mucus gland layer / thickness between epithelium and cartilate (not including the cartilage). Normal is 0.4

19

Bordatella pertussis on gram stain

Gram neg coccobacillus

20

Chediak higashi presentation

Albinism, pyogenic infections, neurologic dysfunction

21

Wiskott aldrich presentation

Recurrent infections, easy bleeding, eczema