Pulmo Flashcards
1
Q
Innervation of the diaphragm
A
Phrenic nerve
2
Q
Nerve roots of origin of phrenic nerve
A
C3,4,5
3
Q
Most common location of Morgagni hernia
A
Right anterior
4
Q
Most common site of Bochdalek hernia
A
Left posterior
5
Q
Most common congenital diaphragmatic hernia
A
Bochdalek
6
Q
Neutrophil-derived elastase that destroy lung parenchyma is inhibited by
A
α1-antitrypsin
7
Q
Source of resistance in inspiration that is being reduced by surfactant
A
Compliance resistance
8
Q
Pathology of adult RDS
A
Diffuse alveolar damage
9
Q
Most common cause of adult RDS
A
Sepsis
10
Q
Type of pneumocytes affected in adult RDS
A
Type I pneumocytes
11
Q
Lung volumes (4)
A
1) IRV
2) TV
3) ERV
4) RV
12
Q
Lung capacities
A
1) Inspiratory capacity
2) Functional residual capacity
3) Vital capacity
4) Total lung capacity
13
Q
Capacity-associated volumes: Inspiratory capacity
A
IRV + TV
14
Q
Capacity-associated volumes: Functional residual capacity
A
ERV + RV
15
Q
Capacity-associated volumes: Vital capacity
A
IRV + TV + ERV
16
Q
Equilibrium point at which the elastic recoil of the lungs is equal and opposite to the outward force of chest wall
A
FRC
17
Q
Best zone of ventilation in children
A
Mid to lower lung fields
18
Q
Ghon’s focus is usually found at which lung fields
A
Mid to lower lung fields
19
Q
States that partial pressure exerted by a gas in a mixture of gases is proportional to the fractional concentration of that gas
A
Dalton’s law
20
Q
Most common cause of V/Q mismatch
A
Hypoxemia
21
Q
Fick’s law of diffusion states that diffusion rate of oxygen across pulmonary membrane depends on
A
1) Pressure gradient
2) Surface area
3) Diffusion distance
22
Q
Processes that impair O2 diffusion
A
1) Decreased O2 gradient (high altitude)
2) Decreased surface area (emphysema)
3) Increased diffusion distance (pulmonary fibrosis)
23
Q
Cardiac output at rest
A
5L/min
24
Q
V/Q ratio at zone 1
A
3.3
25
V/Q ratio at zone 2
1.0
26
V/Q ratio at zone 3
0.6
27
CO2 is converted to carbonic acid: Inside the RBC vs outside the RBC
Inside
28
Direction of flow of Cl in chloride shift
Into RBC
29
Direction of flow of HCO3 in chloride shift
Out of RBC
30
Dorsal and ventral respiratory groups are found in
Medulla
31
Pneumotaxic and apneustic centres are found in
Pons
32
Controls basic rhythm of respiration
DRG
33
Stimulates expiratory muscles
VRG
34
Most preventable cause of death among hospitalized patients
Pulmonary embolism
35
Embolus that occlude the main pulmonary artery, impact across bifurcation
Saddle embolus
36
Embolus that pass through inter arterial and inter ventricular defect to gain access to the systemic circulation
Paradoxical embolus
37
Most common cause of PE
Proximal leg DVT
38
T/F Majority of deep leg vein thrombi are clinically silent
T
39
% of deep leg vein thrombi that cause infarction
10
40
Lobe most commonly affected by PE
Lower lobe
41
% of pulmonary circulation that has to be obstructed to cause sudden death
>60
42
% chance of having a second embolus in PE survivors
30
43
Virchow's triad
SHE
1) Stasis
2) Hypercoagulability
3) Endothelial injury
44
Natural anticoagulants in the body
1) Protein C
2) Protein S
3) AT III
45
Most commonly inherited thrombophilic condition
Factor V Leiden mutation
46
Major risk factors for PE (5)
1) Post op
2) Prior VTE
3) CVA
4) Estrogen treatment
5) APAS
47
PE: Most common history
Unexplained breathlessness
48
PE: Most common symptom
Dyspnea
49
PE: Most common sign
Tachypnea
50
Symptoms of massive PE (4)
1) Dyspnea
2) Hypotension
3) Cyanosis
4) Syncope
51
Symptoms of small PE (3)
1) Pleuritic pain
2) Cough
3) Hemoptysis
52
Most common history of DVT
Cramp in the lower calf
53
Most common signs and symptoms of DVT (4)
1) Swelling
2) Pain
3) Erythema
4) Warmth
54
Classic findings/signs in PE (3)
1) Homans sign
2) Moses sign
3) Palpable cord sign
55
Pain elicited when calf muscle is compressed against the tibia but none when compressed from side to side
Moses sign or Bancroft sign
56
Pain of the calf muscle on compression either by squeezing or forced dorsiflexion
Homans sign
57
Asymmetry in tolerance to pressure of 180mmHg applied on each calves simultaneously
Lowenberg sign
58
Gold standard for diagnosis of DVT
Contrast venography
59
Most reliable criterion for DVT on contrast venography
Constant intraluminal filling defect
60
Natural history of DVT (3)
1) Progressive proximal extension
2) Complete/partial dissolution
3) Embolization
61
PE on ECG
S1Q3T3
62
PE: Most common ECG abnormality
T wave inversion in leads V1-V4
63
Primary criterion for DVT on venous ultrasonography
Loss of vein compressibility
64
PE on x-ray: Focal oligemia
Westermark sign
65
PE on x-ray: Peripheral wedge-shaped density above the diaphragm
Hampton hump
66
PE on x-ray: Enlarged right descending pulmonary artery
Palla sign
67
PE on x-ray: Prominent central artery
Fleischner sign
68
Principal imaging test for diagnosis of PE
Chest CT with IV contrast
69
RV enlargement on chest CT with contrast indicates
Increase likelihood of death within the next 30 days
70
Most common radiographic abnormalities of PE (2)
1) Atelectasis
| 2) Pulmonary opacities
71
PE on ABG
1) Hypoxemia
| 2) Hypocarbia
72
PE on 2D echo
RV pressure overload
73
The Great Masquerader
PE
74
Virchow's triad is a predisposing factor to
DVT
75
PE: Prevention
Heparin
76
PE: Acute management
Unfractionated heparin
77
PE: Long-term prevention of recurrence
Warfarin
78
Substance used in lung scanning
Albumin-labeled gamma-emitting radionuclide
79
PE: High-probability lung scan
2 or more segmental perfusion defects in the presence of normal ventilation
80
Best known indirect sign of PE on 2D Echo
McConnell sign
81
Hypokineses of RV free wall with normal motion of RV apex
McConnell sign
82
Definitive diagnosis of PE
Pulmonary angiography
83
Finding of PE on pulmo angio
Intraluminal filling defect in more than 1 projection
84
Target aPTT in unfractionated heparin therapy for PE
2-3x upper limit of laboratory normal value
85
Major disadvantage of unfractionated heparin therapy
Repeated blood sampling for dose adjustment every 4-6 hrs
86
Unfractionated heparin therapy for PE increases the risk for
Heparin-induced thrombocytopenia
87
Advantage of low molecular weight heparin over unfractionated heparin
No monitoring or dose adjustment needed unless patient is markedly obese or has CKD
88
Monotherapy for symptomatic VTE patients with cancer
Dalteparin
89
Anti-Xa
1) Fondaparinux
| 2) Rivaroxaban
90
Advantages of Fondaparinux (2)
1) Once-daily subcutaneous injection
| 2) No lab monitoring
91
Novel drugs for prevention of VTE after total hip and total knee replacement
1) Rivaroxaban
| 2) Dabigatran
92
Dabigatran MOA
Direct thrombin inhibitor
93
Most serious complication of anticoagulation
Hemorrhage
94
Management for life-threatening or intracranial haemorrhage due to heparin or LMWH
Protamine sulfate
95
Anticoagulant for patients with renal insufficiency
Argatroban
96
Anticoagulant for patients with hepatic failure
Lepirudin
97
2 principal indications for IVC filter insertion
1) Active bleeding that precludes anticoagulation
| 2) Recurrent venous thrombosis despite intensive anticoagulation
98
Lower rate of death and recurrent PE
Fibrinolysis
99
Preferred fibrinolytic regimen for PE
100mg rtPA as continuous IV infusion over 2 hours
100
Patient with PE respond to fibrinolytics up to ___ after PE has occurred
14 days
101
Contraindications to fibrinolysis
1) Intracranial disease
2) Recent surgery
3) Trauma
102
Mode of transmission of pTB
Droplet nuclei
103
Most common and important agent of human disease
MTb
104
T/F Majority of inhaled MTb bacilli reach the alveoli
F
105
Survival of MTb in macrophages depend on
Reduced acidification due to lack of accumulation of proton-adenosine triphosphate
106
Why MTb do not die in macrophages
Inhibits intracellular release of Ca resulting in impaired Ca/calmodulin pathway that lead to phagosome-lysosome fusion
107
T/F Primary PTB may be asymptomatic
T
108
Lesion formed in PTb after initial infection that heals spontaneously into a small calcified nodule
Ghon focus
109
The Ghon focus is pathologically
Subpleural granuloma
110
Most common site of extra pulmonary TB in children
Hilar LN
111
Clinical finding of PTb in young children and impaired immunity
Pleural effusion
112
Most common population of post primary disease
Public school teachers
113
Responsible for the acid-fastness of MTb
Mycolic acid
114
Caseous necrosis in MTb infection is due to
Phosphatides
115
Common location of secondary PTb lesion
1) Apical and posterior segment of upper lobes
| 2) Superior segments of lower lobes
116
Pneumonia in PTb that results from massive involvement of pulmonary segments or lobes
Caseating pneumonia
117
Gold standard for diagnosis of PTb
Mycobacterial culture
118
Duration required for expected growth in mycobacterial culture
4-6 weeks
119
Medium for PTb culture
Egg- or agar-based medium, Lowenstein-Jensen or Middlebrook 7H10
120
Temp for PTb culture
37C
121
CO2/O2 for Middlebrook medium in PTb culture
5% CO2
122
Decreases the time for bacteriologic confirmation of TB to 2-3 weeks
Immunochromatographic lateral flow assay
123
Most useful for the rapid confirmation of TB in persons with AFB-positive, AFB-negative, and extrapulmonary smears
Nucleic acid amplification
124
MTb isolates should be tested for susceptibility to which drugs to detect MDR Tb
1) Isoniazid
| 2) Rifampin
125
When MDR-Tb is found, expanded susceptibility testing should be done against which drugs
Fluoroquinolones and injectable drugs
126
Tuberculin reaction is what type of hypersensitivity
Type IV
127
Positive tuberculin reaction size in mm: HIV infected
>=5
128
Positive tuberculin reaction size in mm: On immunosuppressive therapy
>=5
129
Positive tuberculin reaction size in mm: Low risk persons
>=15
130
Positive tuberculin reaction size in mm: High-prevalence ares
>=10
131
Positive tuberculin reaction size in mm: Malnutrition
>=10
132
Positive tuberculin reaction size in mm: Steroids
>=10
133
Positive tuberculin reaction size in mm: Close contact with Tb patients
>=5
134
Positive tuberculin reaction size in mm: Fibrotic lesions on chest radiography
>=5
135
Positive tuberculin reaction size in mm: Recently infected persons (2 years)
>=10
136
Positive tuberculin reaction size in mm: Persons with high-risk medical conditions
>=10
137
Recommended daily dose: INH
5 mg/kg, max 300 mg
138
Recommended daily dose: RIF
10 mg/kg, max 600 mg
139
Recommended daily dose: PYR
25 mg/kg, max 2g
140
Recommended daily dose: Ethambutol
15 mg/kg
141
First pulmonary infection to set in in patients with HIV infection
PTb
142
PTB treatment regimens: New smear- or culture-positive
2HRZE/4HR (6 months)
143
PTB treatment regimens: New culture-negative
2HRZE/4HR (6 months)
144
PTB treatment regimens: Pregnancy
2HRE/7HR (9 months, no pyrazinamide)
145
PTB treatment regimens: Relapse
2HRZES/1HRZE/5HRE (8 months, with S during induction)
146
PTB treatment regimens: Treatment default
3 HRZES/5HRE (8 months, 3 months induction with S)
147
PTB treatment regimens: Treatment failure, resistance or intolerance to H
6RZE
148
PTB treatment regimens: Treatment failure, resistance or intolerance to R
12-18 mos HZEQ
149
PTB treatment regimens: Treatment failure, resistance or intolerance to H and R
20 mos ZEQ + S or another injectable
150
PTB treatment regimens: Resistance to all first line drugs
20 mos 1 injectable + 3 of cycloserine, ethionamide, Q, PAS
151
PTB treatment regimens: Intolerance to Z
2 mos HRE, 7 mos HR
152
Duration of cough to suspect PTb
2 weeks
153
Initial work-up of choice for PTB
Sputum AFB
154
At least how many sputum specimens should be sent for sputum AFB
2
155
Preferred number of sputum specimens to be sent for sputum AFB
3
156
Most efficient way of identifying cases of PTB
Sputum AFB
157
Diagnostic modality for PTB that correlated with infectiousness
Sputum AFB
158
TB culture with drug susceptibility testing (DST) is primarily recommended for what population of patients
High risk for drug resistance
159
TB culture is recommended for which population of smear positive patients (5)
1) Retreatment
2) Treatment failure
3) MDR-TB suspect
4) Household contacts of patients with MDR-TB
5) HIV
160
PTB drugs: Dosing during initial phase
Daily
161
PTB drugs: Dosing during continuation phase
3x a week
162
PTB relapse case is defined as
Previously treated with 1 full course under DOT and declared cured or treatment completed and has become smear positive again
163
T/F Relapses after a previous regimen under DOT have the same drug susceptibilities as initial isolates
T
164
Management for symptomatic patients who were not on DOTS in the previous treatment (2)
1) TB culture with DST
| 2) 2HRZES/1HRZE/5HRE
165
PTB treatment failure case is defined as
While on treatment, remained or became smear (+) again at 5th month of treatment or later OR smear (-) at the start and becomes smear (+) at the 2nd month
166
T/F BCG vaccination is recommended for adults to confer protection
F
167
T/F Empiric treatment with various anti-TB drugs is recommended for suspected MDR-TB cases
F
168
Recommended management for MDR-TB cases
Immediate referral to PMTM program
169
Preferred mode of administration of anti-TB drugs
FDC
170
Recommended adjunctive therapy for PTB (3)
1) Arginine
2) Vitamin A
3) Zinc
171
MDR-TB is defined by the WHO as
In vitro resistance to both HR
172
PTB case definitions: New
Never had treatment or previous anti-Tb for less than 4 weeks
173
PTB case definitions: Return to treatment after default
Stopped taking meds for >=2 mos and comes back smear (+)
174
PTB case definitions: Transfer-in
Management started from another area and now transferred to a new clinic
175
Management for PTB treatment failure case
2HRZES/1HRZE/5HRE
176
PTB case definitions: Chronic case
Became or remained smear (+) after completing a fully-supervised RETREATMENT regimen
177
WHO case definitions of TB: Latent TB
TB infection, no evidence of disease
178
WHO case definitions of TB: Active TB
Clinically active TB
179
PTB case definitions: 2 weeks or more of cough with or without accompanying symptoms
TB symptomatic
180
3-specimen collection for AFB smear
1-Spot at time of consultation
2-Early morning
3-Second spot specimen when the patient comes back the next day
181
Recommended for patients who are unable to spontaneously bring up sputum for AFB
Sputum induction with nebulisation of a hypertonic saline
182
T/F After a TB symptomatic is found to be smear positive, no further tests are required to confirm the diagnosis of PTB
T
183
T/F T/F After a TB symptomatic is found to be smear positive, no further tests are required to initiate anti-TB therapy
T
184
T/F Chest radiographs are routinely necessary in the management of TB symptomatic patient who is smear positive
F
185
TB radiograph description: Minimal vs extensive - all or the greater portion of a lobe
Extensive
186
TB radiograph description: Minimal vs extensive - 4-cm cavity
Extensive
187
TB radiograph description: Minimal vs extensive - Multiple cavitations measure up to 4 cm
Extensive
188
TB radiograph description: Minimal vs extensive - Cavities less than 4cm
Extensive
189
Status asthmatics is defined as
Severe obstruction persisting for days or weeks
190
Asthma: Single largest risk factor
Atopy
191
Asthma: Most atopic patients have allergic sensitisation to
Dust mite
192
Major risk factors for asthma deaths (3)
1) Poorly controlled disease
2) Lack of corticosteroid therapy
3) Previous admissions to hospital with near-fatal asthma
193
Chronic inflammatory disease of airways characterised by increased responsiveness of the tracheobronchial tree to various stimuli
Asthma
194
Most severe form of asthma
Status asthmaticus
195
Asthma: Peak age
3
196
Asthma: Male-to-female ratio
M
197
Asthma: Sex ratio equalises by
30 y/o
198
Asthma: Drug implicated as a risk factor for asthma
Acetaminophen
199
Asthma: Relation between breastfeeding during infancy and risk of childhood asthma
Reduces risk
200
Hallmark of asthma
Airway hyperresponsiveness to both specific and nonspecific stimuli
201
Types of asthma
1) Allergic/extrinsic
| 2) Idiosyncratic/intrinsic
202
Allergic vs idiosyncratic asthma: Associated with personal and/or family history of allergic diseases
Allergic
203
Allergic vs idiosyncratic asthma: No defined immunologic mechanism
Idiosyncratic
204
Allergic vs idiosyncratic asthma: Precipitated by upper respiratory infections
Idiosyncratic
205
Allergic vs idiosyncratic asthma: Precipitated by exercise
Idiosyncratic
206
Allergic vs idiosyncratic asthma: IgE-mediated
Allergic
207
Allergic vs idiosyncratic asthma: Precipitated by GER
Idiosyncratic
208
Allergic vs idiosyncratic asthma: Precipitated by cold air
Idiosyncratic
209
Allergic vs idiosyncratic asthma: Precipitated by tobacco smoke
Idiosyncratic
210
Allergic vs idiosyncratic asthma: Precipitated by dust mites
Allergic
211
Allergic vs idiosyncratic asthma: Precipitated by Cockroaches
Allergic
212
Allergic vs idiosyncratic asthma: Precipitated by animal dander especially CATS
Allergic
213
Allergic vs idiosyncratic asthma: Precipitated by pollutants
Idiosyncratic
214
Allergic vs idiosyncratic asthma: Precipitated by sulfites in food
Idiosyncratic
215
Allergic vs idiosyncratic asthma: Precipitated by emotional stress
Idiosyncratic
216
Allergic vs idiosyncratic asthma: Precipitated by pharmacologic agents
Idiosyncratic
217
Allergic vs idiosyncratic asthma: Precipitated by seasonal pollen
Allergic
218
Most common trigger for allergic asthma
Atopy
219
Most common trigger for idiosyncratic asthma
Pulmonary infection
220
Ciliated columnar cells sloughed from bronchial linings seen in sections of lungs of asthmatic patients
Creola bodies
221
Characteristic physiologic abnormality of asthma
Airway hyperresponsiveness
222
The only asthma stimulus that can produce constant symptoms
Respiratory viruses
223
Common agents of viral pneumonia in children
1) RSV
| 2) Parainfluenza
224
Common agents of viral pneumonia in older children and adults
1) Rhinovirus
| 2) Influenza
225
Classic triad of asthma
1) Wheezing
2) Dyspnea
3) Cough
226
Typical attack of asthma occurs
At night
227
Characteristic INITIAL wheeze
Expiratory
228
2 signs that are very valuable in indicating severity of obstruction in asthma
1) Accessory muscles become visibly active
| 2) Paradoxical pulse
229
Second wave of bronchoconstriction in 30-50% of allergic asthma cases occurs when
6-10 hours later
230
Heart rate in asthmatic patients with IMPENDING RESPIRATORY FAILURE
Relative bradycardia
231
T/F Heart rate in asthma increases with severity
T
232
Pulsus paradoxus is defined as
Markedly decreased pulse during inhalation
233
Pulsus paradoxus in moderate episode of asthma
10-25 mmHg
234
Pulsus paradoxus in severe episode of asthma
>25 mmHg
235
Absence of wheezing in asthma indicates
Impending respiratory failure
236
Indicators of asthma severity
1) Heart rate
2) Respiratory rate
3) Pulsus paradoxus
4) Use of accessory muscles
237
Most useful measures (pulmonary function test parameters) to show initial airflow obstruction and reversibility with bronchodilator
1) Peak flow
| 2) FEV1
238
Curschmann spirals and Charcot Leyden crystals are seen in what specimen
Sputum
239
Typical acid-base imbalance seen with asthma
Respiratory alkalosis
240
Acid-base imbalance in asthma that indicates impending respiratory collapse
Metabolic acidosis
241
ECG findings in asthma
1) Right axis deviation
2) RBBB
3) Right ventricular hypertrophy with depolarisation abnormalities
242
Reversiblity of asthma is seen on PFT as
>=12% and 200 mL increase in FEV1 15 minutes after 2 puffs of SABA
243
Asthma: Assessment of symptom control is assessed over what duration
4 weeks
244
Asthma: Parameters to assess control
1) Daytime symptoms >2x a week
2) Night awakenings
3) Use of reliever >2x a week
4) Activity limitation
245
Asthma: Comorbidities
1) Rhinitis
2) Rhinosinusitis
3) GERD
4) Obesity
5) Obstructive sleep apnea
6) Depression
7) Anxiety
246
Asthma: Well-controlled if
None of 4 control parameters present
247
Asthma: Partly-controlled if
1-2 of control parameters present
248
Asthma: Uncontrolled if
Asthma: 3-4 of control parameters present
249
Asthma execerbation, mild/mod vs severe vs life-threatening: Talks in words
Severe
250
Asthma execerbation, mild/mod vs severe vs life-threatening: RR less than 30
Mild/mod
251
Asthma execerbation, mild/mod vs severe vs life-threatening: Pulse 100-120
Mild/mod
252
Asthma execerbation, mild/mod vs severe vs life-threatening: Peak expiratory flow >50% predicted or best
Mild/mod
253
Asthma execerbation, mild/mod vs severe vs life-threatening: Use of accessory muscles
Severe
254
Asthma execerbation, mild/mod vs severe vs life-threatening: Drowsy
Life-threatening
255
Asthma excerbation, management: Mild/mod (3)
1) SABA q20 x 1hr
2) Prednisolone
3) Controlled O2
256
Asthma excerbation, management: Target O2 sat
93-95%
257
Asthma excerbation, management: Severe asthma
Admit to acute care facility
258
Disease state characterised by airflow limitation that is not fully reversible
COPD
259
Anatomically defined condition characterised by destruction and enlargement of lung alveoli
Emphysema
260
Clinically defined condition with chronic cough and phlegm
Chronic bronchitis
261
Significant risk factor for emphysema in both smokers and non-smokers
Coal mine dust
262
Most common form of severe α1 antitrypsin deficiency
2 z alleles or 1 z and 1 null allele
263
COPD susceptibility determinants (2)
1) Hedgheog interacting protein gene on chromosome 4
| 2) Cluster of genes on chromosome 15
264
Portions of lung affected by emphysema
Distal to the terminal bronchioles
265
Emphysema: Most common type associated with smoking
Centriacinar
266
Emphysema: Type most commonly associated with α1 antitrypsin
Panacinar
267
Emphysema, type: Distal alveoli spared; affects central/proximal parts of acini
Centrilobular
268
Emphysema, type: Affects all structures from acini to terminal alveoli
Panacinar
269
Emphysema, type: Most often associated with spontaneous pneumothorax
Paraseptal
270
Emphysema, type: Associated with scarring
Irregular
271
Emphysema, type: Target O2 sat
88-92%
272
Emphysema, type: When to repeat ABG after starting O2 supplementation
30-60 mins after
273
Best diagnostic procedure for lymph node Tb
Excisional biopsy
274
Portion of lung affected by bronchiectasis
Proximal to terminal bronchioles
275
Characteristic sign in bronchiectasis
Foul-smelling purulent sputum
276
Honeycomb lung
??? Bronchiectasis
277
Bronchiectasis: Most common location
Lower lobes bilaterally
278
Phases of ARDS: Hyaline membranes
Exudative phase (first 7 days)
279
Phases of ARDS: Interstitial inflammation
Proliferative phase
280
Phases of ARDS: Fibrosis
Fibrotic phase
281
Pneumonia: 2 types
1) Bronchopneumonia2) Lobar pneumonia
282
Pneumonia, CXR finding: Bronchopneumonia
Patchy consolidation
283
Pneumonia: Accounts for majority of lobar pneumonia
S. pneumonia
284
Pneumonia: Most common etiology of atypical pneumonia
M. pneumonia
285
Particle size: Deposited in areas with largely turbulent airflow (nose and upper airways)
>10mm
286
Particle size: Deposited in trachea and bronchi
3-10mm
287
Particle size: Deposited in terminal airways and alveoli
1-5mm
288
Particle size: Remain suspended in inspired air
Less than 1mm
289
Pores implicated in spread of pneumonia within an entire lobe
Pores of Kohn
290
Stages of pneumonia in order
1) Congestion2) Red hepatization3) Gray hepatization4) Resolution
291
Stage of pneumonia characterised by enzymatic digestion
Resolution
292
Stage of pneumonia characterised by red vascular engorgement
Congestion
293
Stage of pneumonia characterised by few neutrophils and macrophages
Congestion
294
Stage of pneumonia characterised by disintegration of red cells
Gray hepatization
295
Stage of pneumonia characterised by exudation of RBCs
Red hepatization
296
Stage of pneumonia characterised by red, firm, airless, liver-like consistency
Red hepatization
297
Stage of pneumonia characterised by fibrinosuppurative exudate
Gray hepatization
298
Stage of pneumonia characterised by dry surface
Gray hepatization
299
Atypical pneumonia is characterized by
Lack of alveolar exudate and presence of interstitial pneumonitis
300
Atypical pneumonia is aka
Walking pneumonia
301
Causative agents of atypical pneumonia
1) M. pneumonia2) Chlamydia psittaci3) Coxiella burnetti4) Legionella pneumophila
302
Causative agent of Q fever
Coxiella burnetti
303
Agent of SARS
SARS coronavirus
304
Superbugs are susceptible only to
1) Polymyxins2) Tigecycline
305
Enzyme present in superbugs
NDM-1 (New Delhi metallo-beta lactamase 1
306
NDM-1 was first isolated in an isolate of
K. pneumoniae
307
T/F Tuberculous intra-thoracic lymphadenopathy (mediastinal and/or hilar) or tuberculous pleural effusion, without radiographic abnormalities in the lungs, constitutes a case of extrapulmonary TB
T
308
T/F PTB can be classified based on HIV status
T
309
Tb classification based on drug resistance: Monoresistance
Resistance to one first-line anti-TB drug only
310
Tb classification based on drug resistance: Polydrug resistance
Resistance to more than one first-line anti-TB drug (other than both isoniazid and rifampicin)
311
Tb classification based on drug resistance: Multidrug resistance
Resistance to at least both isoniazid and rifampicin
312
Tb classification based on drug resistance: Extensive drug resistance
Resistance to any fluoroquinolone and to at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance
313
Tb classification based on drug resistance: Rifampicin resistance
Resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, whether monoresistance, multidrug resistance, polydrug resistance or extensive drug resistance
314
Treatment outcomes for TB: Cured
A pulmonary TB patient with bacteriologically confirmed TB at the beginning of treatment who was smear- or culture-negative in the last month of treatment and on at least one previous occasion
315
Treatment outcomes for TB: Treatment completed
A TB patient who completed treatment without evidence of failure BUT with no record to show that sputum smear or culture results in the last month of treatment and on at least one previous occasion were negative, either because tests were not done or because results are unavailable
316
Treatment outcomes for TB: Treatment failed
A TB patient whose sputum smear or culture is positive at month 5 or later during treatment
317
Treatment outcomes for TB: Died
A TB patient who dies for any reason before starting or during the course of treatment
318
Treatment outcomes for TB: Lost to follow-up
A TB patient who did not start treatment or whose treatment was interrupted for 2 consecutive months or more
319
Treatment outcomes for TB: Not evaluated
A TB patient for whom no treatment outcome is assigned. This includes cases “transferred out” to another treatment unit as well as cases for whom the treatment outcome is unknown to the reporting unit.
320
Treatment outcomes for TB: Treatment success
The sum of cured and treatment completed
