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AM- STEP1 > Resp Review > Flashcards

Resp Review Flashcards

1
Q

Lung development

  • weeks
  • respiration capable when
A

Starting at week 4 –> birth

Week 25 viable

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2
Q

Bronchogenic cysts

A

Caused by abnormal budding of the forgut and dilation of terminal or large bronchi

Discrete, round, sharply defined, fluid filled densities on CXR

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3
Q

Club cells

  • description
  • location
  • fxn (3)
A

Noncilated, low columnar/cuboidal with secretory granules

Located in small airways

Secrete components of surfactant
Degrades toxins
Act as reserve cells

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4
Q

Type I pneumocytes

  • cell type
  • fxn
A

Squamous, thin

Gas diffusion
Line alveoli

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5
Q

Type II pneumocyts

  • cell type
  • fxn
A

Cuboidal and clustered

Precursors to type I cells and other type II cells
Proliferate during lung damage

Secrete surfactant from lamellar bodies
–> decrease alveolar surface tension, prevents alveolar collapse –>
Decrease lung recoil and increase compliance

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6
Q

Pulmonary surfactant composed of

A

Mix of Lecithins

- Most important is dipalmitoylphosphatidylcholine (DPPC)

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7
Q

Screening test for fetal lung maturity

A

Lecithin-sphingomyelin ratio in amniotic fluid >2 is healthy

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8
Q

Persistently low O2 tension in newborn think

A

PDA

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9
Q

Infant, difficulty breathing, grunting

Bulging forhead

A

Intraventricular hemorrahge

  • germinal matrix hemorrhages
  • due to RDS
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10
Q

Cephalohematoma

A

rupture of subperiosteal blood

Due to forceps for birth

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11
Q

Location of ____ in respiratory tree

Pathway

1) Cartilage
2) Pseudostratified ciliated columnar
3) Smooth muscle
4) Goblet cells
5) Simple ciliated columnar
6) Club cells
7) Simple cuboidal epithelium
8) Simple cuboidal/ Squamous

A

Trachea –> Bronchi –> Bronchioles –> Terminal bronchioles –> Respiraotry bronchioles –> Alveolar sacs

1) Cartilage
- Trachea
- Bronchi

2) Pseudostratified ciliated columnar
- Trachea
- Bronchi

3) Smooth muscle
- Trachea –> Terminal bronchiles (Respiratory bronchioles sparse)

4) Goblet cells
- Trachea
- Bronchi

5) Simple ciliated columnar
- Bronchioles

6) Club cells
- Bronchioles
- Terminal bronchioles
- Respiratory bronchioles

7) Simple cuboidal epithelium, ciliated
- Terminal bronchioles

8) Simple cuboidal/ Squamous
- Respiratory bronchioles

9) Loss at cilia
- Respiraotry bronchioles

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12
Q

Common site for inhaled foreign bodies

A

Right lung

Right main stem bronchus wider and more vertical and shorter than left

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13
Q

Inhale peanut while upright

A

Basal segment of right lower lobe

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14
Q

Inhale peanut while supine

A

Enters posterior segment of right upper lobe

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15
Q

Pathologic dead space

A

When part of the respiratory zone becomes unable to perform gas exchange

Ventilated but not perfused

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16
Q

Compliance

High compliance

Low compliance

A

Complaint lungs comply (cooperate) and fill easily with air

High compliance

  • Easier to fill
  • emphysema, normal aging

Lower compliance

  • lungs harder to fill
  • pulmonary fibrosis, pneumonia
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17
Q

Surfactant effect on compliance

A

Increases compliance

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18
Q

Right sift in oxygen hemoglobin dissociation curve (6)

A

Increase

  • Acid
  • CO2
  • Exercise
  • 2,3 BPG
  • Alititude
  • Temperature
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19
Q

Resistance =

A

R= (P pulm artery - P L atrium ) / Cardiac output

R= Change P/ Q

Q= perfusion

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20
Q

V/Q at apex of lung

A

3

Wasted ventilation

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21
Q

V/Q at base of lungs

A

0.6 wasted perfusion

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22
Q

Rhinosinusitis most commonly from

A

S. pneumoniae
H. influenza
M catarrhalis

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23
Q

Epistaxis

- anterior vs posterior segment

A

Most commonly
- anterior

Life threatening

  • posterior segment
  • sphenopalatine artery, branch of maxillary artery
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24
Q

Test to rule out DVT

Diagnosis

Prophylaxis/ Acute management

Long term management

A

D-dimer lab test
- High sensitivity Low specificity

Compression ultrasound with Doppler

Prophylaxis or acute management
- Heparin or low molecular weight heparins (enoxaparin)

Tx: Intravenous heparin drip

Long term prevention

  • Warfarin
  • rivaroxaban
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25
Q

Hypoxemia
Neurlogic abnormalities
Petechial rash

A

Fat emboli

Hypoexemia: low O2 in blood

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26
Q

Obstructive lung volumes

TLC
FRC
RV
FEV1
FVC
FEV1/FVC

Due to

A

Increased TLV
Increased FRC
Increased RV

Decreased FEV1 more than FVC
Decreased FEV1/FVC

Air trapping in lungs
Obstruction of air flow

COPD
Chronic bronchitis
Emphysema

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27
Q

Restrictive lung volumes

FEV1
FVC
FEV1/FVC
TLC
FRC
RV

Due to

A

FVC is more reduced or same as FEV1
Normal FEV1/FVC

Decreased TLV
Decreased FRC
Decreased RV

Pneumoconioses
Sarcoidosis
Pulmonary fibrosis
Granulomatosis with polyangiitis
Langerhans cell histocytosis
Drug toxicity
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28
Q

Chronic bronchitis pathology

clinical presentation

A

Wheezing, crackles, cyanosis
Hypoxemia due to shunting
Dyspnea
Polycythemia (secondary)

Hypertrophy and hyperplasia of mucus secreting glands in bronchi

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29
Q

Emphysema

  • two types
  • pathology
  • due to
  • CXR
  • clinical presentation (2)
A

Centriacinar

  • assoc with smoking
  • upper lobes

Panacinar:

  • associated with alpha 1 antitrypsin
  • Lower lobes

Enlargement of air spaces, decreased recoil, increased compliance

Increased elastase activity –> increase loss of elastic fibers –> increase lung compliance

CXR: increased AP diameter, flattened diaphragm, increase lung field lucency

Barrel shaped chest
Pursed lips breathing

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30
Q

Smooth muscle hypertrophy in lungs

A

Asthma

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31
Q

COPD increase in what cells

A

Neutrophils
Macrophages
CD8 T cells

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32
Q

Purulent sputum
Recurrent infections
Hemoptysis
Digital clubbing

  • pathology
  • assoc with
A

Bronchiectasis

Chronic necrotizing infections of bronchi –> permanently dilated airways

Kartagener syndrome
Cystic fibrosis
Aspergillosis

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33
Q

Asbestos affects what part of lungs

A

Lower lobes

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34
Q

Silica affects what part of lungs

A

Upper lobes

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35
Q

Coal affects what part of lungs

A

Upper lobes

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36
Q

Ivory white calcified plaques

what type of work

A

Asbestosis

Shipbuilding
Roofing
plumbing

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37
Q

Golden brown dumbbells on sputum sample

A

Asbestosis

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38
Q

Aerospace

Granulomatous on histology

A

Berylliosis

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39
Q

Fibrosis

Eggshell calcifications of hilar LN on CXR

A

Silicosis

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40
Q

Mesothelioma associated with

seen on histology
positive for

A

Asbestosis

Psammoma bodies on histology

+ Cytokeratin
+ calretinin

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41
Q

Pulmonary HTN value

A

> 25 mm Hg at rest

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42
Q

Physical findings pleural effusion

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Breath sounds= decreased

Percussion= Dull

Fremitus= Decreased

Tracheal deviation= None or away from side of lesion if large

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43
Q

Physical findings Atelectasis

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Bronchial obstruction

Breath sounds= decreased

Percussion= Dul

Fremitus= Decreased

Tracheal deviation= Toward side of lesion

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44
Q

Physical findings Simple pneumothorax

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Breath sounds= Decreased

Percussion= Hyperresonant

Fremitus= Decreased

Tracheal deviation = None

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45
Q

Physical findings Tension pneumothorax

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Breath sounds= Decreased

Percussion= Hyperresonant

Fremitus= Decreased

Tracheal deviation = Away from side of lesion

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46
Q

Physical findings of Consolidation (lobar pneumonia)

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Breath sounds= Bronchial breath sounds; late inspiratory crackles, egophony, bronchophony, whispered pectoriloquy

Percussion= Dull

Fremitus= Increased

Tracheal deviation = None

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47
Q

Physical findings of pulmonary edema

  • Breath sounds
  • Percussion
  • Fremitus
  • Tracheal deviation
A

Consolidation

Breath sounds= Bronchial breath sounds; late inspiratory crackles, egophony, bronchophony, whispered pectoriloquy

Percussion= Dull

Fremitus= Increased

Tracheal deviation = None

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48
Q

Pleural effusions are

A

Excess accumulation of fluid between pleural layers –> restricted lung expansion during inspiration

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49
Q

Lobar pneumonia

  • organism
  • characteristics
A

S pneumonia (more frequently )
Legionella
Klebsiella

Consolidation

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50
Q

Interstitial (atypical) pneumonia

  • organism
  • characteristics
A 
Mycoplasma
Chlamydophila pneumoniae
Chlamydia psittaci
legionella
Viruses (RSV, CMV, influenza, adenovirus)

DIffuse patchy inflammation localized to interstitial areas at alveolar walls

Diffuse more than 1 lung

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51
Q

Tx Lung abscess

A

Clindamycin

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52
Q

Lung abscess organisms

A

Due to anaerobes

  • Bacteroides
  • Fusobacterium
  • Peptostreptococcus

S. Aureus

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53
Q

Carcinoma in apex of lung

  • type
  • does what
  • symptoms
A

Pancoast tumor (superior sulcus tumor)

Invades cervical sympathetic chain

Compression of locoregional structures
- Recurrent laryngeal n= hoarseness
- Stellate ganglion= Horner syndrome**
(ispl ptosis, miosis, anhidrosis)

  • Superior vena cava= SVC syndrome
  • Brachiocephalic vein= brachiocephalic syn
  • Brachial plexus= sensormotor deficits
54
Q

SVC syndrome

A

Obstruction of SVC impairs blood drain from head

Facial plethora (red face) 
- blanches with poking

JVD
Upper extremity edema

Increased risk fo aneurysm

55
Q

Coin lesion on CXR

A

Lung cancer

56
Q

Small cell carcinoma

  • Location
  • Prognosis
  • Produce
  • Key feature
  • Amplication of
  • Cels
  • Positive for
A

Central

Very aggressive

Product

  • ACTH
  • SIADH
  • Ab against Ca channel

High nucleus to cytoplasm ratio

Amplification of myc oncogenes (nyc)
Abbrevations in TP53, Rb

Neuroendocrine Kulchitsky cells –> small dark blue cells

+ Chromogranin A
+ Neuron-specfiic enolase

57
Q 
A 71-year-old man is brought to the emergency department by ambulance after he was found by his neighbor walking around his garden confused and unable to answer questions. He is confused and oriented only to person. His temperature is 37.6° C (99.7° F), heart rate is 110/min, respiratory rate is 20/min, and blood pressure is 130/92 mm Hg. While in the emergency department the patient has a seizure. Laboratory tests show a serum sodium level of 115 mEq/L, potassium of 3.8 mEq/L, glucose of 100 mg/dL, and osmolality of 250 mOsm/ kg. Urine electrolyte testing show a urine osmolality of 500 mOsm/kg. X-ray of the chest shows a mass in the lung. Which of the following is the most likely etiology of the mass?
(A) Foreign body aspiration
(B) Metastatic brain cancer
(C) Prostate cancer
(D) Small cell carcinoma
(E) Tuberculosis
A

D. Small cell carcinoma

58
Q

Adenocarcinoma

  • location
  • most common in
  • mutation
  • physical feature
  • CXR
  • Histology
  • positive for
A

Peripheral

Most common lung cancer in nonsmokers and overall

Mutations “MARKER”
- MET, ALK, RET, KRAS, EGFR, ROS

Hypertrophic osteoarthropathy (clubbing)

CXR: hazy infiltrates similar to pneumonia; better prognosis

Glandular pattern on histology

+ Mucin

59
Q

Squamous cell carcioma

  • location
  • description
  • produces
  • risk
  • histology
A

Central

Hilar mass arising from bronchus
Cavitation

Cigarattes

Hypercalcemia (PTHrP)

Keratin pearls and intercellular bridges

60
Q

Large cell carcinoma

  • Location
  • Prognosis
  • Associated with
  • Histology
A

Peripheral

Highly anaplastic undifferentiated tumor
Poor prognosis

Smoking

Pleomorphic GIANT cells

61
Q

Bronchial carcinoid tumor

  • Prognosis
  • Symptoms
  • Histology
  • Positive for
A

Excellent prognosis; metastasis rare

Symptoms due to mass effect or carcinoid syndrome
- Flushing, diarrhea, wheezing

Nests of neuroendocrine cells

+ Chromogranin A

62
Q

Decrease of alveolar oxygen in lungs

A

–> Vasoconstriction –> reduce perfusion of lung, shunting of blood toward well-ventilated regions of lung

COPD –> Low alveolar oxygen –> chronic vasoconstriction –> pulmonary HTN –> Cor pulmonale

63
Q

Perfusion

A

How much blood to an area

64
Q

Tx Pulmonary HTN

A

Competitive antagonist for endothelium 1 receptors –> decrease pulmonary vascular resistance

  • Bosentan
  • Ambrisentan

Prostaglandin analog
(dilate vessel like pulmonary arteries)
- Iloprost
- Epoprostenol

Sildenafil
- phosphodiesterase inhibitor that causes vasodilation

Nifedipine
- dihydropyridine Ca channel blocker

65
Q

Tx for SEVERE primary pulmonary htn

A

Inhaled nitric oxide

66
Q

Primary pulmonary hypertension

- assoc with

A

Associated with abnormalities in BMPR2: bone morphogenic protein receptor type II

BMPR2 protein prevents proliferation of vascular smooth muscle

Mutation leads to excessive vascular smooth muscle proliferation –> reduced vessel radius, increased resistance and increased pulmonary arterial pressure

67
Q

Defective tyrosine kinase gene

A

Bruton agammaglobulinemia

68
Q

Hypoxemia

Hypoxia

A

Hypoxemia: low oxygen in blood

Hypoxia: body or region deprived of oxygen

69
Q

High A-a gradient indicates

A

Shunting of blood
Diffusion limitation (pulmonary fibrosis)
V/Q mismatch
Advanced age

70
Q

Oxygenation in Anemia

A

Hemoglobin decreases –> oxygen content decreases

Decrease total O2 content
No change in O2 saturation
No change in arterial PO2 (amount dissolved in blood)

71
Q

V/Q at apex and base

A

Apex
V/Q > 1

Base
V/Q <1

72
Q

Exercise on V/Q ratio

A

V/Q ratio goes down towards one

Vasodilation of capillaries in apex

Perfusion increases

73
Q

V/Q –> zero

A 
Low ventilation (outside body --> alveoli)
High perfusion

Airway obstruction

  • pneumonia
  • pulmonary edema
  • lung cancer

Supplemental O2 ineffective

74
Q

V/Q –> infinity

A

High ventilation, low perfusion

Blood flow obstruction or physiologic dead space

Supplemental O2 effective

75
Q

Response to exercise

A

Increase O2 consumption
Increase CO2 production

V/Q more uniform

Increase pulmonary blood flow due to increase CO

Decrease pH

No change in arterial PO2 and PCO2

Increased venous CO2 levels

76
Q

Acute motion sickness clinical presentation

A

Headache
Fatigue

Extreme

  • Acute cerebral edema due to hypoxia induced vasodilation
  • Acute pulmonary edema
77
Q

Response to high altitudes (6)

A 
Increase ventilation
Increased erythropoietin
Increase 2,3 BPG
Increase meitochondria
Increase efficiency of O2 utililzation
Increased renal excretion bicarb
78
Q

Physiologic changes in chronic mountain sickness

A 
Increase RBC mass and hematocrit
Increased blood viscosity
Decreased tissue blood flow
Elevated pulmonary artery pressure (constricts due to hypoxia) 
Right sided heart enlargement
Peripheral artery pressure falls
Congestive heart failure
79
Q

Positive G force does a visual “ blackout” occur

- due to

A

4-6 G

Due to insufficient blood return to heart
Insufficient pumping of blood to brain

80
Q

How is body affected at zero gravity (5)

A 
Decreased blood volume
Decreased RBC mass
Decreased muscle strength/ work capacity
Decreased maximum and cardiac output
Loss of calcium and phosphate resulting in loss of bone mass
81
Q

The BENDS

A

Breathing problems
Extremity pain
Neurologic changes
Death

82
Q 
Elevated D dimer
Pleuritic chest pain
SOB
Tachypnea
High A-a gradient
  • CXR?
  • gold standard
  • ECG changes
A

Pulmonary embolism

CXR: normal
Pulmonary angiogram

S1Q3T3 deep S in lead I large Q and inverted T in lead III

83
Q

Ankle pain with dorsiflexion

A

Homan’s sign

DVT

84
Q

Primary spontaneous pneumothorax due to

A

Apical blebs

Tall and thin

85
Q

Charcott Leyden crystals

A

Asthma

86
Q

Drop in systolic pressure by 10 mm/Hg during inspiration

  • Disease
  • what happens
  • seen in
A

Pulsus Paradoxus

Decreased intrathoracic pressure –> increased right ventricle blood return

Right ventricle pushed into left ventricle –> poor cardiac output and drop in systolic pressure

Cardiac tamponade
Asthma
Pulmonary embolism (severe)

87
Q

Cyprohepatadine

  • type
  • use
A

Antihistamine
Use: Appetite stimulant
Antidote for serotonin syndrome

88
Q

Promethazine

  • type
  • use
A

Antihistamine

Use: Nausea, vomiting

89
Q

Hydroxyzine

  • type
  • use
A

Antihistamine

Use: Sedation itching

90
Q

Meclizine

  • type
  • use
A

Antihistamine

Vertigo

91
Q

Formoterol

  • type
  • use
  • risk
A

Long Acting beta agonist

Mainstay of COPD tx

For asthma must also be on inhaled corticosteriod

Increased risk when used alone

92
Q

Muscarinic Antagonists used in COPD asthma

- MOA

A

Ipratropium (short acting)
Tiotropium ( long acting)

Decrease overall vagal or parasympathetic tone in lungs

93
Q

Zileuton

  • type
  • MOA
A

5-lipoxygenase inhibitor

Blocks conversion of arachidonic acid into leukotrienes

94
Q

Salmeterol

  • type
  • Use
  • risk
A

Long Acting beta agonist

Mainstay of COPD tx

For asthma must also be on inhaled corticosteriod

Increased risk when used alone

95
Q

Steroids

  • examples
  • MOA
A

Fluticasone
Budesnoide
Beclomethasone

Inhibit cytokine synthesis
Inhibit TNF-alpha production

96
Q

Cromolyn

- MOA

A

Prevents release of histamines from mast cells

Prevents bronchoconstriction and inflammation

97
Q

Montelukast

  • MOA
  • Use
A

Prevents bronchogenic and chemotactic effects of leukotriene D4

Aspirin and allergy induced asthma

98
Q

COPD tx

A

Long Acting beta agonist
Formoterol
Salmeterol

99
Q

Theophylline

  • type
  • MOA
  • characteristic
  • side effect
A

Methylxanthines

Can cause bronchiodilation by inhibiting phosphodiesterase

  • Increase cAMP
  • decrease hydrolysis

Narrow therapeutic index

Side effects

  • Tremor
  • Tachycardia
  • Can cause seizure
100
Q

Guaifenesin

  • type
  • Fxn
  • Does not do what
A

Expectorant

Thin mucus

Does not suppress cough
+ dextromethorphan to suppress cough

101
Q

Omalizumab

  • type
  • use
  • MOA
  • reduces
A

Anti IgE monoclonal Ab

Severe asthma with allergic component

Binds IgE in serum and blocks receptor

Reduces exacerbation and use of rescue inhaler

102
Q

Diphenhydramine

  • type
  • others
  • effects
  • Uses
  • Toxicity
A

1st generation H1 blockers

Diphenhydramine
Dimenhydrinate
Chlorpheniramine

Very sedating
Antimuscarinic and anti-alpha adrenergic effects

Uses:

  • Allergies
  • Motion sickness
  • Sleep aids

Toxicity

  • Sedation
  • Dry mouth
  • Delirum in elderly
103
Q

N- acetylcysteine

  • type
  • uses
  • MOA
A

Expectorant

Tylenol overdose
Use for contrast induce nephropathy

Mucolytic that breaks disfulide bonds in patients with obstructive lung disease

104
Q

2nd Generation H1 blockers

  • examples
  • use
A

Loratadine
Fexofenadine
Desloratadine
Cetirizine

Allergy

Much less sedating

105
Q 
Phenylephrine
Pseudoephedrine
- type
- Use
- MOA
- Reduces
- Adverse
A

Nasal decongestant

Works as alpha adrenergic agonist

Constrict dilated arterioles in nasal mucosa

Reduce airway resistance, swelling and nasal congestion

Adverse
- Long term use can cause rebound congestion

106
Q

Epoprostenol iloprost

  • MOA
  • Use
  • Side effects
A

Works by directly vasodilating the pulmonary vascular beds

Reducing the pressures in both systems

Pulmonary HTN

Side effects

  • Jaw pain
  • Flushing
107
Q

Bosentan

  • type
  • use
  • side effect
A

Antagonizing endothelial receptor 1

Pulmonary HTN

Side effect: hepatotoxicity

108
Q

Sarcoidosis

A

A GRUELING Disease

ACE enzyme increase
Gammaglobulinemia
Rheumatoid factor
Uveitis
Erythema nodosum
Lymphadenopathy (bilateral, hilar) 
Idiopathic
Noncaseating 
Granulomas
vitamin D increase
109
Q

Honeycomb lung on CT

  • disease
  • Genetic mutation
  • CT
A

Idiopathic pulmonary fibrosis

Genetic mutation: telomerase, mucin MUC5B

Patchy interstitial fibrosis

110
Q

What medications cause restrictive lung disease

A

Bleomycin
- Pneumonitis with infiltrates

Busulfan

  • Acute lung injury
  • Chronic interstitial fibrosis
  • Alveolar hemorrhage

Amiodarone
- Pulmonary fibrosis

Methotrexate
- Hypersensitivity like lung reaction

111
Q

Tx Langerhans Cell Histiocytosis

A

Quit smoking

112
Q

Bilateral hilar adenopathy

Uveitis

A

Sarcoidosis

113
Q

Lung metastasis to

A

Brain
Bone
Liver
Adrenal glands

114
Q

Pontiac fever

A

Legionella pneumophilia

115
Q

Causes of transudate pleural effusion

A

Low protein high electrolyte

Increased hydrostatic pressure
Decreased oncotic pressure

CHF
Cirrhosis
Nephrotic syndrome
Fluid overload

116
Q

Causes of Exudate pleural effusion

A

High protein

Results from pleural and lung inflammation –> increased membrane permeabililty

Cancer
Pneumonia, infections, TB
Uremia
Connective tissue disease

117
Q

Obstructive sleep apnea medication

A

Modafinil

- Wake up during day

118
Q

Salicylate intoxication what occurs

A

Respiratory alkalosis
- immediately

Anion gap metabolic acidosis
- after 12 hrs

119
Q

Cystic fibrosis pathogenesis

A

CFTR gene mutation

3 base pair deletion of phnylalanine at amino acid position 508.

Mutations causes impaired post-translational processing (improper folding and glycosylation) of CFTR

120
Q

Inhaled anesthetic

Large arteriovenous concentration gradient

A

Difference between the concentration of gas anesthetic in arterial and venous blood

If tissue solubility is high, results in large amount of anesthetic taken up from arterial blood and low venous concentration

Need more anesthetic to replace what was absorbed by tissues

Blood saturation takes longer
Brain saturation also delayed

121
Q

Pain sensation in anterior tongue

A

Mandibular division of trigeminal nerve

122
Q

Progressive weakness
Gets better as day goes on
Dry mouth and episodic double vision
Difficulty with erections even though good libido
Decreased strength of hip flexors and diminished knee reflexes, repeat shows normalization of strength and reflexes

Condition
Due to

A

Lambert Eaton

Ab to voltage gated calcium channel

Small cell lung cancer

123
Q

Achondroplasia abnormality involving

A

Chondrocytes

AD
Point mutation
FGFR3

124
Q

Vomiting from chemotherapy is due to what region

A

Chemoreceptor trigger zone (CTZ) located on dorsal surface of the medulla at the caudal end of the fourth ventricle

known as area postrema

125
Q

Cells with eye glasses

Tx

A

malaria
plasmodium falciparum

Trophozoites

African species are chloroquine resistant

Tx Chloroquine

Tx Atovaquone-proguanil or artemisinin

P. Vivax and P ovale
Tx primaquine addition

126
Q

Diabetes medication
Weight loss

  • Type
  • Examples
  • MOA
  • Adverse
A

GLP-1 agonist

  • Exenatide
  • Liraglutide

Increase glucose dependent insulin secretion
Decrease glucagon secretion
Delay gastric emptying

Pancreatitis

127
Q

Vaccine to C. tetani how does it prevent symptoms

A

Circulating ab that neutralize bacterial products

Black neurotoxic exotoxin called tetanospasmin

128
Q

Child
Language regression
Tantrums
Hemoglobin 9

Due to
Inhibition of

A

Anemia
Regression

Lead toxicity

Inhibition of ferrochelatase
delta-aminolevulinic acid

129
Q

Accident

Bleeding complications oozing from catheters and venipuncture sites

A

DIC

130
Q

HSV

Tx
MOA

A

Acyclovir

Incorporation into newly replicating viral DNA

131
Q 
2 day hx reduced sensation in legs
Fatigue especially with exercise
Six months ago visual blurring
Psoriasis hx
Glucocorticoid use
Decreased pain and light tough below level of umbilicus
Bilateral spasticity

Brain lesion?

A

Multiple sclerosis

Perivenular inflammatory cells made up of autoreactive T lymphocytes and macrophages directly against myelin components

AM- STEP1 (20 decks)

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