Shit - Resp UWorld

Question 1

Exercise on arterial and venous values

Answer 1

Arterial normal; venous altered

Question 2

CTFR mutation causes

Answer 2

altered post-translational processing of ATP-bincdin-cassette transmembrane Cl- transporter

Question 3

Cheyne-Stokes causes and patters

Answer 3

CHF
Neuro (stroke, brain tumour, TBI)

Delayed response and increased sensitivity to PCO2

Question 4

Theophylline OD

Answer 4

Abdominal pain, vomiting, diarrhea; seizures (high M+M), arrhythmia (Rx = b-blockers)

Question 5

why does hyperventilation cause dizziness?

Answer 5

Decreased PCO2 so body thinks you have high PO2 so cerebral vessels constrict in auto regulation to prevent “intracranial HTN”. VC decreases BF causing dizziness, blurred vision, weakness

Question 6

MOA chronic bronchitis vs. emphysema

Answer 6

CB = narrowed airways, less air thru. Emph = dilates alveoli; decreased ability of deoxygenated blood in vessels to contact the air in the alveoli

Question 7

Dyspnea with dry cough, insidious, sub pleural cysts, restrictive pattern =

Answer 7

Idiopathic/usual progressive pulmonary fibrosis

Question 8

honeycomb lung =

Answer 8

indiopathic/usual progressive pulmonary fibrosis

Question 9

What are mycelia acids

Answer 9

Long, branched, saturated FAs

Question 10

true vs false vocal cord linings

Answer 10

true = start squam. false (and vestibule) = respiratory.

Question 11

drug that needs activation by catalase-peroxidase

Answer 11

INH

Question 12

where is rRNA transcribed, and by what?

Answer 12

Nucelolus; RNA pol-I

Question 13

aspiration pneumonia via what (where from body and bugs)

Answer 13

oropharynx.

fusobacterium, peptostreptococcus, bacteroides

Question 14

eggshell calcifications and birefringent crystals

Answer 14

silicosis

Question 15

coal macules

Answer 15

Macrophages full of carbon

Question 16

INH AE

Answer 16

Neurotoxicity (peripheral neuropathy (rx by B6), hepatotoxicity, sideroblastic anemia, SLE-like

Question 17

Quitting smoking drugs

Answer 17

Bupropion, varenicline (partial agonist)

Question 18

tissue destruction in MTB mediated by:

Answer 18

hypersensitivity reaction

Question 19

Probability of kid getting AR disease =

Answer 19

Parent carrier % x parent carrier % x 1/4

Question 20

Baro-R vs chemo-Rs: names and what they respond to

Answer 20

Peripheral:
Aortic arch and carotid sinus = BP
Carotid body and aortic body = O2 (CO2, H+)

Central:
Medulla = CO2 (via H+/pH)

Question 21

pulmonary C-fibres

Answer 21

= stretch receptors; prevent lung over-inflation

Question 22

what causes pus to be green?

Answer 22

Myeloperoxidase from neutrophil azurophilic granules

Question 23

MAC (vs MTB): s/s, host, prophylaxis

Answer 23

MAC:
s/s = like TB, but also hits reticuloendothelial system so anemia, hepatosplenomegally, high LDH, high ALP. Also grows best @41C (MTB doesn’t).
Host = HIV CD4

Question 24

Nerve near piriform recess

Answer 24

internal branch of superior laryngeal n = afferent of gag reflex

Question 25

A-a calculation

Answer 25

150 - PaCO2/0.8

Question 26

Why would a kid with CF present with signs of hedydration?

Answer 26

Excessive sweating, leads to SODIUM loss (not water), which causes an intravascular volume contraction

Question 27

MTB drugs that works at acidic pH?

Answer 27

Pyrazinamide: works in INTRAcellular (within macrophage)) MTB, because it works best in acidic environments like the phago-lysosome

Question 28

where is airflow resistance highest in the lungs and why

Answer 28

sections 2-5 because of turbulent flow [so resistance increases then drastically decreases as you do down the lung divisions]

Question 29

neutrophil chemotaxis via:

Answer 29

C5a, LTB4, IL-8, 5-HETE (LT precursor)

Question 30

Atelectasis

Answer 30

collapse of lung (can be partial, i.e. ARDS)

Question 31

Pancoast tumour vs. SVC syndrome

Answer 31

Pancoast has SVC syndrome as a component, but also has horners and shoulder pain and hoarseness due to apical location. SVC syndrome can occur with a mediastinal mass, thus blocks SVC but is NOT found in apex so no horners or shoulder pain. MCC = lung cancer and NHL

Question 32

mesothelioma histology

Answer 32

long thin microvilli with lots of tonofilaments

Question 33

pathophysiology of high ESR

Answer 33

Injury --> neutrophils and macrophages ---> release TNF-a, IL-1, IL-6 -> cause liver to release acute phase reactants --> one of them is fibrinogen --> RBC rouleaux --> faster sedimentation than normal (individual) RBCs

Question 34

Pancoast tumour pain dermatomes

Answer 34

C8, T1, T2

Question 35

size of particles (URT vs cilia vs dust cells)

Answer 35

URT = 10-15 nm. cilia = 2.5-10nm. dust =

Question 36

LTs in asthma

Answer 36

C4, D4, E4

Question 37

Scleroderma + CREST and lung problems

Answer 37

pulmonary arterioles damages --> pulmonary HTN, loud S2 (increased back pressure on pull valve), and signs of RHF

Question 38

Capillary wedge pressure in ARDS

Answer 38

NORMAL! Non-cariogenic cause of pulmonary edema

Question 39

Compliance in ARDS

Answer 39

Decreased

Question 40

Decreased compliance caused by:

Answer 40

pulmonary fibrosis, insufficient surfactant, pulmonary edema