Term
| What is the histological change that takes place in the trachea of a smoker? |
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Definition
| Ciliated columnar epithelium become squamous (metaplasia) |
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Term
| A patient in the ER is having anaphylaxis. You make an incision beneath the thyroid cartilage to establish airway, what structure was cut? |
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Definition
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Term
| What structures traverse the diaphragm and through what vertebral level do they pass? |
|
Definition
T8: IVC
T10: Esophagus, vagus nerve
T12: aorta, thoracic duct, azygous vein |
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Term
| What cell type proliferates during lung damage? |
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Definition
|
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Term
| What amniotic fluid measurement is indicative of fetal lung maturity? |
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Definition
| lectin to sphingomyelin ratio of > 2.0 |
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Term
| A young woman has infertility, recurrent URIs and dextrocardia. Which of her proteins is defective |
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Definition
| Kartagener's syndrome: defective dynein arm (causing nonfunctional ciliated cells) |
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Term
The following lung volumes are obtained from an elderly smoker:
FRC 5.0L, IRV 1.5L, IC 2.0L, VC 3.5L
What is his total lung capacity? |
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Definition
|
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Term
| What substances are known for causing methemoglobinemia? |
|
Definition
Nitrates
Chloroquine, Primaquine
Dapsone, sulfonamides
Local anesthetics
Metoclopramide |
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Term
| A 42 year old woman with fibroids is chronically tired. What is the most likely dx, and what changes have occurred in the O2 content and saturation? |
|
Definition
Dx: woman has anemia because of her fibroids (microcytic anemia)
-no change in O2 content or sat
-not enough hemoglobin to be saturated |
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Term
| A patient is known to have hypoxia and CXR reveals an enlarged heart. What is the most likely cause of hypoxia? |
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Definition
| Heart failure, not perfusing hte lungs well enough to oxygenate the rest of the body |
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Term
| A patient suffers a stroke after incurring multiple long bone fractures in a skiing accident. What likely caused the infarct? |
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Definition
| Fat embolus (going through patent foramen ovale, causing stroke) |
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Term
| A patient with a tibia fracture and no history of COPD or asthma is shown to have hypoxia. CXR is normal. What is the cause of the hypoxia and what disease process does this mimic? |
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Definition
| Could be PE or fat embolus. Most likely PE bc of immobility (broken leg). Mimics an MI |
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Term
| A person presents with asthma attack. What immunologic process is taking place that is responsible for anaphylaxis in this patient |
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Definition
| Antigen crosslinks IgE on presensitive mast cells leads to release of leukotrienes and histamine which cause inflammation and bronchoconstriction |
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Term
What asthma medication fits the following statement:
Inhaled treatment of choice for chronic asthma |
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Definition
| Inhaled steroid (Beclomethasone, prednisone) |
|
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Term
What asthma medication fits the following statement:
Inhaled treatment of choice for acute exacerbations |
|
Definition
| albuterol (Beta2 agonist) |
|
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Term
What asthma medication fits the following statement:
Narrow therapeutic index, drug of last resort |
|
Definition
| Theophylline (Methylxanthine, inhibits phosphodiesterase) |
|
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Term
What asthma medication fits the following statement:
Blocks the conversion of arachidonic acid to leukotriene |
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Definition
|
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Term
What asthma medication fits the following statement:
Inhibits mast cell release of mediators; used for prophylaxis only |
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Definition
|
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Term
What asthma medication fits the following statement:
Inhaled treatment that blocks muscarininc receptors |
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Definition
|
|
Term
What asthma medication fits the following statement:
Inhaled long acting B2 agonist |
|
Definition
|
|
Term
What asthma medication fits the following statement:
Blocks leukotriene receptors |
|
Definition
| Zafirlukast (>5yrs old), Montelukast (>1year old) |
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Term
| A patient has an extended respiratory phase. What is the disease process |
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Definition
|
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Term
| What are the 1st generation H1 blockers? |
|
Definition
| Diphenhydramine, Dimenhydrinate, chlorpheniramine |
|
|
Term
| What are the 2nd generation H1 blockers? |
|
Definition
| Loratadine, fexofenadine, desloratadine, cetirizine |
|
|
Term
| What are the H1 blockers uses? |
|
Definition
1st gen: Allergy, Motion sickness, sleep aid
2nd gen: Allergy (non-drowsy) |
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Term
| H and E of lung biopsy from a plumber shows elongated structures with clubbed ends in tissue. What is the dx and what is he at risk for? |
|
Definition
| Ferruginous bodies seen in asbestosis; increased risk for bronchogenic carcinoma and mesothelioma |
|
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Term
| Preterm infant has difficulty breathing. Xray reveals a diffuse ground glass appearance with air bronchograms. What is the dx and what could have prevented this condition? |
|
Definition
Neonatal respiratory distress syndrome
-prevent with maternal steroids prior to delivery |
|
|
Term
| A pt develops ARDS from an occupational inhalation of nitrous oxide. What histologic changes are seen in a person recovering from ARDS? |
|
Definition
| Type II pneumocytes proliferate |
|
|
Term
| A tall thin teenaged male has abrupt onset of dyspnes and left-sided chest pain. Percussion on the affected side reveals hyperresonance, and breath sounds are diminished. What is the dx? |
|
Definition
| Spontaneous pneumothorax. Trachea deviates to the ipsilateral side |
|
|
Term
| What are the clinical findings of pleural effusion |
|
Definition
| decreased breath sounds. Dullness to percussion, decreased fremitus |
|
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Term
| CXR shows collapse of middle lobe of right lung and mass in the R bronchus. Pt has hx of recurrent pneumonias. What is the dx? |
|
Definition
| Carcinoma of the lung (bronchogenic) |
|
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Term
| A patient of yours developed bronchogenic lung cancer, but has never smoked. He is a coal miner. Exposure to what substance has out him at risk for this cancer? |
|
Definition
| Radon (heavy gas settles in coal mines) |
|
|
Term
| What complications can arise from lung cancer? |
|
Definition
SPHERE:
Superior Vena Cava syndrome
Pancoast tumor
Horner's syndrome
Endocrine (paraneoplastic)
Recurrent laryngeal symptoms
Effusions (pleural or pericardial) |
|
|
Term
What infectious agent fits the following description:
Common cause of pneumonia in immunocompromised patients |
|
Definition
|
|
Term
What infectious agent fits the following description:
Most common cause of atypical/ walking pneumonia |
|
Definition
|
|
Term
What infectious agent fits the following description:
Common causative agent for pneumonia in alcoholics |
|
Definition
|
|
Term
What infectious agent fits the following description:
Can cause an interstitial pneumonia in bird handlers |
|
Definition
|
|
Term
What infectious agent fits the following description:
Often the cause of pneumonia in a person with a hx of exposure to bat droppings |
|
Definition
|
|
Term
What infectious agent fits the following description:
Often the cause of pneumonia in a patient who has recently visited Southern California, New Mexico, or West Texas |
|
Definition
|
|
Term
What infectious agent fits the following description:
Pneumonia a/w currant jelly sputum |
|
Definition
|
|
Term
What infectious agent fits the following description:
Q fever |
|
Definition
|
|
Term
What infectious agent fits the following description:
A/w pneumonia acquired from air conditioners |
|
Definition
|
|
Term
What infectious agent fits the following description:
Most common cause of pneumonia in children < 1 year of age |
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Definition
|
|
Term
What infectious agent fits the following description:
Most common cause of pneumonia in children and young adults |
|
Definition
|
|
Term
What infectious agent fits the following description:
Most common cause of pneumonia in neonate |
|
Definition
|
|
Term
What infectious agent fits the following description:
Common cause of pneumonia in patients with other health problems |
|
Definition
|
|
Term
What infectious agent fits the following description:
Most common cause of viral pneumonia |
|
Definition
|
|
Term
What infectious agent fits the following description:
Causes wool-sorter's disease |
|
Definition
|
|
Term
What infectious agent fits the following description:
Endogenous flora in 20% of adults |
|
Definition
|
|
Term
What infectious agent fits the following description:
Common bacterial cause of COPD exacerbation |
|
Definition
|
|
Term
What infectious agent fits the following description:
Common cause of pneumonia in ventilator patients and those with CF? |
|
Definition
|
|
Term
What infectious agent fits the following description:
Pontiac fever |
|
Definition
|
|
Term
| Examination of a lung at autopsy reveals a peripheral lesion with caseous necrosis. Dx? |
|
Definition
|
|
Term
What pathology is associated with the following statement:
Most common cause of SIADH |
|
Definition
Small cell lung cancer
Brain injury/insult |
|
|
Term
What pathology is associated with the following statement:
Most common testicular tumor |
|
Definition
|
|
Term
What pathology is associated with the following statement:
Most common tumor of infancy |
|
Definition
|
|
Term
What pathology is associated with the following statement:
translocation 9;22 and drug used to treat |
|
Definition
Philadelphia chromosome; CML
drug: Imatinib |
|
|
Term
| What is the triad of Kartagener's syndrome? What is the underlying defect |
|
Definition
defect in dynein arm
1.Sterility
2.bronchiectasis
3.sinusitis |
|
|
Term
| What are the 3 most common locations of lung cancer mets? |
|
Definition
| adrenals, Brain, bone, liver |
|
|
Term
| What is the V/Q at the apex and base of lung? |
|
Definition
Apex: 3 (ventilation better than perfusion)
Base: 0.6 (perfused better than ventilated) |
|
|
Term
| What is the V/Q during airway obstruction? |
|
Definition
|
|
Term
| What is the V/Q during blood flow obstruction? |
|
Definition
| Approaches infinity (Q=0) |
|
|
Term
| How does the emphysema caused by smoking differ from the emphysema caused by a1-antitrypsin deficiency? |
|
Definition
Smoking = centriacinar
a1-antitrypsin def = panacinar |
|
|
Term
| What is the hallmark sign of COPD? |
|
Definition
|
|
Term
| What is the hallmark sign of restrictive lung disease? |
|
Definition
| Normal to elevated FEV1/FVC ratio |
|
|
Term
| What tumors arise centrally in the lung and are a/w smoking? |
|
Definition
| Small cell carcinoma; squamous cell carcinoma |
|
|
Term
| Which tumors arise peripherally in the lung and are less linked to smoking? |
|
Definition
Adenocarcinoma
Large lung cell carcinoma |
|
|
Term
| How does the body compensate for hypoxia at high altitude? |
|
Definition
Increased ventilation
Make more RBCs
Increased 2-3DPG
Increase mitochondria
Increase renal excretion of HCO3 |
|
|
Term
| What are common causes of ARDS? |
|
Definition
| Trauma, sepsis, shock, gastric aspiration, uremia, acute pancreatitis, amniotic fluid embolism |
|
|
Term
| What are the causes of pulsus paradoxus? |
|
Definition
Asthma
COPD
Croup
Cardiac tamponade |
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