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68 Cards in this Set

  • Front
  • Back
Risk factors for pneumonia
Alcoholism
Institiutionalism
Smoking
COPD
Immune compromise
Extremes of age
Bronchopneumonia: Location & PE
Alveoli around bronchi
Rales +/- rhonchi
Etiology of bronchopneumonia
Hemophilus
Pseudomonas
Staph aureus
Lobar pneumonia: Location & PE
Entire lobe
Dull to percussion
CXR - consolidation "white out"
Etiology of lobar pneumonia
Strep pneumonia (Pneumococcal pneumonia)

Klebsiella pneumonia (Friedlander's pneumonia)
S/S Pneumococcal pneumonia
Sudden onset dyspnea, cough, fever, rigors (shaking chills)
S/S Klebsiella pneumonia
Prolonged onset progressive dyspnea, cough, fever over days
CURRANT-Jelly sputum
Atypical pneumonia: location? bil or unilateral?
Patchy pneumonia lower lobes bilaterally
Clinical atypical pneumonia
Rales
CXR - patchy bil pulmonary infiltrate
Etiology Atypical pneumonia
Viral: kid - RSV, adenovirus, influenza; adult - influenza A & B

Mycoplasma pneumonia: 5-35 yo
What kind of pneumonia is called "Walking pneumonia"? Triad?
Atypical pneumonia

Malaise, Sore throat, dry cough
Legionnaire's disease: CXR & PE
CXR - Unilateral patchy segmental or lobar
Rales
Clinical legionnaire's disease
Hi fever w/ relative bradycardia
Diarrhea
Productive cough
Who does legionnaire's affect
Middle-age Males
Etiologic agent legionnaire's disease
Legionella pneumophilia
Aspiration pneumonia - 3 types
Chemical pneumonitis (gastric acid)
Anaerobic bacteria
Mechanical obstruction
Clinical gastric acid chemical pneumonitis
Acute onset
SOB
Pink frothy sputum
Bronchospasm
Cyanosis
Clinical anaerobic bacteria aspiration pneumonia
Insidious onset
Cough
Fever
Purulent foul-smelling sputum
Clinical mechanical obstruction causing aspiration pneumonia
ACUTE
SOB
Cyanosis
Cause of anaerobic bacteria aspiration pneumonia
Aspiration gingival organisms in saliva
2nd decreased consciousness or decreased pharyngeal space/airway control (MS, ALS, stroke)
Primary lung tumors
Peak 45-70 yo
Smoking
Types of benign lung masses
Hamartoma
Adenoma - glandular
Leiomyoma - sm m
Carcinoid lung tumor
Serotonin & histamine producing tumor from GI mucosa
Carcinoid syndrome
Flushing
Diarrhea
Bronchospasm
R heart valve lesion
Hypotension
Dx of carcinoid syndrome
24-hr urinary 5'-HIAA
1st symptom carcinoma
New onset cough OR
Change in freq or character pre-existing cough
4 kinds of lung carcinoma
adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
Small cell carcinoma
Adenocarcinoma
Pre-existing lung scar (non-smoker)
Peripheral
Squamous cell carcinoma
Smoking
PTH-like peptide --> hypercalcemia
Central to mediastinum
Large cell carcinoma
Smoking
Peripheral
Small cell carcinoma
Smoking - worse px
Mediastinum
ADH --> fluid overload
ACTH --> cushing's syndrome
Autoimmune - Eaton Lambert syndrome
What is Eaton Lambert syndrome
Proximal m. weakness
Ab to presynaptic Ca channels on neurons of NMJ
What lung tumor is a/w Horner's syndrome
Pancoast tumor - apex of lung

(compression of cervical sympathetic ganglia)
S/S Horner's syndrome
Sinking of eyeball
Miosis
Ptosis
VD
Anhidrosis of face
Nephritic syndrome
Acute onset & rapid progression
Cause of nephritic syndrome
Inflammation of glomerulus
Clinical of nephritic syndrome
Hematuria
Red cell casts
HTN
edema
Increased BUN & creatinine (Azotemia)
Examples of nephritic syndrome
Post-strep glomerulonephritis
Goodpasture's syndrome
Diffuse proliferative glomerulonephritis
Nephrotic syndrome
Changes in glomerular permeability
(no longer adequately limits filtration of proteins)
**Structural change**
Clinical nephrotic syndrome
Severe proteinuria
Frothy urine
Hypoalbuminemia
Hyperlipidemia
Edema
Examples of nephrotic syndrome
Minimal change disease
Membranous GN
Acute nephritic syndrome
Hematuria
Azotemia
Variable proteinuria
Oliguria
Edema
HTN
Rapidly progressive glomerulonephritis
Acute nephritis
Proteinuria
Acute RF
Severe oliguria
Severe edema
HTN
Marked azotemia
Crescents
Chronic renal failure
Azotemia w/ uremia progressing for yrs
Uremia defined
M. twitching & cramps
Fatigue
Decreased mental acuity
N/V
HTN
Pruritis
Pericarditis
Occ. uremic frost
Cause of Type I RPGN
Idiopathic, Goodpasture's
(Ab-mediated cytotoxicity)
Cause type II RPGN
Idiopathic, SLE, Henoch-Schonlein, post-infectious
(Immune complex disease)
Cause type III RPGN
Idiopathic, Wegener's, microscopic polyangiitis, advanced terminal polyarteritis nodosa
(pseudo-immune --> +ANCA d/o)
Purulent discharge (vagina, urethra, rectum, pharynx)
Gonorrhea
2 STDs which can ascend causing PID
Gonorrhea & Chlamydia
Lymphogranuloma venereum: s/s, etiology, tx
Lg palpable granulomas in inguinal LNs
Erupt on skin surface
Chlamydia trachomatis
Doxy
Granuloma inguinale: s/s, etiology, tx
Granuloma develops on genitals then organism blocks lymphatic drainage
Klebsiella granulomatis
Tetracycline
Chancroid: s/s, etiology, tx
soft PAINFUL chancre
Hemophilus ducreyi
Ceftriaxone
Syphilis: s/s, etiology, tx
1 - PAINLESS hard chancre, 2 - rash palms, condyloma lata genitals, 3 - gummas
Treponema pallidum
Pen G
Condyloma acuminatum: s/s, etiology, tx
Painless
HPV 6&11 (16&18 dangerous)
Cryotherapy
Pathophysiology HPV
HPV viral genes E6 & E7 interfere w/ p53 & RB (tumor suppressor genes) --> overgrowth epithelial cells

(Koilocytes)
Genital herpes: s/s, etiology, tx
PAINFUL fluid-filled vesicles in grps on erythematous base
HSV 1 or 2
Acyclovir
Which non-germ cell testicular tumor produces high testosterone?
Leydig cell tumor (intersititial cell tumor)
-precocious puberty (occur before puberty)
-gynecomastia (occur post-puberty)
Differentiate serous & mucinous surface epithelial ovarian tumors
Serous - fallopian tube epithelium (watery secretion); 1/2 of ovarian CA; bilateral
Mucinous - columnar cells (mucus); pseudomyxoma peritonei
What is pseudomyxoma peritonei?
rupture of mucinous cystandeocarcinoma to produce multiple intraperitoneal tumor implants
Teratoma
2 or more germ layers
(more are mature form)
Dermoid cyst
Mature teratoma
cyst lined by skin w/ hair follicles +/- nails, sebaceous glands; bones, teeth, GI, neuro, resp., thyroid tissue
Struma ovarii
unusual variant dermoid cyst
Only 1 tissue element - THYROID
(hyperthyroidism)
Granulosa-theca cell tumor
Secretes E
+ Call-Exner bodies (follicle w/eosinophilic material)
A/w 2nd endometrial hyperplasia or CA
Sertoli-Leydig cell tumor in ovary
Secretes T
(virilization in female - irreversible)
Meig's syndrome
caused by ovarian fibroma
-ascites
-pleural effusion
-(+) ovarian tumor
Krukenberg tumor
Tumor in ovary that mets from elsewhere and bilaterally replacement of ovaries w/ mucin-producing signet-ring cell
Primary source for Krukenberg tumor
Stomach