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81 Cards in this Set
- Front
- Back
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name the 2 kinds of ASDs
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ostium primum - next to AV valve
ostium secundum - fenestrated oval fossa (90% of ASDs) |
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what EKGs do you see in a subendocardial MI vs a transmural MI
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Subendo- non Q wave, NSTeMI
Transmural - Q wave and STEMI |
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what type of Acute coronary syndrome is NOT releived by nitroglycerin
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Unstable angina, and MIs (q wave and non q wave)
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patient presents with fever, spots on retina, painful papules on fingers and toes, and red macules on palms and soles
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Infective endocarditis
these are roth spots, osler nodes, and janeway lesions. |
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what bugs cause acute vs subacute infective endocarditis
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acute - staph aureus and strep spa.
subacute - strep viridans (live in mouth) and E coli |
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what are the kinds of non infective endocardidits
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Libman sacks - SLE
marantic - thrombi on endocardium - chronic illness Acute rheumatic fever - Ab made against M protein for strep pyogenes infection attack heart. check ASO titers |
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what are the types of pericarditis
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fibrous (most common after MI or dressler syndrome)
Serous - coxsackie, uremia, acute rheum fever, scleroderma, rheumatic heart dz, SLE Suppurative - from direct invasion of organism |
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px presents with fever, pleuritic pain, and pericardial effusion(rub)
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dressler syndrome
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What is an aschoff body
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focal area of myocardial inflammation - contains collagen, enlarged myocytes(anitschkow myocytes) and some aschoff cells(multinucleate giant cells)
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what are the kinds of Obstructive lung disease and what is FEV1/FVC
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COPD - Emphysema, brochiectasis, and chronic bronchitis
Asthma |
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describe the types of cell damage in emphysema
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panacinar - scattered throughout lobule - alpha1-antitrypsin deficiency
Centrilobular - in the center of lobule - smoking |
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Px presents with long term wet productive cough and dyspnea.
dx? cause? time? sounds and other findings? |
chronic bronchitis - hypertrophy of mucus glands in bronchioles
REID index >50% time- >3mo. in 2+ yrs wheezing, crackles, CYANOSIS |
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what happens when the lungs are chronically infected?
what two diseases do we see? |
brochiectasis- chronic necrotizing infection of bronchi
permanently dilates airway hemoptysis CF and kartegeners |
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what is the tetrad of kertageners
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bronchiectasis
situs inverses male sterility hearing problems |
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what is charcot leyden crystals?
what is similar? |
crystals seen in asthma
curshman spirals in mucus also seen. |
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what lab values do we see in restrictive lung disease
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los FEV1 and low FVC. but the FEV1/FVC is generally normal or greater than 80%
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Px presents with non caseating granulomas surrounded by fibrosing scars
cough dyspnea and night sweats |
sarcoidosis
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what causes adult respiratory distress syndrome
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starts with endothelial damage - blood leaks into alveoli, - then interstitial and bronchoalveolar inflammation with cell proliferation
lastly collagen accumulates rapidly - severe fibrosis |
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what is lecithin?
ratio? |
we see a low lecithin in neonatal ARDS aka hyaline membrane disease.
low surfactant. lecithin:sphingomyelin <2.0 = ARDS |
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what is a ferruginous body
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the lung infiltrate seen in asbestosis
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px pressents with shortness of breath and works in a sandblaster factory
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silicosis
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name the process of lobar pneumonia
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1. congestion - lobe filled with bacteria
2. red hepatization - filled with rbc 3. grey hepatization - lobe filled with fibrin 4. resolution |
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name the 3 primary causes of bronchopneumonia
findings? |
hemophilus
pseudomonas staphylococcus Rales, Peri bronchial infiltrates on X-ray. |
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top causes of atypical pneumonia
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Viral - Kids - RSV
Adults - Infuenza virus A and B Bacterial mycoplasma pneumoniae |
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Px presents with fever, bradycardia, diarrhea, productive cough
x ray? |
legionella
unilateral patchy segmental or lobar alveolar infiltrate |
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what are the complications of oat cell carcinoma?
X-ray? |
ADH
ACTH Eaton lambert syndrome - autoimmune Ab to presynatpic Ca channels at NMJ Mediastinal/central lesion |
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Px presents with weight loss, is a smoker, and has hypercalcemia
Location? |
squamous cell carcinoma with paraneoplatic syndrome - secretes PTH.
lesion occurs central to mediastinum |
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what lung cancer occurs in the lung peripheries
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Large cell carcinoma AND adenocarcinoma
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difference between the two neisseria species
tx for each? |
Meningococcus - capsule and ferments Maltose - Pen G
Gonococcus - has Pilus, does NOT ferment maltose - Ceftriaxone |
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I see chinese characters under a scope, what am i looking at?
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Listeria - sepsis or meningitis
OR Corynebacterium diptheria - URI leads into pseudomembrane on oral and nasal mucosa |
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what are the toxins in c Perf and what diseases
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Alpha toxin - gas gangrene
Entertoxin - food poisoning |
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Px presents with Fever, diarrhea, headache, Rose spots on abdomen
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Salmonella
food poisoning - poultry enteric fever- typhoid - incubation 10-14days |
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what UTI bug causes ammonium calculi, why?
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proteus, due to urease production
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Px presents with diarrhea after eating sushi
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vibrio parahaemolyticus
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most common diarrhea in USA, shape? and tx?
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campylobacter
curved rod treat with erythromycin (or fq or aminoglyc) |
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what bug is tranmitted from rodents to fleas to humans
sx? tx? |
yersinia pests - bubonic plague
large very tender LNs streptomycin, tetracycline |
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px presents with undulating fever
associated with? tx |
Brucella
associated with animals abortus-cows melitensis-goats and sheep sues - hogs tetracycline, gentamycine |
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What is permethrin
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Drug used to treat lice, scabies, and fly larvae that are skin parasites
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Name the NRTIs and the NNRTIs
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NRTIs. Zidovudine,stavudine, lamivudne, didanosne
NNRTIs. Neviripine, efavirenz, delavirdine |
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Name the fusions inhibitors and protease inhibitors
And what is the last group |
FI- enfurvitide gp41, maraviroc ccr5
PI -navirs Integrase inhibitors - raltegravir - prevent HIV DNA insertion into human DNA |
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Standard tx for hiv
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2 NRTIs always
Plus 1nnrti or 1pi or 1ii |
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FEV1/FVC ratio in obstructive lung dz
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less than 80.....80 is nl
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a person w pulmonary emphysema presents w panacinar alveolar destruction. what is the cause
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alpha 1 antitrypsin deficiency
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alpha 1 antitrypsin deficiency is caused by what
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defective protein folding, the misfolded proteins cannot escape the liver, so liver dies and elastase eats your lung
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charcot leyden crystals and cusrchmann spirals in a mucus sample should make you think....
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ASTHMA! IgE mediated
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FEV1/FVC ratio in restrictive lung dz
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nl or high (>80)
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what is the classic xray finding in sarcoid
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bilateral hilar adenopathy on chest xray
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what is a panda sign
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bilateral sarcoidosis of parotid glands on imaging
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sarcoid causes what in the lung
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noncaseating granuloma
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neonatal ARDS can be Dx with what
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lecithin:sphingomyelin ratio less than 2 in amniotic fluid
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which pneumoconioses hit the lower lung and which hit the upper lung
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Bottom lung - asBestosis, Berylliosis
upper lung...whatevers left - silicoses, anthracosis (coal) |
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a person presents w idiopathic pulmonary fibrosis....what do you see on chest xray
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honeycomb lung
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primary etiologic agents of bronchopneumonia
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HPS.....hemophilus
pseudomonas staph (bronchopneumonia only hits alveoli contiguous w bronchi...so the organisms Hate to Part w Structures...(resp structure) |
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4 stage process of lobar pneumona
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congestion (lobes full of bacteria/mucus)
red hepatization (lobes full RBCs) grey hepatization (full fibrin) resolution |
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causes of lobar pneumonia
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strep pneumo
klebsiella pneumo |
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causes of atypical pneumonia
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viruses (RSV,adeno, influenza in kids and inluenze A/B in adults)
mycoplasma pneumo - walking pneumonia |
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SSx legionanaires dz
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unilateral patchy alveolar infiltrate on xray
High FEVER, BRADY, Diarrea, productive cough in a middle age male legionella pneumophilia |
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most common bacteria to cause anaerobic aspiration pneumonia
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peptostreptococcus
bacteroides fusobacterium |
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which lung cancers are central
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SCC, small cell carcinoma,
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which lung cancers are peripheral
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adenocarcinoma, large cell carcinoma
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pathonogmonia Sx in nephritic syndrome
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RED CELL CASTS
hematuria htn |
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SSx in nephrotic syndrom
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severe proteinuria, frothy urine, hypoalbuminemia, hyperlipidemia and edema
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classic lab findings in CRF
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hi creatinine, high BUN (elevations of both = azotemia)
high K normocytic anemia low Ca metabolic acidosis small kidneys on imaging |
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kidney biopsy - spike and dome subepithelial deposits of IgG anf C3
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membranous glomerulonephritis (nephrotic syndrome)
NOTE - all the glomerulopathies that start w an M are nephrotic...min change, membranoprolif)... |
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kidney biopsy - sclerosis of glomerulos in a focal and segmental pattern
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focal segmental glomerulosclerosis
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kidney biopsy - effacement of foot processes
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minimal change dz
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kidney biopsy - tram tracking subendothelial deposits of C3....labs show decreased complement
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membranoproliferative glomerulonephritis
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kidney biopsy - lump bumpy or hump like subepithelial IgG and C3 deposits w a +ASO titer
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acute proliferative/post strep glomerulonephritis
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kidney biopsy - LINEAR deposits of IgG and C3 on BM
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anti GBM dz....goodpastures sydrome
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kimmelstiel wilson nodule
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found in diabetic glomerulosclerosis....thick bm and mesangial growth = nodular sclerosis.
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early lab finding in diabetic glomerulosclerosis
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microalbuminemia
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alports syndrome
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splitting of the BM of glomerulus
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muddy brown casts of urinalysis pathonogmonic for
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ATN
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labs in pre renal ARF
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hi BUN and creatinine w BUN/Creatinine ratio of >20:1
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labs in renal ARF
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hi BUN and creatinine w BUN/creatinine ration <10:1
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the most common type of kidney stone is.....and it is precipitated in what kind of urine....acid/alkaline?
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calcium stone
precipitates in alkaline urine usually due to dehydration tx w thiazide |
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which urinary stones precipitate in alklaline urine
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calcium
struvite stone |
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which urinary stones precipitiate in acidic urine
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uric acid stone,
cystine stone |
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two causes of a struvite stone
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proteus and staph saprphyticus...who both have urease
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the cystine stone is a result of cystinuria (AR) and is composed of what
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COAL
cystine, ornithine, arginine, lysine...it's a black looking stone |
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candidiassis micro findings
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germ tubes and pseudophyphae
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