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50 Cards in this Set
- Front
- Back
Acute pancreatitis: this is what our US attorney general had. : pathophysiology mechanism?
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activation and thus autodigestion by pancreatic enzymes
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Acute pancreatitis: this is what our US attorney general had. : Causes? (good mnemonic)
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Get Smashed (EtOH will can lead to AP) = 1) Gallstones 2) EtOH 3) Trauma 4) Steroids 5) Mumps 6) autoimmune disease 7) scorpion sting of all things! 8) hyperlipidemia 9) drugs
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Acute pancreatitis: this is what our US attorney general had. : clinically presents with?
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intense epigastric pain radiating to back
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Acute pancreatitis: this is what our US attorney general had. : labs(name 2): which of the two has a higher specificity?
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↑ amylase + ↑lipase (higher specificity) "li is hi"
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Acute pancreatitis: this is what our US attorney general had. : Name 5 nasty complications that can result from AP?
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1) DIC 2) ARDS 3) diffuse fat necrosis 4) hypocalcemia 5) pseudocyst formation
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Acute pancreatitis: this is what our US attorney general had. : if you have CHRONIC pancreatitis: what do we think of your life habits?
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Chronic Pancr. Is strongly associated w/ alcoholism
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Acute pancreatitis: this is what our US attorney general had. : 0
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0
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Acute pancreatitis: this is what our US attorney general had. : Pancreatic cancer
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p.250
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what is a common and fatal pancreatic cancer?
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pancreatic adenocarcinoma
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pancreatic adenocarcinoma : what is the prognosis?
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6 months: very aggressive: usually has mets when pt. presents
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pancreatic adenocarcinoma: where are tumors most commonly located? And what does this lead to?
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pancreatic head → obstructive jaundice.
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COPD = also known as OLD: obstructive lung disease: why is it called obstructive?
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obstruction of AIR FLOW → air trapping in lungs
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COPD = also known as OLD: obstructive lung disease: what is the major PFT finding?
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FEV1 / FVC ration is ↓ (hallmark finding)
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COPD = also known as OLD: obstructive lung disease: name the 4 types of COPD
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1) Chronic Bronchitis (Blue Bloater) 2) emphysema (pink puffer) 3) asthma 4) bronchietasis
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COPD = also known as OLD: obstructive lung disease: what is the definition of Chronic Bronchitis
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productive cough for >3 consecutive months in two or more years.
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COPD = also known as OLD: obstructive lung disease: what do you expect on lung histology?
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hypertrophy of mucus-secreting glands in the bronchioles (Reid index of >50%)
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COPD = also known as OLD: obstructive lung disease: leading cause is smoking: what are the physical findings for Chronic Bronchitis? (name 3)
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1)cyanosis 2) wheezing 3) crackles
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what is the pathophysiological mechanism of EMPHYSEMA?
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destruction of fibrous septa/alveolar walls → enlargement of air space and ↓ total surface area for gas exchange
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if the cause is smoking, what kind of emphysema would you see on histo slide?
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centri-acinar emphysema
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what else can cause emphysema: (also may work synergistically with smoking): What kind of findings do you see in lung histo and name another organ affected?
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alpha 1-antitrypsin deficiency → panacinar emphysema + liver cirrhosis
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what causes the emphysema in this disorder?
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↑ elastase activity to damage lung tissue.
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name 4 findings of emphysema (in general)
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1) dyspnea; 2) ↓ breath sounds 3) tachycardia 4) ↓ I/E ratio
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What is mechanism of asthma
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BRONCHIAL hypersensitivity/hyperresponsiveness → REVERSIBLE bronchoconstriction
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name 3 common asthma triggers
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1) viral URI 2) allergens 3) stress!!
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name 7 asthma findings
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1) cough 2) wheezing 3) dyspnea 4) hypoxemia 5)↓ I/E ratio 6) tachypnea 7) pulsus paradoxus
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BRONCHIECTASIS: what is its mechanism??
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chronic necrotizing infection of BRONCHI → dilated airways, purulent sputum, recurrent infections, hemoptysis (see Robbins for a good discussion of this)
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what disorders is bronchietasis commonly associated with?
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1) bronchial obstruction 2) cystic fibrosis 3) poor ciliary motility
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What are classic PFT findings for RLD?
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↓ VC ↓TLC ; FEV1/FVC ration > 80%
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Name the two MAJOR types of RLD
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1) poor breathing mechanics (EXTRA-pulmonary) 2) Interstitial lung diseases
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Name 3 lung volumes that are increased in COPD
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↑TLC, ↑FRC, ↑RV
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What 2 values are BOTH reduced in COPD and RLD?
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1) FEV1 and 2) FVC (think FEV1/FVC ratio) NOTE! in COPD, FEV1 is more dramatically reduced and thus the FEV1/FVC ratio is ↓
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what is the main pathology resulting from asbestosis?
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DIFFUSE, interstitial fibrosis caused by inhaled asbestos Fibers.
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What cancers are increased in pts with asbestosis?
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1) pleural mesothelioma 2) bronchogenic carcinoma (BC)
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Major finding in lung w/ asbestosis?
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Ferruginous bodies: asbestos fibers coated with hemosiderin also 2) ivory white pleural plaques
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Neonatal respiratory distress syndrome: What is the main cause
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surfactant deficiency --> to increased surface tension --> alveolar collapse
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Neonatal respiratory distress syndrome: surfactant is made by which cells? After when?
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type 2 pneumocytes after 35th gestational week
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Neonatal respiratory distress syndrome: what do you measure? Where do you get this fluid?
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lecithin-to-sphingomyelin ratio in the amniotic fluid = measure of lung maturation <1.5 in neonatal distress syndrome
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Neonatal respiratory distress syndrome: what is surfactant made of (chemical name)
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dipalmitoyl phosph-tidyl-choline (DP-PTC)
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Neonatal respiratory distress syndrome: treatment for poor maturation of lungs
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1) before birth = maternal steroids 2) after= artificial surfactant
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Karta-gener's syndrome: what is this?
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immotile cilia due to dynein arm defect
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Karta-gener's syndrome: results in what in female and male? (4 things)
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1) sterility (in male sperm also immotile) 2)bronchietasis 3)recurrent sinusitis (bacteria & particles not pushed out) 4) associated with situs inversus (e.g. dextro-cardia)
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name the 3 main classes of cancers that affect parts of the lung
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1) bronchogenic carcinoma (with different subtypes) 2) carcinoid tumor 3) metastasis
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list the 5 types of major bronchogenic carcinomas
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CENTRAL 1) squamous cell ca 2)small cell ca; PERIPHERAL 3) adenocarcinoma 4) bronchoalveolar ca 5) large cell ca
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mnemonic: what is meant by SPHERE of symptoms?
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S= superior vena cava syndrome; P= pancoast tumor; H= Horner's syndrome; E= Endocrine (paraneoplastic); Recurrent laryngeal / hoarseness; E = Effusions (pleural OR pericardial)
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What can a CARCINOID tumor cause?
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Carcinoid Syndrome = flushing, diarrhea, wheezing, and salivation
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Metastases to lung is very common, LUNG cancer also prone to metastasize to what other parts?
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1) brain (epilepsy) 2) bone (fracture) 3)liver (jaundice + hepatomegaly)
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What is Pancoast's tumor?
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it's a carcinoma of the apex of lung
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what may Pancoast's tumor affect?
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may affect CSP= cervical sympathetic plexus causing Horner's syndrome
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what is Horner's syndrome?
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P.A.M. is Horny = Ptosis, Anhydrosis, Miosis
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1st AID breaks it down into TYPE/ ORGANISM/ CHARACTERISTICS = cover parts of this table and fill in the blanks
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0
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