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54 Cards in this Set
- Front
- Back
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What is the most utilized intervention in psychoanalysis?
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Interpretation
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In what types of patients is supportive psychotherapy generally utilized?
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Pt in crisis
Pt w/ severe personality disroders |
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What kind of psychotherapy is best used in panic attacks and generalized anxiety, and impassivity?
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Behavioral Therapy
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What is the best psychotherapy used for patients with borderline personality disorder?
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Dialectical Behavior Therapy
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What are the 3 medications that can cause lung fibrosis?
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Bleomycin
Amiodarone Nitrofurantoin |
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What are the two cell types important in wound healing?
What factor do TH1 cells release which are important in the removal of ECM? |
TH2 & TH1
Interferon |
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Is DLCO increased or decreased in emphysema?
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Decreased in emphysema b/c of alveolar destruction
It is increased in asthma b/c of hyperinflation |
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True or False
Inflammation is NOT necessary for the development of interstitial pulmonary fibrosis? |
True
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What is the critical step in the evolution of fibrosis?
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Loss of integrity of the basement membrane
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What cell type is responsible for the Right -> Left shunt seen in interstitial pulmonary fibrosis?
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TH2 -> myofibroblasts -> vascular remodeling
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What are the two causes of hypoxemia in Idiopathic interstitial fibrosis?
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Low V/Q
Diffusion impairment |
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What two pulmonary diseases present as rapid shallow breathing?
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Obstructive chronic bronchitis
Interstitial Pulmonary Fibrosis |
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What is the defining characteristic of interstitial pulmonary fibrosis?
is it increased or decreased? |
RV/TLC ratio
Increased TLC decreases more than RV |
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What is the reason for the FEV1/FVC ratio to be increased in restrictive lung diseases?
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Fibrosis holds airway open = lower airway resistance = prevention of dynamic compression
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Is the slope of the effort independent curve steeper or shallower in COPD vs RLD?
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COPD = Shallow
RLD = Steep |
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What is the best test to diagnose restrictive lung disease?
Is it increased or decreased? |
DLCO
Decreased by >80% |
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An FEV1/FVC < 70% is diagnositc for what dz?
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COPD
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Late-inspiratory velcro crackles =?
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Interstital fibrotic restrictive lung disease
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If a chest x-ray shows "ground glass" infiltrates, what dz should you suspect?
What gross appearance should you expect of the lungs? |
Idiopathic pulmonary fibrosis
Honeycomb appearance |
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In restrictive lung disease:
Is the FEV1/FVC increased or decreased? Is the RV/TLC increased or decreased? |
Increased or normal
Increased or normal |
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True or False
Clubbing only occurs in a L->R shunt? |
False
ONLY in a right -> left shunt |
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What is the criteria for the development of cyanosis?
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When > 5 grams of deoxygenated Hb are present in systemic capillaries
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What is the cause of central cyanosis?
What is the cause of peripheral cyanosis? |
Low ARTERIAL O2 saturation
Low CAPILLARY O2 saturation |
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True or False
All types of shock can cause cyanosis? |
False
Septic shock – is a high cardiac output state w/ vasodilation |
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If a pulmonary emboli were to occur, at what level of the pulmonary tree would bronchopulmonary arterial anastomoses occur?
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Terminal Bronchioles
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True or False
Normally the pulmonary circulation has HIGH resistance? |
False
It has LOW resistnace |
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What is the initiating insult in obstructive shock?
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Sudden increase in RV afterload
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Does PAWP increase or decrease in obstructive shock?
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Remains normal b/c decreased LV filling is accompanied by decreased LV distensibility
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Will a left MCA stroke cause the eyes to look towards the right or the left?
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Eyes look towards the left ("away from the lesion") b/c it involves the frontal eye fields
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What are the 3 manifestations of medial medullary syndrome?
What vessel is most often the cause? What vessel often causes lateral medullary syndrome? |
Contralateral weakness, contralateral loss of epicritics (V/P), ipsilateral tongue deviation
Anterior spinal artery PICA |
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If a patient has a wernicke's aphasia, what other finding could you suspect?
If a patient has a broca's aphasia, what other finding could you suspect? |
Homonymous hemianopsia
Arm & Leg clumsiness/weakness |
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What are 3 possible causes of a coexisting UMN and LMN exam finding?
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ALS
Cervical radiculopathy w/ myelopathy B12 deficiency |
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What are 4 possible causes of a patient presenting with protopathic loss (pain/temp) > epicritic loss (V/P)?
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Peripheral neuropathy
Anterior spinal artery infarction Lateral medullary syndrome Syringomyelia |
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What are the 3 components of a fitness prescription?
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Frequency
Intensity Time |
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About how many million of people are infected with TB in the US?
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15 million
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True or False
Two step testing in TB is done to reduce false positives |
False
Reduces false negatives |
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In the United States what % of adults do not engage in vigorous exercise?
What % do? |
62%
24% |
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Activity of 500 MET minutes a week results in a substantial reduction in the risk of ?
Doing > 500 MET minutes a week results in reduction in the risk of ? |
Premature death
Breast cancer |
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For substantial health benefits from exercise how much
moderate activity is required a week? vigorous intensity activity is required a week? |
150 minutes
75 minutes |
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What is the minimum requirement of muscle strengthening to maintain muscle mass?
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Weight lifting at least 2 days a week
At least 8-12 repetitions |
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How much exercise should eldery patients get?
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Moderate exercise for at least 3 days a week w/ balance
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How much exercise should kids get?
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1 hour or more of physical activity a day
With vigorous intensity at least 3 days a week |
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How many more times likely is a kid to smoke if he lives in a home w/ a parent who smokes?
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5x
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What % of lung cancers are attributed to cigarette use?
What % of COPD are attributed to cigarette use? What % of total cancers are attributed to cigarette use? |
90%
80% 30% |
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Regular exercise will lower the risk of what two cancers?
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Colon & Breast Cancer
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What are the 3 causes of dyspnea seen in a patient with a PE?
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Atelectasis -> increased work of breathing
Vagal J receptors Acute hypoxemia |
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Pleuritic chest pain is the most common symptom of what pulmonary embolism syndrome?
Why? |
Pulmonary infarction syndrome
Emboli trigger subpleural innervation |
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What is the major cause of hypoxemia after a PE?
Why? |
Low V/Q
Increased blood flow to other parts of the lung Chemical mediators released by dying lung (histamine, substance P) |
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What is the most common arterial blood gas finding for a person who suffered a PE?
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PaO2 <80 mm Hg is the most common finding
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Why do you get atelectasis after a PE?
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B/c ischemia of type 2 pneumocytes = less surfactant = alveolar collapse
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What is the most common symptom of a PE?
What is the most common physical finding of a PE? |
Dyspnea is the most common symptom
Tachypnea is the most common physical exam finding |
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Is the DLCO high or low after a PE?
Why? |
It is low
B/c pulmonary bed is obstructed |
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If on a ventilation-perfusion lung scan you find the same pattern for both ventilation and perfusion is the patient always normal?
What if the ventilation pattern is more than the perfusion pattern? |
No, the patient could have chronic lung dz (COPD)
Mostly likely a PE |
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What is the gold standard for diagnosis of a pulmonary embolism?
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Catheter pulmonary angiography
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