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47 Cards in this Set
- Front
- Back
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what cells regenerate lung epithelium following injury?
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type II pneumocytes; their other major fxn is pulmonary surfactant secretion
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where does pseudostratified columnar ciliated epithelium stop?
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at the level of respiratory bronchioles becomes cuboidal ciliated; cilia are absent from terminal alveolar ducts
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a stab wound just superior to the clavical risks damaging?
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lung; it extends superior to the clavical through the thoracic aperature
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why is there tachycardia w/tension pneumo?
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increased intrathoracic pressure decreases venous return and thus CO
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ansa cervicalis arise from? Innervates?
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C1, C2, C3; innervates sternohyoid, sternothyroid, & omohyoid; might be injured by penetrating trauma superior to the cricoid cartilage
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what cells release elastase?
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neutrophils & alveolar macrophages; centriacinar emphysema associated w/smoking
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what do clara cells do?
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secrete CCSP (clara cell secretory protein) - inhibits neutrophil recruitment & activation, & neutrophil dependent mucin production
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how does streptomycin inhibit mycobacterial growth?
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AMINOGLYCOSIDE; interferes w/initiation step of prtn synthesis; binds 30S subunit & changes structure
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what antibiotics interefere with translocation?
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erythromycin & clindamycin
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what prevents binding of amino-acyl tRNA to A site?
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tetracycline
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failed sterilization of mechanical ventilators leads to pneumoniae caused by what bugs?
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e. coli, klebsiella, acinetobacter, pseudomonas
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nitroblue tetrazolium testing is used for what?
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tests for NADPH oxidase activity; fails to turn blue if deficient, as is the case in Chronic Granulomatous Disease; at risk for infection by Catalase positive organisms
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why neutrophils of patients with CGD still kill catalase negative organisms?
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hydrogen peroxide produced by the organisms accumulates in the phagosome
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lecithiniase is produced by what organism?
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clostridium perfrinogens; it is alpha toxin or phospholipase C - lyses erythrocyts platelets luekocytes & endothelial cells, in part responsible for the rapid necrotizing
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how is chronic granulomatous disease inherited genetically?
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X-linked
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what PFTs are expected in emphysema?
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decreased FEV1/FVC ratio; increased TLC, decreased diffusional capacity
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Dz incidence tables - what goes top & bottom? Negative predictive value?
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Dz incidence on top; test results on vertical; Neg predictive = d/[c+d] (true neg over true neg + false neg)
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how does negatie predicitve value change with prevalence?
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NPV is inversely proportional to prevalence,
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enlarged, centrally located epithelial cell - intranuclear & cytoplasmic inclusions; context: lung transplant pt 4mos post transplant - sob cough fever, diffuse infiltrates
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Cytomegalovirus, lookup picture
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How can mycobacterium become resistant to isoniazid?
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1.) decreased activity of catalase-peroxidase, which is necessary for activation of isonizid; 2.) mutation of the required peptide sequence for binding
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What bacteria found in the soil can survive boiling?
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spore forming bacteria - bacillus & clostridium; killed by autoclaving
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which polio vaccine is approved in the US?
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only the inactivated salk vaccine
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flunisolide therapy is initiated - what is it for? What complications occur and how can they be prevented?
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it's steroid aerosol for asthma, oral candidiasis can occur, oral rinsing instructions are necessary
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What bacterial immunizations require conjugation to toxoid?
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Capsular bacteria - Strep pneumoniae, neisseria meningitidis, haemophilus influenza B
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what drug inhibits fungal wall composition? What side effects does it have?
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itraconazole (inhibit demethylation of lanosterol into ergosterol); inhibits P450 enzymes important to many other drugs
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big name p450 metabolized drugs?
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warfarin, cyclosporin, tacrilomus, phenytoin, isoniazid, rifampin, oral hypoglycemics, etc
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what drugs induce cytochrome oxidases that result in decreased levels of -azoles for fungal tx?
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rifampin and a bunch of PSYCH drugs (phenytoin, carbamazepine, phenobarbital)
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congenital defect - oxygen "step-up" from RA to RV? Findings?
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VSD; finding would be holosystolic murmur at left sternal border
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what sO2 would be found w/ASD? Physical exam finding?
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oxygen step up from vena cava to RA; fixed splitting of S2
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spike & dome carotid pulse upstroke?
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hypertrophic obstructive cardiomyopathy - dynamic LV outflow tract obstruction
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what happens to blood & the heart with inspiration?
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decreased thoracic pressure --> increased venous return to RIGHT heart; INCREASED PULMONARY VESSEL CAPACITY --> decreased blood return to LEFT HEART
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most important prognostic factor in tetrolagy of fallot?
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degree of pulmonic stenosis
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pulmonary infarct characteristic?
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almost always hemorrhagic, b/c of dual blood supply (would be difficult to be ischemic)
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pulmonary infarct in IV drug user?
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septic emboli from tricuspid endocarditis; s. aureus & pseudomonas are MCC in this population
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reliability vs precision
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essentially the same (contrast to accurate)
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adult homeless man; increasing fatigue exertional dyspnea; LE edema, decreased sensation over feet/legs?
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wet Beriberi - high output CHF; thiamine (B1) deficient
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verapamil effect on AV & SA node?
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slows diastolic (?) depolarization - [phase 0; calcium channel blocker]
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what drugs increase the threshold potential of cardiac pacemaker cells?
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Only class I (A-C)
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what drugs prolong repolarization of cardiac pacemakers?
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class IA, IC, III
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what drugs shorten the action potential of cardiac pacemakers?
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class IB
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carpopedal spasms soon after birth, absent thymic shadow, narrowing of the aortic arch - what dz? What embryological structure?
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DiGeorge's Syndrome; 3rd & 4th PHARYNGEAL pouch; - associated w/hypoPTH from parathyroid aplasia - hypocalcemia & tetany; aortic arch abnormalities
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sildafenil and nitroglycerine together?
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nitrates + phosphodiesterase inhibitors cause cGMP accumulation; profound hypotension; absolutely contraindicated
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hypotension, JVD, distant/muffled heart sounds (& tacchycardia)
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Becks triad - cardiac tamponade; loss of palpable pulse could be due to pulsus paradoxus
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34 yo female w/progessive exertional sob & coronary sinus dilation?
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pulmonary HTN; coronary sinus communicates with RA, if RA pressure goes up can cause coronary sinus dilation
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antiarrhythmic decrease the outward flow of an ion active in the late phase of cardiac myocte action potential?
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class III - K channel blockers; ibutilide, sotalol, betyu…?, amiodarone, dofetilide
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65 yo man loses conciousness while buttoning shirt, which nerve is stimulated?
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glossopharyngeal (carotid baroreceptors; responds to both increase & decrease); not vagus b/c that is aortic arch baroceptors (not hit by shirt buttoning), responds only to increased BP
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functional heart murmurs
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caused by acute hemodynamical changes, in absence of any structural lesions
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