S1 - Falcon - Pathology Iii-A

Front 1

RESPIRATORY

- calculate PAO2

Back 1

= (%O2 x 713) - (PaCO2 / 0.8)

Front 2

RESPIRATORY

- an A-a gradient greater than 30 implies what?

Back 2

- Lung disease

(ventilation, perfusion, diffusion problem)

Front 3

RESPIRATORY

- a normal A-a gradient implies what?

Back 3

- Extrapumonary Dz

COPD, depression of resp center obstruct upper airway from epiglottitis, larygiotracheobronchitis, café coronary (paralyzed muscles of resp), Guillain Barre syndrome,
amyotrophic lateral sclerosis, and paralysis of diaphragm. These all produce resp acidosis and hypoxemia

Front 4

RESPIRATORY

- what is the FEV1/FVC in Obstructive Dz

Back 4

- Decreased

(because FEV1 decrease is greater than FVC decrease)

Front 5

RESPIRATORY

- what is the FEV1/FVC in Restrictive Dz

Back 5

- Normal to increased

(because FVC decrease is greater than FEV1 decrease)

Front 6

NASAL POLYPS

- MC nasal polyp?

- seen in what population group

Back 6

- Allergic polyps

- Adults with Hx of allergies (IgE mediated)

Front 7

NASAL POLYPS

- Triad asthma?

- seen in what population group?

Back 7

1.) ASA
2.) Nasal Polyp
3.) Asthma

(ASA or other NSAIDs could do this)

- Females with chronic pain

Front 8

NASAL POLYPS

- Nasal polyp in child would have what probable etiology?

Back 8

- CF

(so order a sweat test)

Front 9

OBSTRUCTIVE SLEEP APNEA (OSA)

- OSA causes what pulmonary condition based on ABG?

- OSA causes what acid/base disorder?

Back 9

- Hypoxemia

- Respiratory Acidosis

Front 10

OBSTRUCTIVE SLEEP APNEA (OSA)

- OSA induced hypoxemia & respiratory acidosis can lead to what complication?

- above complication can then lead to what complication?

Back 10

- Pulmonary HTN

- Right Ventricular Hypertrophy

(cor pulmonale eventually)

Front 11

OBSTRUCTIVE SLEEP APNEA (OSA)

- what is the confirmatory test that documents OSA during sleep?

Back 11

- polysomnography

Front 12

SINUSITIS

- MCC of sinusitis (microbial agent)

- MCC of sinusitis (clinical dz)

Back 12

- Staph. aureus

- Viral URI (Rhinovirus)

(viral URI blocks drainage of sinuses in to nasal cavity)

Front 13

SINUSITIS

- MC sinus affected in adults

- MC sinus affected in kids

Back 13

- Maxillary sinus

- Ethmoid sinus

Front 14

SINUSITIS

- most sensitive test in diagnosing sinusitis

Back 14

- CT

(recommended especially for surgery)

Front 15

NASOPHARYNGEAL CARCINOMA

- associated with what microbial agent?

- MC location?

Back 15

- EBV

- China

Front 16

NASOPHARYNGEAL CARCINOMA

- Cancer type?

- Mestasizes usually to where?

Back 16

- Squamous CC
(could be undifferentiated CA too)

- Cervical LN

Front 17

OBESITY

- defined as what BMI?

- what hormone is plays an important role in obesity

Back 17

Greater or equal to 30 kg/m2

Leptin

Front 18

OBESITY

- Leptin has what general function?

- Leptin has influence over what 2 specific physiological processes?

Back 18

- Maintains Energy balance

1.) Satiety
2.) Beta Oxidation

Front 19

OBESITY

- when Adipose Stores are adequate or elevated, then Leptin levels will?

- above changes in Leptin levels causes what effects?

Back 19

- Leptin goes UP

- Intake DOWN (b/c satiety)
- Beta-oxidation UP

Front 20

OBESITY

- Leptin hormone is secreted by?

Back 20

- adipose tissue

Front 21

OBESITY

- 1 pound of fat usually involves how many excess calories?

- defective gene associated with obesity?

Back 21

3500 calories

Leptin gene

Front 22

OBESITY

- increased adipose will decreased synthesis of?

Back 22

- Insulin RECEPTORS

Front 23

OBESITY

- Obesity causes an increased risk of what type of CAs?

- this is due to an increased level of what in adipose?

- pathogenesis?

Back 23

- Estrogen related CA
(e.g. - endometrial & breast ca)

- Aromatase

- Aromatase aromatizes androgens to estrogens in adipose
(thus estrogen-related ca)

Front 24

OBESITY

- Obesity causes an increased incidence of what GI problems?

- what is the pathogenesis

Back 24

- Cholethiasis / Cholecystitis

- Bile is SUPERSaturated with cholesterol

Front 25

OBESITY

- can cause what major Dz?

- pathogenesis?

Back 25

- DM type 2

- Adipose decreases synthesis of Insulin receptors

Front 26

OBESITY

- Obesity has what affect on blood pressure?

- pathogenesis?

Back 26

- HTN

1st: Adipose decreases Insulin Receptor synthesis

2nd: Insulin accumulates in blood

3rd: Hyperinsulinemia causes Sodium Retention

Front 27

OBESITY

- Obesity can cause what lipid-blood condition?

- thus increased synthesis of?
- thus decreased levels of?

Back 27

Hypertriglyceridemia

- VLDL
- HDL

Front 28

OBESITY

- Hypercholesterolemia increases levels of what lipids in blood?

- increases risk of what CV disease?

Back 28

- LDL

- CAD

Front 29

OBESITY

- Obesity is the MCC of what sleep disorder?

- pathogenesis

Back 29

- Obstructive Sleep Apnea

- Weight of adipose compresses airways of trachea

(leads to resp acidosis & hypoxemia)

Front 30

OBESITY

- Obesity can cause what bone problems?

- pathogenesis

Back 30

- Osteoarthritis

- degeneration of Articular cartilage from increased weight

Front 31

OBESITY

- 1 pound of fat usually involves how many excess calories?

- defective gene associated with obesity?

Back 31

3500 calories

Leptin gene

Front 32

OBESITY

- increased adipose will decreased synthesis of?

Back 32

- Insulin RECEPTORS

Front 33

OBESITY

- Obesity causes an increased risk of what type of CAs?

- this is due to an increased level of what in adipose?

- pathogenesis?

Back 33

- Estrogen related CA
(e.g. - endometrial & breast ca)

- Aromatase

- Aromatase aromatizes androgens to estrogens in adipose
(thus estrogen-related ca)

Front 34

OBESITY

- Obesity causes an increased incidence of what GI problems?

- what is the pathogenesis

Back 34

- Cholethiasis / Cholecystitis

- Bile is SUPERSaturated with cholesterol

Front 35

OBESITY

- can cause what major Dz?

- pathogenesis?

Back 35

- DM type 2

- Adipose decreases synthesis of Insulin receptors

Front 36

OBESITY

- Obesity effect on BP?

- pathogenesis

Back 36

HTN

1st: Adipose decreases synthesis of Insulin RECEPTORS

2nd: Insulin accumulation

3rd: Hyperinsulinemia increases Sodium retention

4th: Increase in Plasma Volume

Front 37

OBESITY

- lipid disorders caused by obesity

Back 37

- HyperTriglyceridemia

- HyperCholesterolemia

Front 38

OBESITY

- Hypertriglyceritdemia increases what levels?

- decreases what levels?

Back 38

- VLDL

- HDL

Front 39

OBESITY

- Hypercholesterolemia increases what levels?

- HyperCholesterolemia increases the risk of what CV dz?

Back 39

- LDL

- CAD

Front 40

OBESITY

- Obesity causes what sleep dysfunction?

- pathogenesis

Back 40

- OSA

- excessive weight compresses the airways of trachea

(complicates into hypoxemia and respiratory acidosis)

Front 41

OBESITY

- Obesity causes what bone problems?

- pathogenesis

Back 41

- Osteoarthritis

- degeneration of articular cartilage due to increased weight

Front 42

LARYNX

- MC type of CA?

- MC location?

Back 42

- keratinizing Squamous Cell Carcinoma

- True vocal cords
(below the false cords)

Front 43

LARYNX

- MCC of Laryngeal carcinoma
- 2nd MCC of Laryngeal carcinoma

- what effect is seen when having both of above?

Back 43

- Smoking

- Alcohol

- Synergistic effects

Front 44

LARYNX

- Laryngeal carcinoma presents with what MC symptom?

Back 44

- persistent hoarseness

Front 45

ATELECTASIS

- define

- what are the 2 types of atelectasis

Back 45

- loss of lung volume due to airway collapse

- Reabsorption atelectasis
- Compression atelectasis

Front 46

ATELECTASIS

- MCC of fever 24 to 36 hours after surgery?

Back 46

- Resorption atelactasis

Front 47

ATELECTASIS

- in resorption atelectasis, resorption of air occurs where?

Back 47

- Pores of Kahn

(in the alveolar walls)

Front 48

ATELECTASIS

- Symptoms of resorption atelectasis

- PE features of resorption atelectasis

Back 48

- Fever
- Dyspnea

- Dullness to Percussion
- Absent Vibratory sensations
- Absent Breath sounds

Front 49

ATELECTASIS

- define compression atelectasis

- 2 examples of compression atelectasis

Back 49

- Air under pressha or phluid in pleural cavity

- Pleural Effusion
- Tension Pneumothorax

Front 50

ATELECTASIS

- atelectasis can also occur due to a loss of?

Back 50

- Surfactant

Front 51

SURFACTANT

- synthesized by what cells?

- stored in what cells?

Back 51

- Type II Pneumocytes

- Lamellar bodies

Front 52

SURFACTANT

- which week of gestation does the fetus start synthesizing surfactant?

Back 52

- 28th week

Front 53

SURFACTANT

- major component?

Back 53

- Phosphatidylcholine (Lecithin)

Front 54

SURFACTANT

- what hormone increases synthesis?

- what hormone inhibits synthesis?

Back 54

- cortisol / corticosteroids
(also thyroxine & prolactin)

- insulin

Front 55

SURFACTANT

- effects on alveoli of the small airways

Back 55

- Decreases surface tension

Front 56

SURFACTANT

- surfactant prevents collapse during when?

- why then?

Back 56

- Expiration

- when collapsing pressure is greatest

Front 57

SURFACTANT

- Decreased surfactant levels cause what condition in newborns?

Back 57

- Respiratory Distress Syndrome (RDS)

Front 58

RESPIRATORY DISTRESS SYNDROME

RDS is a:

a.) Ventilation defect
b.) Perfusion defect
c.) Diffusion defect

Back 58

a.) Ventilation

(b/c its an intrapulmonary shunting problem)

Front 59

RESPIRATORY DISTRESS SYNDROME

- what are the different circumstances prompting RDS in the newborn?

- RDS can concurrently occur with what 2 conditions?

Back 59

- Prematurity
- Maternal DM
- C-section

- PDA
- Superoxide damage

Front 60

RESPIRATORY DISTRESS SYNDROME

- Fetal surfactant levels can be increased by giving what to mommy?

Back 60

- Glucocorticoids

Front 61

RESPIRATORY DISTRESS SYNDROME

- DM mommy gets hyperglycemic, but what about the fetus?

- this will cause the fetus to synthesize?

- what is the effect of this synthesis?

Back 61

- Hyperglycemic also

- Insulin

- Insulin decreases surfactant synthesis

Front 62

RESPIRATORY DISTRESS SYNDROME

- Why does DM mommy give birth to big-ass baby?

Back 62

- mommy's hyperglycemia makes fetus hyperglycemic, so fetal insulin secreted

- insulin increases fat storage
- insulin increases amino acid uptake

Front 63

RESPIRATORY DISTRESS SYNDROME

- why does a DM mommy give birth, only to find out the baby is HYPOGlycemic?

Back 63

- DM mommy's sugar makes fetus insulin high.

- once cord is cut, mommy's sugar not there, but baby insulin is there

- thus baby get HYPOGlycemic
(and that is bad shit)

Front 64

RESPIRATORY DISTRESS SYNDROME

- why do babies with RDS commonly have PDA?

Back 64

B/c they have hypoxemia.

Normal baby takes a breath & starts functional closure of the ductus.

However, with hypoxemia after they are born, it remains open.

Front 65

RESPIRATORY DISTRESS SYNDROME

- PDA babies have what murmur quality?

Back 65

- machinery murmur

Front 66

RESPIRATORY DISTRESS SYNDROME

- Hyaline membranes seen in RDS are due to?

Back 66

- Degeneration of Type II pneumocytes
&
- Leakage of Fibrinogen

Front 67

RESPIRATORY DISTRESS SYNDROME

- RDS involving Superoxide damage presents with what clinical conditions?

Back 67

(Super B-BaD)

- Blindness
- Bronchopulmonary Dysplasia

Front 68

RESPIRATORY DISTRESS SYNDROME

- TX?

Back 68

- PEEP therapy
(Positive End Expiratory Pressure)

- surfactant maybe

Front 69

ADULT RDS (ARDS)

- ARDS is similar to RDS in newborns EXCEPT?

Back 69

- ARDS is NEUTROPHIL related injury
(thus inflammation)

- RDS is surfactant problem
(thus non-inflammatory)

Front 70

ADULT RDS (ARDS)

- MCC of ARDS?

Back 70

- Septic shock