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49 Cards in this Set
- Front
- Back
Acute Bronchitis
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Brief, self limited inflammatory process of large/midsized airways; dry or productive cough of less than 3 weeks duration; most prevalent in winter; primarily caused by viruses
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Bacteria associated with acute bronchitis
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Mycoplasma pneumoniae; chalmydophila pneumoniae; bordetella pertussis
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Most common viral cause of acute bronchitis in the winter
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Influenza viruses
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Which other illness must you differentiate from acute bronchitis?
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pneumoniae; commonly s. pneumoniae
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Cystic Fibrosis
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Why are cystic fibrosis males often infertile
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Bilateral absence of vas deferences
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CFTR function in lungs and GI tract
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Secretes Cl- in lungs and GI tract;
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CTFR function in sweat glands
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Reabsorbs cl- from sweat
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Meconium Ileus in newborns
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Cystic fibrosis
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Biochemically what happens to the CTFR
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Mutation causes abnormal protein folding, resulting in degradation of channel before reaching cell surface
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Diagnostic test for cystic fibrosis?
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Increase concentratio nof Cl- ions (>60mmol/liter) in sweat is diagnostic
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What is the most common CFTR mutation
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Phe 508; causes CFTR to be recognized as midfolded in the ER and degraded via UPS
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Bronchiectasis
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Dilation of the bronchi and bronchioles (due to destruction of elastic tissues); caused by chronic necrotizing infections, dilation is permanent
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Primary Ciliary Dyskinesia (Kartagener Syndrome)
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Impaired cilia functioning; recurrent infections and retention of secretions
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Allergic Bronchopulmonary Aspergillosis
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Hypersensitivity reaction to aspergillus fumigatus; can occur in pts with asthma and Cf; can lead to bronchiectasis and pulmonary fibrosis of untreated
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Bronchiectasis; note widely dilated bronchi and thickening of the bronchial walls and fibrosis of the parenchyma; can be secondary to cystic fibrosis
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Note the 2 bronchi and their lumens are filled with pus; fibrovascular granulation tissue in walls with infiltration of inflammatory cells
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Pancreas w cystic fibrosis; the ducts are dilated and plugged with mucin; the parenchymal glands are atrophic and have been replaced by fibrous tissue
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Meconium Ileus; obstruction of the terminal ileum due to accumulation of tenacious meconium
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Obstructive Azospermia
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Lack of semen in sperm; secondary to congenital bilateral absence of the vas deferns in cystic fibrosis
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P. aeruginosa isolated from Cf pt; note thick mucoid capsule
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lungs of CF pt w P. aeruginosa; not characteristic greenish color
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Five distinguishing features of P. aeruginosa are:
The synthesis of pyocyanin (blue) and pyoverdin (yellow-green) pigments under aerobic conditions. Pyocyanin generates superoxide radicals and hydrogen peroxide. Pyoverdin is a siderophore. Fruity grape-like smell Oxidase positive Presence of a mucoid alginate capsule |
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Pseudomonas aeruginosa; gram negative rods in pairs or chains; opportunistic so very common source of nosocomial infections; presence of pili and flagella important for establishment of infection in lower respiratory tract
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Small gram negative rods (coccobacilli); polyribol capsule
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Burkholderia cepacia; not common but is a huge concern for Cf pts as it results in a highly accelerated course of the dz and poor prognosis
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Most common tx?
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Antibiotic resistance is a major problem
Acute: Ceftazidime, tobramycin Chronic: Azithromycin |
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Best treatment?
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H. influenzae
Ampicillin or broad spectrum cephalosporins are commonly used Immunization is of course important for prevention for type b |
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Staph aureus
Resistance to penicillins a problem; MRSA in particular Vancomycin the drug of choice with MRSA Oxacillin, clindamycin and doxycyline are also commonly used |
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Atopic Asthma
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type I IgE mediated hypersensitivity reaction; starts in childhood; triggered by environmental allergins; family history
SKIN TEST FOR ALLERGEN POSITIVE |
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Non atopic asthma
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No evidence of allergin sensitization and skin tests are generally negative
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Drug Induced Asthma
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Asprin sensitive asthma in pts w recurrent sinusitis and nasal polyps
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Occupational Asthma
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Triggered by various chemicals
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Late Phase Reaction
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In asthma; leukocyte recruitment secondary to chemokine production by mast cells, epithelial cells, T cells and other cytokines
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Asthma
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Curshmann spirals in asthma (shed epithelium from mucuous plugs)
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Chest radiograph of diffuse interstitial disease
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Bilateral infiltrative lesions that can take the form of nodules, irregular lines and ground glass shows
Lungs decrease in compliance; generally DILD is resistrictive |
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Honeycomb lung representative of chronic diffuse interstitial lung disease
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Idiopathic Pulmonary Fibrosis
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Repeated cycles of lung injury and wound healing with increases collagen
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Formation of honeycomb lung; dense fibrosis = destruction of alveolar architecture
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Cryptogenic Organizing Pneomonia Morphology; note polypoid loose plugs of organizing connective tissue located within alveolar ducts, alveoli and bronchiles
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Coal Workers Pneumoconiosis; associated with coal miners (inhaled carbon taken up by macrophages); can resul tin cor pulmonale, Caplan's syndrome; affects upper lobes
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Silicosis
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Inhalatoin of crystalline silicon dioxide (silica); Associated with foundries, sandblasting and mines
Macrophages respond to silica and release fibrogenic factors, leading to fibrosis; if is thought that silica may disrupt phagolysomes and impair macrophages, increasing susceptibility to TB Affects upper lobes, "eggshell" calcification of hiliar lymph nodes |
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Asbestos bodies; golden brown beaded rods with a translucent center (ferruginous bodies = iron coating)
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Sarcoidosis
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Proposed model for sarcoidosis
Antigen presenting cell/helper T cell interaction results in cytokine release leading to granuloma formation. Over time the disorder may resolve or result in chronic disease. |
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Asteroid body: stellate inclusions in the cytoplasm of epitheliod or giant cells; sarcoidosis
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Schumann body; laminations composed of calcium and protein
Sarcoidosis |
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Organs commonly involved in sarcoidosis
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Eosinophilic Granuloma
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Infiltration of eosinophils
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