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Flashcards in Pulmo Deck (320):
1

Innervation of the diaphragm

Phrenic nerve

2

Nerve roots of origin of phrenic nerve

C3,4,5

3

Most common location of Morgagni hernia

Right anterior

4

Most common site of Bochdalek hernia

Left posterior

5

Most common congenital diaphragmatic hernia

Bochdalek

6

Neutrophil-derived elastase that destroy lung parenchyma is inhibited by

α1-antitrypsin

7

Source of resistance in inspiration that is being reduced by surfactant

Compliance resistance

8

Pathology of adult RDS

Diffuse alveolar damage

9

Most common cause of adult RDS

Sepsis

10

Type of pneumocytes affected in adult RDS

Type I pneumocytes

11

Lung volumes (4)

1) IRV
2) TV
3) ERV
4) RV

12

Lung capacities

1) Inspiratory capacity
2) Functional residual capacity
3) Vital capacity
4) Total lung capacity

13

Capacity-associated volumes: Inspiratory capacity

IRV + TV

14

Capacity-associated volumes: Functional residual capacity

ERV + RV

15

Capacity-associated volumes: Vital capacity

IRV + TV + ERV

16

Equilibrium point at which the elastic recoil of the lungs is equal and opposite to the outward force of chest wall

FRC

17

Best zone of ventilation in children

Mid to lower lung fields

18

Ghon's focus is usually found at which lung fields

Mid to lower lung fields

19

States that partial pressure exerted by a gas in a mixture of gases is proportional to the fractional concentration of that gas

Dalton's law

20

Most common cause of V/Q mismatch

Hypoxemia

21

Fick's law of diffusion states that diffusion rate of oxygen across pulmonary membrane depends on

1) Pressure gradient
2) Surface area
3) Diffusion distance

22

Processes that impair O2 diffusion

1) Decreased O2 gradient (high altitude)
2) Decreased surface area (emphysema)
3) Increased diffusion distance (pulmonary fibrosis)

23

Cardiac output at rest

5L/min

24

V/Q ratio at zone 1

3.3

25

V/Q ratio at zone 2

1.0

26

V/Q ratio at zone 3

0.6

27

CO2 is converted to carbonic acid: Inside the RBC vs outside the RBC

Inside

28

Direction of flow of Cl in chloride shift

Into RBC

29

Direction of flow of HCO3 in chloride shift

Out of RBC

30

Dorsal and ventral respiratory groups are found in

Medulla

31

Pneumotaxic and apneustic centres are found in

Pons

32

Controls basic rhythm of respiration

DRG

33

Stimulates expiratory muscles

VRG

34

Most preventable cause of death among hospitalized patients

Pulmonary embolism

35

Embolus that occlude the main pulmonary artery, impact across bifurcation

Saddle embolus

36

Embolus that pass through inter arterial and inter ventricular defect to gain access to the systemic circulation

Paradoxical embolus

37

Most common cause of PE

Proximal leg DVT

38

T/F Majority of deep leg vein thrombi are clinically silent

T

39

% of deep leg vein thrombi that cause infarction

10

40

Lobe most commonly affected by PE

Lower lobe

41

% of pulmonary circulation that has to be obstructed to cause sudden death

>60

42

% chance of having a second embolus in PE survivors

30

43

Virchow's triad

SHE
1) Stasis
2) Hypercoagulability
3) Endothelial injury

44

Natural anticoagulants in the body

1) Protein C
2) Protein S
3) AT III

45

Most commonly inherited thrombophilic condition

Factor V Leiden mutation

46

Major risk factors for PE (5)

1) Post op
2) Prior VTE
3) CVA
4) Estrogen treatment
5) APAS

47

PE: Most common history

Unexplained breathlessness

48

PE: Most common symptom

Dyspnea

49

PE: Most common sign

Tachypnea

50

Symptoms of massive PE (4)

1) Dyspnea
2) Hypotension
3) Cyanosis
4) Syncope

51

Symptoms of small PE (3)

1) Pleuritic pain
2) Cough
3) Hemoptysis

52

Most common history of DVT

Cramp in the lower calf

53

Most common signs and symptoms of DVT (4)

1) Swelling
2) Pain
3) Erythema
4) Warmth

54

Classic findings/signs in PE (3)

1) Homans sign
2) Moses sign
3) Palpable cord sign

55

Pain elicited when calf muscle is compressed against the tibia but none when compressed from side to side

Moses sign or Bancroft sign

56

Pain of the calf muscle on compression either by squeezing or forced dorsiflexion

Homans sign

57

Asymmetry in tolerance to pressure of 180mmHg applied on each calves simultaneously

Lowenberg sign

58

Gold standard for diagnosis of DVT

Contrast venography

59

Most reliable criterion for DVT on contrast venography

Constant intraluminal filling defect

60

Natural history of DVT (3)

1) Progressive proximal extension
2) Complete/partial dissolution
3) Embolization

61

PE on ECG

S1Q3T3

62

PE: Most common ECG abnormality

T wave inversion in leads V1-V4

63

Primary criterion for DVT on venous ultrasonography

Loss of vein compressibility

64

PE on x-ray: Focal oligemia

Westermark sign

65

PE on x-ray: Peripheral wedge-shaped density above the diaphragm

Hampton hump

66

PE on x-ray: Enlarged right descending pulmonary artery

Palla sign

67

PE on x-ray: Prominent central artery

Fleischner sign

68

Principal imaging test for diagnosis of PE

Chest CT with IV contrast

69

RV enlargement on chest CT with contrast indicates

Increase likelihood of death within the next 30 days

70

Most common radiographic abnormalities of PE (2)

1) Atelectasis
2) Pulmonary opacities

71

PE on ABG

1) Hypoxemia
2) Hypocarbia

72

PE on 2D echo

RV pressure overload

73

The Great Masquerader

PE

74

Virchow's triad is a predisposing factor to

DVT

75

PE: Prevention

Heparin

76

PE: Acute management

Unfractionated heparin

77

PE: Long-term prevention of recurrence

Warfarin

78

Substance used in lung scanning

Albumin-labeled gamma-emitting radionuclide

79

PE: High-probability lung scan

2 or more segmental perfusion defects in the presence of normal ventilation

80

Best known indirect sign of PE on 2D Echo

McConnell sign

81

Hypokineses of RV free wall with normal motion of RV apex

McConnell sign

82

Definitive diagnosis of PE

Pulmonary angiography

83

Finding of PE on pulmo angio

Intraluminal filling defect in more than 1 projection

84

Target aPTT in unfractionated heparin therapy for PE

2-3x upper limit of laboratory normal value

85

Major disadvantage of unfractionated heparin therapy

Repeated blood sampling for dose adjustment every 4-6 hrs

86

Unfractionated heparin therapy for PE increases the risk for

Heparin-induced thrombocytopenia

87

Advantage of low molecular weight heparin over unfractionated heparin

No monitoring or dose adjustment needed unless patient is markedly obese or has CKD

88

Monotherapy for symptomatic VTE patients with cancer

Dalteparin

89

Anti-Xa

1) Fondaparinux
2) Rivaroxaban

90

Advantages of Fondaparinux (2)

1) Once-daily subcutaneous injection
2) No lab monitoring

91

Novel drugs for prevention of VTE after total hip and total knee replacement

1) Rivaroxaban
2) Dabigatran

92

Dabigatran MOA

Direct thrombin inhibitor

93

Most serious complication of anticoagulation

Hemorrhage

94

Management for life-threatening or intracranial haemorrhage due to heparin or LMWH

Protamine sulfate

95

Anticoagulant for patients with renal insufficiency

Argatroban

96

Anticoagulant for patients with hepatic failure

Lepirudin

97

2 principal indications for IVC filter insertion

1) Active bleeding that precludes anticoagulation
2) Recurrent venous thrombosis despite intensive anticoagulation

98

Lower rate of death and recurrent PE

Fibrinolysis

99

Preferred fibrinolytic regimen for PE

100mg rtPA as continuous IV infusion over 2 hours

100

Patient with PE respond to fibrinolytics up to ___ after PE has occurred

14 days

101

Contraindications to fibrinolysis

1) Intracranial disease
2) Recent surgery
3) Trauma

102

Mode of transmission of pTB

Droplet nuclei

103

Most common and important agent of human disease

MTb

104

T/F Majority of inhaled MTb bacilli reach the alveoli

F

105

Survival of MTb in macrophages depend on

Reduced acidification due to lack of accumulation of proton-adenosine triphosphate

106

Why MTb do not die in macrophages

Inhibits intracellular release of Ca resulting in impaired Ca/calmodulin pathway that lead to phagosome-lysosome fusion

107

T/F Primary PTB may be asymptomatic

T

108

Lesion formed in PTb after initial infection that heals spontaneously into a small calcified nodule

Ghon focus

109

The Ghon focus is pathologically

Subpleural granuloma

110

Most common site of extra pulmonary TB in children

Hilar LN

111

Clinical finding of PTb in young children and impaired immunity

Pleural effusion

112

Most common population of post primary disease

Public school teachers

113

Responsible for the acid-fastness of MTb

Mycolic acid

114

Caseous necrosis in MTb infection is due to

Phosphatides

115

Common location of secondary PTb lesion

1) Apical and posterior segment of upper lobes
2) Superior segments of lower lobes

116

Pneumonia in PTb that results from massive involvement of pulmonary segments or lobes

Caseating pneumonia

117

Gold standard for diagnosis of PTb

Mycobacterial culture

118

Duration required for expected growth in mycobacterial culture

4-6 weeks

119

Medium for PTb culture

Egg- or agar-based medium, Lowenstein-Jensen or Middlebrook 7H10

120

Temp for PTb culture

37C

121

CO2/O2 for Middlebrook medium in PTb culture

5% CO2

122

Decreases the time for bacteriologic confirmation of TB to 2-3 weeks

Immunochromatographic lateral flow assay

123

Most useful for the rapid confirmation of TB in persons with AFB-positive, AFB-negative, and extrapulmonary smears

Nucleic acid amplification

124

MTb isolates should be tested for susceptibility to which drugs to detect MDR Tb

1) Isoniazid
2) Rifampin

125

When MDR-Tb is found, expanded susceptibility testing should be done against which drugs

Fluoroquinolones and injectable drugs

126

Tuberculin reaction is what type of hypersensitivity

Type IV

127

Positive tuberculin reaction size in mm: HIV infected

>=5

128

Positive tuberculin reaction size in mm: On immunosuppressive therapy

>=5

129

Positive tuberculin reaction size in mm: Low risk persons

>=15

130

Positive tuberculin reaction size in mm: High-prevalence ares

>=10

131

Positive tuberculin reaction size in mm: Malnutrition

>=10

132

Positive tuberculin reaction size in mm: Steroids

>=10

133

Positive tuberculin reaction size in mm: Close contact with Tb patients

>=5

134

Positive tuberculin reaction size in mm: Fibrotic lesions on chest radiography

>=5

135

Positive tuberculin reaction size in mm: Recently infected persons (2 years)

>=10

136

Positive tuberculin reaction size in mm: Persons with high-risk medical conditions

>=10

137

Recommended daily dose: INH

5 mg/kg, max 300 mg

138

Recommended daily dose: RIF

10 mg/kg, max 600 mg

139

Recommended daily dose: PYR

25 mg/kg, max 2g

140

Recommended daily dose: Ethambutol

15 mg/kg

141

First pulmonary infection to set in in patients with HIV infection

PTb

142

PTB treatment regimens: New smear- or culture-positive

2HRZE/4HR (6 months)

143

PTB treatment regimens: New culture-negative

2HRZE/4HR (6 months)

144

PTB treatment regimens: Pregnancy

2HRE/7HR (9 months, no pyrazinamide)

145

PTB treatment regimens: Relapse

2HRZES/1HRZE/5HRE (8 months, with S during induction)

146

PTB treatment regimens: Treatment default

3 HRZES/5HRE (8 months, 3 months induction with S)

147

PTB treatment regimens: Treatment failure, resistance or intolerance to H

6RZE

148

PTB treatment regimens: Treatment failure, resistance or intolerance to R

12-18 mos HZEQ

149

PTB treatment regimens: Treatment failure, resistance or intolerance to H and R

20 mos ZEQ + S or another injectable

150

PTB treatment regimens: Resistance to all first line drugs

20 mos 1 injectable + 3 of cycloserine, ethionamide, Q, PAS

151

PTB treatment regimens: Intolerance to Z

2 mos HRE, 7 mos HR

152

Duration of cough to suspect PTb

2 weeks

153

Initial work-up of choice for PTB

Sputum AFB

154

At least how many sputum specimens should be sent for sputum AFB

2

155

Preferred number of sputum specimens to be sent for sputum AFB

3

156

Most efficient way of identifying cases of PTB

Sputum AFB

157

Diagnostic modality for PTB that correlated with infectiousness

Sputum AFB

158

TB culture with drug susceptibility testing (DST) is primarily recommended for what population of patients

High risk for drug resistance

159

TB culture is recommended for which population of smear positive patients (5)

1) Retreatment
2) Treatment failure
3) MDR-TB suspect
4) Household contacts of patients with MDR-TB
5) HIV

160

PTB drugs: Dosing during initial phase

Daily

161

PTB drugs: Dosing during continuation phase

3x a week

162

PTB relapse case is defined as

Previously treated with 1 full course under DOT and declared cured or treatment completed and has become smear positive again

163

T/F Relapses after a previous regimen under DOT have the same drug susceptibilities as initial isolates

T

164

Management for symptomatic patients who were not on DOTS in the previous treatment (2)

1) TB culture with DST
2) 2HRZES/1HRZE/5HRE

165

PTB treatment failure case is defined as

While on treatment, remained or became smear (+) again at 5th month of treatment or later OR smear (-) at the start and becomes smear (+) at the 2nd month

166

T/F BCG vaccination is recommended for adults to confer protection

F

167

T/F Empiric treatment with various anti-TB drugs is recommended for suspected MDR-TB cases

F

168

Recommended management for MDR-TB cases

Immediate referral to PMTM program

169

Preferred mode of administration of anti-TB drugs

FDC

170

Recommended adjunctive therapy for PTB (3)

1) Arginine
2) Vitamin A
3) Zinc

171

MDR-TB is defined by the WHO as

In vitro resistance to both HR

172

PTB case definitions: New

Never had treatment or previous anti-Tb for less than 4 weeks

173

PTB case definitions: Return to treatment after default

Stopped taking meds for >=2 mos and comes back smear (+)

174

PTB case definitions: Transfer-in

Management started from another area and now transferred to a new clinic

175

Management for PTB treatment failure case

2HRZES/1HRZE/5HRE

176

PTB case definitions: Chronic case

Became or remained smear (+) after completing a fully-supervised RETREATMENT regimen

177

WHO case definitions of TB: Latent TB

TB infection, no evidence of disease

178

WHO case definitions of TB: Active TB

Clinically active TB

179

PTB case definitions: 2 weeks or more of cough with or without accompanying symptoms

TB symptomatic

180

3-specimen collection for AFB smear

1-Spot at time of consultation
2-Early morning
3-Second spot specimen when the patient comes back the next day

181

Recommended for patients who are unable to spontaneously bring up sputum for AFB

Sputum induction with nebulisation of a hypertonic saline

182

T/F After a TB symptomatic is found to be smear positive, no further tests are required to confirm the diagnosis of PTB

T

183

T/F T/F After a TB symptomatic is found to be smear positive, no further tests are required to initiate anti-TB therapy

T

184

T/F Chest radiographs are routinely necessary in the management of TB symptomatic patient who is smear positive

F

185

TB radiograph description: Minimal vs extensive - all or the greater portion of a lobe

Extensive

186

TB radiograph description: Minimal vs extensive - 4-cm cavity

Extensive

187

TB radiograph description: Minimal vs extensive - Multiple cavitations measure up to 4 cm

Extensive

188

TB radiograph description: Minimal vs extensive - Cavities less than 4cm

Extensive

189

Status asthmatics is defined as

Severe obstruction persisting for days or weeks

190

Asthma: Single largest risk factor

Atopy

191

Asthma: Most atopic patients have allergic sensitisation to

Dust mite

192

Major risk factors for asthma deaths (3)

1) Poorly controlled disease
2) Lack of corticosteroid therapy
3) Previous admissions to hospital with near-fatal asthma

193

Chronic inflammatory disease of airways characterised by increased responsiveness of the tracheobronchial tree to various stimuli

Asthma

194

Most severe form of asthma

Status asthmaticus

195

Asthma: Peak age

3

196

Asthma: Male-to-female ratio

M

197

Asthma: Sex ratio equalises by

30 y/o

198

Asthma: Drug implicated as a risk factor for asthma

Acetaminophen

199

Asthma: Relation between breastfeeding during infancy and risk of childhood asthma

Reduces risk

200

Hallmark of asthma

Airway hyperresponsiveness to both specific and nonspecific stimuli

201

Types of asthma

1) Allergic/extrinsic
2) Idiosyncratic/intrinsic

202

Allergic vs idiosyncratic asthma: Associated with personal and/or family history of allergic diseases

Allergic

203

Allergic vs idiosyncratic asthma: No defined immunologic mechanism

Idiosyncratic

204

Allergic vs idiosyncratic asthma: Precipitated by upper respiratory infections

Idiosyncratic

205

Allergic vs idiosyncratic asthma: Precipitated by exercise

Idiosyncratic

206

Allergic vs idiosyncratic asthma: IgE-mediated

Allergic

207

Allergic vs idiosyncratic asthma: Precipitated by GER

Idiosyncratic

208

Allergic vs idiosyncratic asthma: Precipitated by cold air

Idiosyncratic

209

Allergic vs idiosyncratic asthma: Precipitated by tobacco smoke

Idiosyncratic

210

Allergic vs idiosyncratic asthma: Precipitated by dust mites

Allergic

211

Allergic vs idiosyncratic asthma: Precipitated by Cockroaches

Allergic

212

Allergic vs idiosyncratic asthma: Precipitated by animal dander especially CATS

Allergic

213

Allergic vs idiosyncratic asthma: Precipitated by pollutants

Idiosyncratic

214

Allergic vs idiosyncratic asthma: Precipitated by sulfites in food

Idiosyncratic

215

Allergic vs idiosyncratic asthma: Precipitated by emotional stress

Idiosyncratic

216

Allergic vs idiosyncratic asthma: Precipitated by pharmacologic agents

Idiosyncratic

217

Allergic vs idiosyncratic asthma: Precipitated by seasonal pollen

Allergic

218

Most common trigger for allergic asthma

Atopy

219

Most common trigger for idiosyncratic asthma

Pulmonary infection

220

Ciliated columnar cells sloughed from bronchial linings seen in sections of lungs of asthmatic patients

Creola bodies

221

Characteristic physiologic abnormality of asthma

Airway hyperresponsiveness

222

The only asthma stimulus that can produce constant symptoms

Respiratory viruses

223

Common agents of viral pneumonia in children

1) RSV
2) Parainfluenza

224

Common agents of viral pneumonia in older children and adults

1) Rhinovirus
2) Influenza

225

Classic triad of asthma

1) Wheezing
2) Dyspnea
3) Cough

226

Typical attack of asthma occurs

At night

227

Characteristic INITIAL wheeze

Expiratory

228

2 signs that are very valuable in indicating severity of obstruction in asthma

1) Accessory muscles become visibly active
2) Paradoxical pulse

229

Second wave of bronchoconstriction in 30-50% of allergic asthma cases occurs when

6-10 hours later

230

Heart rate in asthmatic patients with IMPENDING RESPIRATORY FAILURE

Relative bradycardia

231

T/F Heart rate in asthma increases with severity

T

232

Pulsus paradoxus is defined as

Markedly decreased pulse during inhalation

233

Pulsus paradoxus in moderate episode of asthma

10-25 mmHg

234

Pulsus paradoxus in severe episode of asthma

>25 mmHg

235

Absence of wheezing in asthma indicates

Impending respiratory failure

236

Indicators of asthma severity

1) Heart rate
2) Respiratory rate
3) Pulsus paradoxus
4) Use of accessory muscles

237

Most useful measures (pulmonary function test parameters) to show initial airflow obstruction and reversibility with bronchodilator

1) Peak flow
2) FEV1

238

Curschmann spirals and Charcot Leyden crystals are seen in what specimen

Sputum

239

Typical acid-base imbalance seen with asthma

Respiratory alkalosis

240

Acid-base imbalance in asthma that indicates impending respiratory collapse

Metabolic acidosis

241

ECG findings in asthma

1) Right axis deviation
2) RBBB
3) Right ventricular hypertrophy with depolarisation abnormalities

242

Reversiblity of asthma is seen on PFT as

>=12% and 200 mL increase in FEV1 15 minutes after 2 puffs of SABA

243

Asthma: Assessment of symptom control is assessed over what duration

4 weeks

244

Asthma: Parameters to assess control

1) Daytime symptoms >2x a week
2) Night awakenings
3) Use of reliever >2x a week
4) Activity limitation

245

Asthma: Comorbidities

1) Rhinitis
2) Rhinosinusitis
3) GERD
4) Obesity
5) Obstructive sleep apnea
6) Depression
7) Anxiety

246

Asthma: Well-controlled if

None of 4 control parameters present

247

Asthma: Partly-controlled if

1-2 of control parameters present

248

Asthma: Uncontrolled if

Asthma: 3-4 of control parameters present

249

Asthma execerbation, mild/mod vs severe vs life-threatening: Talks in words

Severe

250

Asthma execerbation, mild/mod vs severe vs life-threatening: RR less than 30

Mild/mod

251

Asthma execerbation, mild/mod vs severe vs life-threatening: Pulse 100-120

Mild/mod

252

Asthma execerbation, mild/mod vs severe vs life-threatening: Peak expiratory flow >50% predicted or best

Mild/mod

253

Asthma execerbation, mild/mod vs severe vs life-threatening: Use of accessory muscles

Severe

254

Asthma execerbation, mild/mod vs severe vs life-threatening: Drowsy

Life-threatening

255

Asthma excerbation, management: Mild/mod (3)

1) SABA q20 x 1hr
2) Prednisolone
3) Controlled O2

256

Asthma excerbation, management: Target O2 sat

93-95%

257

Asthma excerbation, management: Severe asthma

Admit to acute care facility

258

Disease state characterised by airflow limitation that is not fully reversible

COPD

259

Anatomically defined condition characterised by destruction and enlargement of lung alveoli

Emphysema

260

Clinically defined condition with chronic cough and phlegm

Chronic bronchitis

261

Significant risk factor for emphysema in both smokers and non-smokers

Coal mine dust

262

Most common form of severe α1 antitrypsin deficiency

2 z alleles or 1 z and 1 null allele

263

COPD susceptibility determinants (2)

1) Hedgheog interacting protein gene on chromosome 4
2) Cluster of genes on chromosome 15

264

Portions of lung affected by emphysema

Distal to the terminal bronchioles

265

Emphysema: Most common type associated with smoking

Centriacinar

266

Emphysema: Type most commonly associated with α1 antitrypsin

Panacinar

267

Emphysema, type: Distal alveoli spared; affects central/proximal parts of acini

Centrilobular

268

Emphysema, type: Affects all structures from acini to terminal alveoli

Panacinar

269

Emphysema, type: Most often associated with spontaneous pneumothorax

Paraseptal

270

Emphysema, type: Associated with scarring

Irregular

271

Emphysema, type: Target O2 sat

88-92%

272

Emphysema, type: When to repeat ABG after starting O2 supplementation

30-60 mins after

273

Best diagnostic procedure for lymph node Tb

Excisional biopsy

274

Portion of lung affected by bronchiectasis

Proximal to terminal bronchioles

275

Characteristic sign in bronchiectasis

Foul-smelling purulent sputum

276

Honeycomb lung

??? Bronchiectasis

277

Bronchiectasis: Most common location

Lower lobes bilaterally

278

Phases of ARDS: Hyaline membranes

Exudative phase (first 7 days)

279

Phases of ARDS: Interstitial inflammation

Proliferative phase

280

Phases of ARDS: Fibrosis

Fibrotic phase

281

Pneumonia: 2 types

1) Bronchopneumonia2) Lobar pneumonia

282

Pneumonia, CXR finding: Bronchopneumonia

Patchy consolidation

283

Pneumonia: Accounts for majority of lobar pneumonia

S. pneumonia

284

Pneumonia: Most common etiology of atypical pneumonia

M. pneumonia

285

Particle size: Deposited in areas with largely turbulent airflow (nose and upper airways)

>10mm

286

Particle size: Deposited in trachea and bronchi

3-10mm

287

Particle size: Deposited in terminal airways and alveoli

1-5mm

288

Particle size: Remain suspended in inspired air

Less than 1mm

289

Pores implicated in spread of pneumonia within an entire lobe

Pores of Kohn

290

Stages of pneumonia in order

1) Congestion2) Red hepatization3) Gray hepatization4) Resolution

291

Stage of pneumonia characterised by enzymatic digestion

Resolution

292

Stage of pneumonia characterised by red vascular engorgement

Congestion

293

Stage of pneumonia characterised by few neutrophils and macrophages

Congestion

294

Stage of pneumonia characterised by disintegration of red cells

Gray hepatization

295

Stage of pneumonia characterised by exudation of RBCs

Red hepatization

296

Stage of pneumonia characterised by red, firm, airless, liver-like consistency

Red hepatization

297

Stage of pneumonia characterised by fibrinosuppurative exudate

Gray hepatization

298

Stage of pneumonia characterised by dry surface

Gray hepatization

299

Atypical pneumonia is characterized by

Lack of alveolar exudate and presence of interstitial pneumonitis

300

Atypical pneumonia is aka

Walking pneumonia

301

Causative agents of atypical pneumonia

1) M. pneumonia2) Chlamydia psittaci3) Coxiella burnetti4) Legionella pneumophila

302

Causative agent of Q fever

Coxiella burnetti

303

Agent of SARS

SARS coronavirus

304

Superbugs are susceptible only to

1) Polymyxins2) Tigecycline

305

Enzyme present in superbugs

NDM-1 (New Delhi metallo-beta lactamase 1

306

NDM-1 was first isolated in an isolate of

K. pneumoniae

307

T/F Tuberculous intra-thoracic lymphadenopathy (mediastinal and/or hilar) or tuberculous pleural effusion, without radiographic abnormalities in the lungs, constitutes a case of extrapulmonary TB

T

308

T/F PTB can be classified based on HIV status

T

309

Tb classification based on drug resistance: Monoresistance

Resistance to one first-line anti-TB drug only

310

Tb classification based on drug resistance: Polydrug resistance

Resistance to more than one first-line anti-TB drug (other than both isoniazid and rifampicin)

311

Tb classification based on drug resistance: Multidrug resistance

Resistance to at least both isoniazid and rifampicin

312

Tb classification based on drug resistance: Extensive drug resistance

Resistance to any fluoroquinolone and to at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance

313

Tb classification based on drug resistance: Rifampicin resistance

Resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, whether monoresistance, multidrug resistance, polydrug resistance or extensive drug resistance

314

Treatment outcomes for TB: Cured

A pulmonary TB patient with bacteriologically confirmed TB at the beginning of treatment who was smear- or culture-negative in the last month of treatment and on at least one previous occasion

315

Treatment outcomes for TB: Treatment completed

A TB patient who completed treatment without evidence of failure BUT with no record to show that sputum smear or culture results in the last month of treatment and on at least one previous occasion were negative, either because tests were not done or because results are unavailable

316

Treatment outcomes for TB: Treatment failed

A TB patient whose sputum smear or culture is positive at month 5 or later during treatment

317

Treatment outcomes for TB: Died

A TB patient who dies for any reason before starting or during the course of treatment

318

Treatment outcomes for TB: Lost to follow-up

A TB patient who did not start treatment or whose treatment was interrupted for 2 consecutive months or more

319

Treatment outcomes for TB: Not evaluated

A TB patient for whom no treatment outcome is assigned. This includes cases “transferred out” to another treatment unit as well as cases for whom the treatment outcome is unknown to the reporting unit.

320

Treatment outcomes for TB: Treatment success

The sum of cured and treatment completed