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D&T 3: Exam 2 > Pulmonary PE > Flashcards

Flashcards in Pulmonary PE Deck (23)
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1
Q

Wheezes

A

High-pitched noises secondary to chronic airway obstruction but usually due to swelling

Ex. - asthma

2
Q

Crackles/Rales

A

Typically suggest the presence of fluid in the interstitium

3
Q

Fine crackles

A

Suggest scarring and fibrosis of the interstitium

-Typically only heard at the end of inspiration; sounds like a fireplace or velcro

4
Q

Percussion abnormalities

A

Increased resonance =» Pneumothorax, emphysema

Decreased resonance =» Pleuritis, effusion

5
Q

Ronchi

A

Low-pitched, musical wheezes that are typically caused by an airway obstruction

Ex.- mucous

6
Q

Most common metastases to lung

A

Testicular, thyroid, kidney

7
Q

Virulence factor of P. aeruginosa in CF pts

A

Alginate polysaccharide

Biofilm that is excreted to prevent phagocytosis

8
Q

Tx for P. aeruginosa pneumonia

A

Inhale= Tobramycin

IV= Penicillin + AGC (gentamicin)

9
Q

Virulence factors of M. tuberculosis

A

Prevents phagosome fusion

Synthesizes HEMOLYSIN to escape phagocytic vesicles

Prevents acidification of phagosome

Indirect=> Causes secretion of TNF-a which damages lungs

10
Q

Hemagluttinin

A

Influenzae virulence factor that binds to sialic acid on cell membranes facilitating its endocytosis

Human influenza virus =» a-2,6 sialic acids (type I pneumocytes, Tracheobronchial epithelium)

Avian flu =» a-2,3 sialic acid (type II pneumocytes, terminal bronchial epithelium)

11
Q

NA

A

Cleaves sialic acid from glycoproteins allowing for viral release from the cell; prevents viral aggregation in ECM

(ACTUALLY THIS PART RELATES TO HA)
Single AA =» extracellular cleavage only
**Can only replicate in the respiratory tract

Multiple AA cleavage site =» cleavage can occur intracellularly
**Can causes systemic infxn

12
Q

Complications of the flu

A

Secondary infxn from S. pneumonia (bacterial pneumonia)

Reyes Syndrome (acute encephalopathy w/ fatty liver degeneration)

  • Young children w/ viral fever
  • Aspirin used to treat their fever
13
Q

Oseltamivir/Zanamivir

A

NA inhibitor; DOC for influenza

-Resistance is rare; effective against Influenza A and B

14
Q

Pneumovirus

Paranormal Mixer

A

Causative agent of RSV and a member of the paramyxovirus family; most common cause of bronchiolitis and other LRI worldwide in children under 8

Presence of F-protein on infected cells allows for fusion of cells forming a GIANT CELL

  • **MATERNAL IG ACTUALLY ENHANCES SEVERITY; dunno why
    • IgA most important antibody for immunity

RSV-IG and monoclonal abs can be given IV for prophylaxis in high risk pts.; palivizumab administered 1/month to high risk babies too

15
Q

Coronavirus

Kingdom of SARS

A

Severe Acute Respiratory Syndrome ; similar to Middle-East Respiratory Syndrome (get travel history)

ssRNA, helical, enveloped) spread thru the air infecting the lower respiratory tract causing high fever, SOB, cough

**Binds to ACE-II on cell membranes

-Mandated quarantine of hospital until PCR can rule out

16
Q

Adenoviridae

A Den-o Lions

A

Virion composed of viral DNA and icosahedral capsid (no enveloped); capsid is composed of 252 capsomers w/ 240 hexons and 12 pentons

-Pentons have *unique base, fiber, and knob
BIG FUCKIN KNOX

  • Cell is not lysed when virus is released; looks like a grape-like cluster
  • Shows predilection for causing keratoconjunctivitis (Type 8), pharyngitis, and pneumonia
  • **Types 4 and 7= MCC; live, oral vaccine exists and is given to military recruits
    • Gives rise to IgG that spills into respiratory tract giving immunity
17
Q

Early proteins synthesized by adenoviridae

A

Tymidine kinase
DNA polymmerase

-Both important to viral replication

18
Q

MC location of lung metastasis

A

Adrenal glands

19
Q

Specific Glycoprotein spike for Paramyxovirus

A

HN-Hemagluttinin and Neuraminidase

-Helps to break down protective mucin in the respiratory tract

20
Q

Immune response to Influenza

A

Short lived IgA against HA and long lived CTL for about 6 months

21
Q

Flu vaccines

A

Made from circulating strains at the end of last season; uses inactivated whole virus or HA/NA glycoprotein

  • Must update every year due to antigenic shift/drift and natural short-lived immunity of vaccine
  • Can cause GBS and anaphylaxis (w/ egg allergy)
22
Q

Charcot-Leiden Crystals

A

Bi pyramidal crystalline collections of Eosinophilic proteins

⭐️ Seen in Asthma

23
Q

Curschmann spirals

A

Mucoid plugs that can be seen in asthma pts.; may see assoc. Goblet cell hyperplasia