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Enviromental

Pulmonary disease is caused by _____ factors NOT genetic!

Asthma

hyperactive airway disorder with episodes of reversible bronchoconstriction?

COPD

What disorders are Chronic bronchitis and emphsema?

smoking

What is the most common cause of chonic broncitis?

smoking, pollution, & genetics

Name the 3 reasons ppl develope COPD?

Chonic bronchitis

What disease has cough product of sputum for 3 months for at least 2 yrs?

PMP granulocytes

What indicates continuous irrititation in the septum?

Emphysema

An increase beyond normal size of airspaces distal to terminal bronichioles?

Alveolar

Dilation is due to loss of ____walls and appears as holes?

hypoxia & cardiac

Interstitial lung diseases stiffness and effects are due to _____(respitory failure) and _____failure?

ARDS

____results in Death, resolution and fibrosis.

Linear, reticular, nodular, and reticulonodular

What are the 4 patterns that can be seen in interstitial lung disease?

SHOCK

Sepsis, difuse infection, severe trauma, and oxygen can all lead to _____lung which can be seen in ARDS?

Neonatal RDS

What syndrome is found in premature infants who are deficient in surfactant so they have increase effort in breathing leading to damage cells?

Idiopathic pulmonary fibrosis, sarcoidosis, extrinsic allergic alveolitis, pneumoconiosis, and connective tissue disease

What are 5 chronic intersitial diseases?

Sarcoidosis

A multisystem granulomatous resulting from exagerated immune response to self antigens or other antigens?

granulomas, macrophages, epitheloid cells, giant cells, and Non caseating granulomas

Name the 5 types of inflamatory cells and t helper cells that arrise in sarcoidosis?

LUNGS

In sarcoidosis 90-95 % of the time the first site involved is _____ of the time 10X more in blacks than whites?

anterior uveitis, posterior uveitis, conjuctivitis

Sarcodois can arrise in the eye 25-30% as _____,______, and _____?

Heerfordts syndrome

What syndrome is also known as uveoparotid fever, ( facial palsy, fever, uveitis, partoditis)?

Lupus pernio

____ are indurated blue/purple lesions on nose, cheeks, lips, ears, and fingers?

Lofgrens

IN what syndrome is there erthema nodosum, joint pains and bilateral hilar adenopathy?

Serum ACE, CD4/CD8, Mantoux test

What 3 ways can you diagnose sacroidosis?

GAllium 67 scanning

This technique is used for staging and to detect extrapulmonary sarcoidosis?

Kveim stilzbach test

intradermal injection of homogonized tissue of organs involved with sarcoidosis causing a delayed cutaneous rxn in 4-6 weeks?

STEROIDS

What medicine do you give a pt with sarcoidosis with ocular lesions, where posterior segment or ON are threatened?

steroids or cytotoxic drugs

How do you treat sarcoidois?

Pneumonoconiosis

Lung disease caused by mineral dust (asbestos, coal workers lung, anthracosis, or silicosis).

serpentine, straight

_____asbestos are safe, while ____ (amphibole) abstestos are VERY dangerous?

pleural effusion, exudate, transudate, empyema, chylothorax

What are the 5 different pleural diseases?

Pneumonia

What is the most common age related lethal nosocomial infection and the 6th leading cause of death in the US?

viral, bacterial, infections

Pneumonia is caused by ___in children ___in young adults and ___in adults?

lobar, segmental, bronchopneumonia, interstitial

Name the 4 different types of pneumonia based on location?

cough, fever, sputum, tachypnea, crackles

Name 5 symptoms of pneumonia?

Leigionaires

Severe bacterial pneumonia occuring in large buildings like hotels or hospitals?

throats

Pneumococcal (lobar) pneumonia is caused by bacteria in healthy ___demonstrating fluid on one lobe?

bed rest & antibiotics

TX for pneumococall in culdes _____and _____ resolving in 1 week?

Aspiration pneumonia

____pneumonia is caued by acid vomitus aspired by lower respiratory tract?

Viral

___Pneumonia is caused by influenza A & B symptoms being dry cough and fever?

atelectasis, lung absess, parapneumoic effusion, bacteremia, & metastatic infects

What are the 5 complications of Pneumonia?

chorioretinitis & uveitis

Most common ocular manifestations of TB include ___and ___ although it can occur anywhere?

Miliary TB

___TB where immunosuppressed pt inefction is more aggresive overwhelming immune systmem spreads to lungs and causes pneumoia?

Scleritis

_____ocular infection is caused directly by atypical mycobacteria and does not need lung.

Mantoux test

_____ test is a local intradermal injection of proteins looking for red wheal to form 48-72 hrs indurfation?

Bronchiectasis

Permanent dilation of 1 or more lg bronchi resulting in lung abscess?

Lung absess

Localized area of dead lung tissue surounded by inflamatory debri, resulting from periodontal, neoplasms, pneumoia, or other invading microbes?

Right

What lung is more prone to lung abcess?

Bronchogenic carcinoma

What is the most common malignancy in the US tumors arrising near hilar area and spreads, has a 5 year survival rate of 12-14%?

Asbestos

Mesothelioma is caused by ____70% of the time and is NOT caused by cancer?

CT

Much more senstiive at detecting small metastatic lesions?

Radiographs

Pulmonary metastases are detactable on ___ with common arrival from breast, GI, kidney, and female reproductive systems?

vascular wall, coagulation, and platelets

Hemostasis and thrombosis are dependent on ____, _____, and _____?

hematoma

pocket of blood that takes up space?

Hemophillia B

Patients lack factor 9 so no fibrin is produced in this coagulation disorder?

FALSE

T/F Most Thrombosis are symptomatic?

Cancer, tissue damage, pregnancy, elderly, lipids

5 risk factors for thrombosis?

arterial, cardiac, and venous

What are the 3 locations of thrombus?

venous, arterial

If the embolism is in the right side of heart it came from the ___, where as if it affects the left side of the heart it came from the ____?

Lodge in major bifurcation

Healthy patient clenches chest falls over and dies?

pulmonary, fat, bone marrow, air, amniotic

What are the 5 types of embolisms?

ischemia/clots ; hemorages

87% of strokes are caused by ______ where as 20% are due to ______?

STROKE

Lack of bld flow to the brain caused by a clot or rupture of bld vessels leading to sudden brain damage?

10, 15, 75

Out of 100 strokes pts ___will have complete recovery, ___will die, and ____will be permantly disabled?

TIA

Brief episode of neurologic dysfunction caused by focal brain or retinal ischemia, with symptomsm lasting less than 1 hour without acute infarction?

TIA

____is a warning sign of future strokes (40%)?

perfusion with low BP, fluid resuscitation, and antiplatelet

What are 3 ways to tia?

clipping & coiling

____&____ treat hemorrhagic strokes or brain bleeding?

T-PA, merci retriver, penumbra

____clot bursting medication and ___+____ clot removing devices treat ischemic strokes?

oncotic and hydrostatic

To avoid edema in capillaries there should be a balance btwn ___pressure and ___pressure?

cardiac, hypoproteinemia, and renal

Name 3 types of generalized edema?

inflamation, allergic, venous obstruction, lympatic obstruction

Name 4 localized edemas?

plerual, pericardium, peritoneum

Name the 3 places edema can occur in body cavities?

32, 15, 25

The capilary hydrostatic pressure for arteriolar end is ___mmHG, at the venous end its ___mmHG and the mean is ____mmHG?

6

In the brain interstitial hydro pressure can reach to ___mmHG?

oncotic

Reduction of colloids(plasma proteins) from Cirrhoiss, liver failure, malnutrition, nephrotic, or catabolic states results in lower ______pressure?

heart failure, deep venous thrombosis, s. vena cava obstruction

___, ___, & ___ will result if hydrostatic pressure is increased at VENOUS end?

Pre-capilary dilatation & Ca channel blockers

____and ____ result form increased hydrostatic pressure at ARTERIAL end?

lympatic obstruction

Increased intersitial oncotic pressures can result in hypoplasia, or obstruction

Anemia, hypothroidism, or heart failure

What are the 3 diverse reasons ppl get edema?

two million

___milliion ppl suffer from CHF and 29,000 die annually?

SHOCK

Hypoperfusion without hypotension resulting in lower oxygen delivery?

Hypovolemic, cariogenic, and distributive

What are the 3 types of shock?

septic, anaphylatic, & neurogenic

Distributive shock resulting in a decrease in SVR can include _____, ____, and ____ shocks

blood volume, CO, and blood

Shock changes vascular flow by lowering _____and ____and redistributing _____?

HR and vasoconstriction

The non progressive stage of shock the body tries to increase ____and cause _____?

Decrease CO, and Acidosis

The progressive stage of shock inlcudes a decrease in _____and ______?

vasodilation & permiability

The irreversible stage of shock includes widespread ____and ____of bld vessels resulting in death of patient?

airway, breathing circulation

In treating shock you want to perform the trendelenburg postiion on patient and think about the ABC's whcih are?

GLIA

What cell in the CNS can proliferate and form a scar?

0-15 ; 40

Normal ICP is btwn ____and can't surpass ____without causing harm?

swelling, hemorrage, and CSF

3 reasons why someone would have increase ICP?

brain, blood, CSF

ICP increases as __, ___, and ____ increases?

herniation

When the brain is squeezed thru foramen magnum ____results causing brainstem to be compressed and patient stops breathing and dies?

HA, vomiting, papilledema, and herniation

What are some symptoms of increased ICP?

subarachonoid hemorage

If CSF is yellow then pt has a _____?

infection

IF CSF is cloudy pt has a ____?

hypertension

What is the most common cause of intracerebral hemorage?

stroke

sudden brain damage?

lacunar

Hypertensive can result i n ____infarcts?

watershed

Hypoptension or hypoxia/anoxia can results in ___infarcts?

hemorrhagic

Venous thrombosis and emobilc can cause ____infarcts?

maintain perfusion to the brain and prevent lower blood pressure

What is the treatment for a stroke?

high blood pressure

_____is the silent killer and pts may have HA, blurred vision, chest pain, or frequent urination?

renal, vascular, endocrine, and latrogenic

What are the 4 causes for secondary HTN?

TRUE

T/F Primary HTN has no known cause?

Labile

____HTN blood pressure changes often due to various factors like stress?

total peripherial resistance and kidney

What are the 2 main players in HTN?

defect in natriuresis

Renal sodium excretion?

HR, duration of stystolic contractions, and direct stimulation of bld vessels

In sympathetic nervous system HTN you have increase ____decrease ________________and direct ______________?

smooth mm contraction, thickening of media, hyaline arteriosclerosis

What are the 3 pathologies of ESSENTIAL HTN?

, bld pressure, fibrinoid necrosis, serum renin levels

What are the 3 pathologies of MALIGNANT HTN?

vasoconstriction, exudates, sclerosis, flame shaped hemorrages

What are 4 retinal changes in HTN?

foam, fatty streaks, intermediate lesions, atheroma, fibrous plaque, complicated lesion/rupture

List the progression of atherosclerosis?

echocardiogram

Shows a graphic outline of the hearts movement

Ejection fraction

Determines how well your heart pump with each beat?

electrocardiograms, stress test, and cornonary angiography

what are the 3 screening test for CVD?

bypass graft

____ enables blood to reach your heart and reduces angina and the risk of a heart attack?

AGING

CAD is a chronic disease and most common serious effects of ____?

Asymptomatic, stable angina, progressive angina, acute coronary syndrome (unstable angina)

What are the 4 phases of CAD?

syndrome X Agnina

____angina is a reduced capacity of vasodilation in microvasculature.

Anginal Equivalent syndrome

_______ is caused by exercise induced left ventricular dysfunction?

Prinzmetal

____angina is a spasm of the large coronary artery and its accompanied by transmural ischemia?

Variant

___angina is a transient impairment of coronary bld supply by vasospasm or platelet aggregation?

Silent

___ischemia is very common and often difficult to dx so we use holter monitor and exercise testing?

medical tx, percutaneous intervention, or coronary artery bypass graft surgery

What are the 3 stable angina tx options?

Thrombotic disease

MI, unstable angina, stroke, and PAD can lead to ______disease?

80

PTCA has a ____% or greater success rate?

TRUE

T/F The presence of Q waves does not differentiate transmural MI and non-transmural MI?

Q or ST

The presence of _____or ____ is associated wtih higher mortality and morbidity?

TRUE

T/F An asymptomatic mI is not necessarily less severe than a symptomatic?

Irreversible

If occlusion persists long enough 20-40 mins than ____myocardial cell damge and cell death will occur?

double

The presence of any risk factor for atherosclerotic coronary disease will ____ risk?

DIED

Blood testing for creatine phosphokinase, troponin, myoglobin, and C reactive protein changes found in samples over time represent how much heart mm has _____?

AMI

Expedient restoration of normal coronary bld flow and max salvage of functional myocardium is the goal of ____?

Cariogenic shock

Percutaneous coronary intervention is better for ppl w ith _____than fibrolysis?

stress test, implantable cardiac defibrillators, and cardiac rehabilitation

What are three post MI mangement options?

Restrictive myopathy

Abnormal filling and diastolic function?

dilatated

Ventricular enlargement and systolic dysfunciton?

Echo doppler

_____is a manifestation of RCM that has abnormal mitral inflow patterns with a prominent E wave and increased LA pressure?

dyspnea, angina

90 % of pts with HCM will have ____ while 75% will have ____ plus fatigue, pre syncope, and synscope.

HCM

Small LV cavity, asymetrical septal hypertrophy, systolic anterior motion of mitral valve leaflet, with 50% autosomal dominant?

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