What type of antibodies prevent reinfections in influenza patients?
Hemagglutinnin antibodies
Recent travel to Arizona? Coccidiodes (spherules containing endospores)
These lamellar bodies that secrete surfactant are found where? Type 2 pneumocytes
What process contributes to the formation of giant cells? Cytokine secretion by CD T4 lymphocytes. Infected macrophages (APCs) display antigens on MHC II, leading to stimulation of CD4 cells. These cells then release INF-y which then activate macrophages. These macrophages can differentiate into epitheloid histiocytes and coalasce into multinucleated Langerhans giant cells.
Pneumonia and brain abcess in immunocompromised patient? Norcardia (partial acid fast stain)
What allows elastin to recoil? Interchain crosslinks involving lysine
Chain assembly to form a triple helix gives collagen its elasticity, not elastin.
Mississippi or Ohio river valley? Histoplasmosis
Questions on respiratory titers:
Pancreatic patient with worsening hypoxemia and bilateral lung infiltrates? ARDS (an inflammatory response that leads to alveolar capillary leakage and pulmonary edema).
Edema prevents ventilation of affected alveoli, facillitating alveolar collapse leading to increased intrapulmonary shunting (Perfusion without ventilation). FRC (air in lungs after exhaling) is reduced.
How does PEEP help ARDS? It opens collapsed alveoli to reduce intrapulmonary shunting and increase FRC back to normal.
In a baby with respiratory distress, which is the best medication to give them to extend their life? Dexamethasone: most likely it is a preterm baby who has not produced enough surfactant. Dexamethasone is a cortisol analogue so it stimulates surfactant production in the baby's lungs, by accelerating maturation of type 2 pneumocytes.
Ketamine has sympatommimetic activity as a side effect, so helps with bronchospams.
Which drug reduces nicotine cravings while decreasing pleasurable effects of nicotine cigarettes?
Varenicline is an agonist of the alpha4beta2 nicotinic ach receptor. It competes with nicotine to prevent it from binding to this receptor. Since it is a partial agonist, it helps reduce the symptoms of nicotine withdrawal by mildly stimulating the receptor.
During exercise:
There is an increase in O2 consumption and CO2 production.
There is decreased systemic vascular resistance to allow increased blood flow to skeletal muscles.
There is an increase in HR and SV that increases Cardiac output and O2 delivery to tissues.
There is an increase in venous blood CO2 content.
Decreased pulmonary vascular resistance
Increased alveolar ventilation and gas exchange efficiency, arterial O2 and CO2 remain constant during exercise.
Minute ventilation increases, as well as ventilation/perfusion ratio.
Mixed venous O2 content decreases
Thoracocentesis:
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