Podcast
Questions and Answers
What is the role of endothelin-1 in pulmonary hypertension?
What is the role of endothelin-1 in pulmonary hypertension?
- It is a vasoconstrictor that is elevated in pulmonary hypertension. (correct)
- It enhances nitric oxide production.
- It is a vasodilator that decreases arterial pressure.
- It has no significant impact on pulmonary vasculature.
Which class of medication is used to block endothelin-1 receptors?
Which class of medication is used to block endothelin-1 receptors?
- Endothelin receptor antagonists like Bosentan (correct)
- β-adrenergic agonists
- Angiotensin-converting enzyme inhibitors
- Calcium channel blockers
What is characteristic of limited scleroderma?
What is characteristic of limited scleroderma?
- It includes widespread skin thickening and renal involvement.
- It is also known as CREST syndrome. (correct)
- It is marked by severe pulmonary fibrosis only.
- It is synonymous with diffuse scleroderma.
Which symptom is NOT associated with sclerodactyly?
Which symptom is NOT associated with sclerodactyly?
What condition is suggested by a significant increase in blood pressure due to renal involvement?
What condition is suggested by a significant increase in blood pressure due to renal involvement?
What is a recommended strategy to reduce the recurrence of Raynaud's phenomenon?
What is a recommended strategy to reduce the recurrence of Raynaud's phenomenon?
Which medication should be avoided in patients with Raynaud's phenomenon?
Which medication should be avoided in patients with Raynaud's phenomenon?
Esophageal dysmotility related to scleroderma is often characterized by:
Esophageal dysmotility related to scleroderma is often characterized by:
What is the primary defect in primary ciliary dyskinesia?
What is the primary defect in primary ciliary dyskinesia?
In a patient with situs inversus, which cardiac finding is most likely to be observed?
In a patient with situs inversus, which cardiac finding is most likely to be observed?
What characterizes the granulomas found in sarcoidosis?
What characterizes the granulomas found in sarcoidosis?
What consequence might women with primary ciliary dyskinesia experience due to abnormal cilia in the fallopian tubes?
What consequence might women with primary ciliary dyskinesia experience due to abnormal cilia in the fallopian tubes?
What is the role of epithelioid macrophages in sarcoidosis?
What is the role of epithelioid macrophages in sarcoidosis?
In sarcoidosis, what happens to parathyroid hormone levels?
In sarcoidosis, what happens to parathyroid hormone levels?
Which gene mutation is primarily associated with primary pulmonary hypertension (PPH)?
Which gene mutation is primarily associated with primary pulmonary hypertension (PPH)?
How does primary pulmonary hypertension differ from cor pulmonale?
How does primary pulmonary hypertension differ from cor pulmonale?
Which demographic is typically associated with sarcoidosis?
Which demographic is typically associated with sarcoidosis?
What imaging findings are typical for sarcoidosis?
What imaging findings are typical for sarcoidosis?
Which of the following findings would indicate cor pulmonale rather than primary pulmonary hypertension?
Which of the following findings would indicate cor pulmonale rather than primary pulmonary hypertension?
What is a likely finding in the semen of a patient with primary ciliary dyskinesia?
What is a likely finding in the semen of a patient with primary ciliary dyskinesia?
In the context of sarcoidosis, what does high levels of 1,25-(OH)2-D3 cause?
In the context of sarcoidosis, what does high levels of 1,25-(OH)2-D3 cause?
Which symptom is NOT typically associated with sarcoidosis?
Which symptom is NOT typically associated with sarcoidosis?
What symptom may indicate pulmonary hypertension in a patient in their 20s to 30s?
What symptom may indicate pulmonary hypertension in a patient in their 20s to 30s?
What should be chosen if a vignette suggests sarcoidosis but indicates a normal CXR?
What should be chosen if a vignette suggests sarcoidosis but indicates a normal CXR?
What is the primary clinical significance of clubbing in patients?
What is the primary clinical significance of clubbing in patients?
What is the most common cause of fever within 24 hours post-surgery?
What is the most common cause of fever within 24 hours post-surgery?
What is the primary function of the sweat chloride test in cystic fibrosis diagnosis?
What is the primary function of the sweat chloride test in cystic fibrosis diagnosis?
In cystic fibrosis, what genetic characteristic is common among siblings?
In cystic fibrosis, what genetic characteristic is common among siblings?
Which CFTR-related therapy aims at correcting channel localization and folding?
Which CFTR-related therapy aims at correcting channel localization and folding?
What does the transepithelial nasal voltage test assess?
What does the transepithelial nasal voltage test assess?
Which of the following conditions can be associated with congenital bilateral absence of vas deferens (CBAVD)?
Which of the following conditions can be associated with congenital bilateral absence of vas deferens (CBAVD)?
What is the role of Dornase-alfa in the treatment of cystic fibrosis?
What is the role of Dornase-alfa in the treatment of cystic fibrosis?
What indicates a possible diaphragmatic rupture in a trauma patient?
What indicates a possible diaphragmatic rupture in a trauma patient?
Which condition is characterized by acute-onset sharp chest pain in a tall, lanky teenager?
Which condition is characterized by acute-onset sharp chest pain in a tall, lanky teenager?
What does a contralateral tracheal shift indicate in a patient?
What does a contralateral tracheal shift indicate in a patient?
What mechanism primarily leads to the symptoms of tension pneumothorax?
What mechanism primarily leads to the symptoms of tension pneumothorax?
What finding is expected in a physical examination of a patient with pneumothorax?
What finding is expected in a physical examination of a patient with pneumothorax?
What is the standard initial treatment for pneumothorax?
What is the standard initial treatment for pneumothorax?
Which of the following conditions could lead to water-soluble contrast being visualized in the mediastinum?
Which of the following conditions could lead to water-soluble contrast being visualized in the mediastinum?
What correlates with low blood pressure in the context of pneumothorax?
What correlates with low blood pressure in the context of pneumothorax?
What is a likely cause of low bicarbonate levels in a patient experiencing shock?
What is a likely cause of low bicarbonate levels in a patient experiencing shock?
Which clinical presentation is more indicative of an amniotic fluid embolism rather than a pulmonary embolism?
Which clinical presentation is more indicative of an amniotic fluid embolism rather than a pulmonary embolism?
What critical finding would suggest fat embolism in a patient with a long-bone fracture?
What critical finding would suggest fat embolism in a patient with a long-bone fracture?
What is the most common presentation of a patient experiencing an air embolism after central venous line insertion?
What is the most common presentation of a patient experiencing an air embolism after central venous line insertion?
Which statement accurately describes lactic acidosis in the context of shock?
Which statement accurately describes lactic acidosis in the context of shock?
What event is often the precursor to developing disseminated intravascular coagulation (DIC) after childbirth?
What event is often the precursor to developing disseminated intravascular coagulation (DIC) after childbirth?
In the case of pulmonary embolism, which scenario would most likely lead to a diagnosis?
In the case of pulmonary embolism, which scenario would most likely lead to a diagnosis?
What is a characteristic diagnostic method for identifying fat embolism in pulmonary biopsy?
What is a characteristic diagnostic method for identifying fat embolism in pulmonary biopsy?
Flashcards
What is Atelectasis?
What is Atelectasis?
A condition where lung tissue collapses, usually due to blocked airways.
What is the significance of Atelectasis post-surgery?
What is the significance of Atelectasis post-surgery?
Atelectasis is the most common cause of fever within 24 hours of a post-surgical procedure.
What is Cystic Fibrosis?
What is Cystic Fibrosis?
A genetic disorder that affects the CFTR gene, causing thick mucus buildup in the lungs, pancreas, and other organs.
What is the Sweat Chloride Test?
What is the Sweat Chloride Test?
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What is Congenital Bilateral Absence of the Vas Deferens (CBAVD)?
What is Congenital Bilateral Absence of the Vas Deferens (CBAVD)?
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What are -caftor medications?
What are -caftor medications?
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What is Dornase-alfa?
What is Dornase-alfa?
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What is Guaifenesin?
What is Guaifenesin?
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Pneumothorax
Pneumothorax
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Tension Pneumothorax
Tension Pneumothorax
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Spontaneous Pneumothorax
Spontaneous Pneumothorax
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Traumatic Pneumothorax
Traumatic Pneumothorax
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Diaphragmatic Rupture
Diaphragmatic Rupture
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Needle Decompression
Needle Decompression
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Chest Tube Insertion
Chest Tube Insertion
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Tube Thoracostomy
Tube Thoracostomy
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Sarcoidosis
Sarcoidosis
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Epithelioid macrophages
Epithelioid macrophages
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1,25-(OH)2-D3
1,25-(OH)2-D3
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Parathyroid hormone (PTH)
Parathyroid hormone (PTH)
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Erythema nodosum
Erythema nodosum
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Bihilar lymphadenopathy
Bihilar lymphadenopathy
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Sarcoidosis vs. Asthma
Sarcoidosis vs. Asthma
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Sarcoidosis: Other Findings
Sarcoidosis: Other Findings
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What are P2 and Tricuspid Regurgitation in pulmonary hypertension?
What are P2 and Tricuspid Regurgitation in pulmonary hypertension?
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What is Endothelin-1?
What is Endothelin-1?
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What is Bosentan?
What is Bosentan?
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What is Systemic Sclerosis (Scleroderma)?
What is Systemic Sclerosis (Scleroderma)?
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What is Limited Scleroderma (CREST syndrome)?
What is Limited Scleroderma (CREST syndrome)?
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What is Diffuse Scleroderma?
What is Diffuse Scleroderma?
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What is the Pulmonary Impact of Scleroderma?
What is the Pulmonary Impact of Scleroderma?
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What is Pericardial Fibrosis in Scleroderma?
What is Pericardial Fibrosis in Scleroderma?
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Primary Ciliary Dyskinesia (Kartagener Syndrome)
Primary Ciliary Dyskinesia (Kartagener Syndrome)
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Dynein
Dynein
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Dextrocardia
Dextrocardia
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Situs Inversus
Situs Inversus
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Primary Pulmonary Hypertension (PPH)
Primary Pulmonary Hypertension (PPH)
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BMPR2 gene
BMPR2 gene
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Cor Pulmonale
Cor Pulmonale
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Cor Pulmonale due to Primary Pulmonary Hypertension
Cor Pulmonale due to Primary Pulmonary Hypertension
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Amniotic Fluid Embolism
Amniotic Fluid Embolism
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Fat Embolism
Fat Embolism
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Air Embolism
Air Embolism
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Lactic Acidosis in Shock
Lactic Acidosis in Shock
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Lactic Acidosis
Lactic Acidosis
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Dead Space
Dead Space
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Pulmonary Edema
Pulmonary Edema
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Bicarbonate Level
Bicarbonate Level
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Study Notes
Asthma
- Asthma can be idiopathic or hereditary, triggered by allergens or cold air.
- A third of asthma patients only present with a dry cough (cough-variant asthma). This cough is often worse in winter.
- It can be part of a broader presentation of conditions like seasonal allergies, eye/nose irritation, hives, and skin rashes.
- Aspirin can induce asthma in some, via a pathway impacting leukotrienes. Aspirin allergy, asthma, and nasal polyps are indicators of this triad.
- Asthma often presents with increased expiratory effort, but this is not specific.
- Acutely, asthma causes decreased CO2, increased pH (respiratory alkalosis). Increased breathing rate initially leads to decrease in CO2 buildup.
- The combination of CO2 and O2 levels in an acute asthma attack can be indicative of type I respiratory failure (low CO2 and high pH).
- Eventually, fatigue and slowing of breathing can lead to an increase in CO2 and pH reversal (transition to type II respiratory failure, marked by high CO2 and low O2).
- Intubation may be a necessary intervention.
- Spirometry and methacholine challenges can help diagnose asthma.
- First-line outpatient treatment is a Beta-2 agonist (albuterol).
- Patients with weekly episodes often require continuous use of inhaled corticosteroids (ICS) in addition to Beta-2 agonists.
Bronchiectasis
- Most common causes worldwide and in Western countries are tuberculosis and cystic fibrosis respectively.
- Patients often describe copious amounts of foul-smelling sputum.
- Clubbing is frequently present.
- This condition isn't related to asthma
Atelectasis
- Lung collapse is the primary feature.
- Post-surgery, this is a common cause of fever within 24 hours.
- Bibasilar shadows seen on x-rays.
- Related to slower, shallower breathing in patients on respiratory support post-surgery.
- Resorptive atelectasis occurs when obstruction distally in a section of lung causes distal area collapse.
- Obstruction can be due to a tumor.
- Chronic respiratory acidosis (increased CO2, decreased pH) is a characteristic.
Obstructive sleep apnea (OSA)
- OSA can contribute to pulmonary hypertension, leading to cor pulmonale.
Anaphylaxis
- Characterized by acute dyspnea, bilateral wheezing, tachycardia, and low blood pressure.
- Triggers include environmental or food allergens, insect stings and recently introduced medication.
- Epinephrine is a key treatment.
Scombroid
- An often misdiagnosed condition that may mimic seafood allergy;
- Due to toxin produced in decaying fish;
- Treatment involves antihistamine medications.
Shellfish allergy
- Triggered by shellfish consumption.
- Can display similar symptoms to asthma.
- Not related to scombroid syndrome.
Cystic fibrosis
- Autosomal recessive, caused by mutations in the CFTR gene.
- Characterized by abnormal chloride channel function.
- Causes thick secretions in the lungs, resulting in recurrent infections (pneumonia).
- Pancreatic insufficiency is a common symptom, which leads to fat malabsorption and vitamin deficiency.
- Males can present with infertility due to the absent vas deferens in congenital form.
Primary ciliary dyskinesia (Kartagener syndrome)
- Autosomal recessive, a disorder of cilia function.
- Characterized by situs inversus (organs reversed).
- Presents with chronic respiratory infections.
Primary pulmonary hypertension (PPH)
- Pulmonary hypertension originating in the lungs.
- Elevated endothelin-1 levels often present.
- Characterized by right-ventricle hypertrophy.
Systemic sclerosis
- Autoimmune disorder causing fibrosis in various parts of the body (sclerosis).
- Classified as limited or diffuse subtypes.
- Limited scleroderma and CREST syndrome (Calcinosis, Raynaud's, Esophageal dysmotility, Sclerodactyly, Telangiectasias) are frequent presentations.
- Associated with pulmonary fibrosis and hypertension.
Sarcoidosis
- Idiopathic condition with non-caseating granulomas in various organs;
- Often affects lungs.
- Characteristic of altered vitamin D metabolism, and hypercalcemia.
Rheumatoid lung
- Restrictive lung disease, is a complication of rheumatoid arthritis.
- Fibrosis development can lead to problems breathing.
Pulmonary embolism
- Obstruction by clots in the pulmonary arteries.
- Risk factors include, recent surgery, in-situ issues, and inherited blood clotting disorders.
- Characterized by acute shortness of breath, tachycardia, and hypoxia.
- Possible for it to occur while on oral anticoagulation medicines.
Amniotic fluid embolism
- Obstetric complication.
- Related to placental separation and amniotic fluid entering the circulatory system after delivery.
- Presents similar to pulmonary embolism and potentially leads to coagulopathy.
Fat embolism
- Embolization of fat post-fracture;
- Characterized by shortness of breath and petechiae over the body.
Air embolism
- Air blockage in circulatory system via introduction via a medical procedure,
- Often leads to sudden death.
Cholesterol embolism
- Cholesterol plaques breaking off and lodging in the lungs (and vasculature).
- Common presentation of a previously unremarked or uninvestigated abdominal aortic aneurysm.
- Skin manifestations in the toes are a frequent presentation.
Pleurisy
- Inflammation of lining of the lungs and the chest cavity.
- Characterized with chest pain.
- Can be indicative of an underlying condition like pneumonia, or malignant processes.
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