dowjunk
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Lets start with this weeks topic, Respiration, that is!
Throw your words, and questions.
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| dowjunk
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A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
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| dowjunk
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WHEN CONSIDERING THE DRUG TREATMENT OF ASTHMA WITH INHALER DEVICES
A. The incidence of oral candidiasis is increased by the use of spacer devices.
B. Salmeterol is indicated for p.r.n. usage.
C. Intermittent terbutalin has been shown to lead to long term worsening of asthma.
D. Steroid dosage of 600mg daily has been shown to be associated with adrenal suppression in adults.
E. Sodium cromoglycate is of no proven value in treating acute asthmatic attacks.
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| dowjunk
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A 65-year old male hospital in-patient has smoked cigarettes since he was 18 years old. He has a chronic cough and marked sputum production. When his doctor starts to give him the usual talk about losing weight, he explains that since he has about fifty pounds to lose, he has tried to exercise, but is unable to because of shortness of breath with any activity. Upon further questioning, he comments that his symptoms have been present for a very long time, but he was hospitalized due to a marked exacerbation of his complaints. On auscultation, rhonchi and wheezes are heard.His laboratory results are as follows:
pCO2 60 mm Hg(35-45 mm Hg)
pH 7.34( 7.35-7.45)
bicarbonate 31 mEq/L( 24 mEq/L)
Na+ 140 mEq/L( 135-145 mEq/L)
K+ 4.0 mEq/L( 3.5-5.5 mEq/L)
Cl-100 mEq/L(98-109 mEq/L)
What is the primary disorder?
a) metabolic acidosis with a normal anion gap
b) metabolic acidosis with an elevated anion gap
c) metabolic alkalosis
d) respiratory acidosis
e) respiratory alkalosis
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| Tiff
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dowjunk wrote:
A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess
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| Tiff
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Posts: 563
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dowjunk wrote:
WHEN CONSIDERING THE DRUG TREATMENT OF ASTHMA WITH INHALER DEVICES
A. The incidence of oral candidiasis is increased by the use of spacer devices.
B. Salmeterol is indicated for p.r.n. usage.
C. Intermittent terbutalin has been shown to lead to long term worsening of asthma.
D. Steroid dosage of 600mg daily has been shown to be associated with adrenal suppression in adults.
E. Sodium cromoglycate is of no proven value in treating acute asthmatic attacks.
Good q. Choice E.
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| Tiff
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dowjunk wrote:
A 65-year old male hospital in-patient has smoked cigarettes since he was 18 years old. He has a chronic cough and marked sputum production. When his doctor starts to give him the usual talk about losing weight, he explains that since he has about fifty pounds to lose, he has tried to exercise, but is unable to because of shortness of breath with any activity. Upon further questioning, he comments that his symptoms have been present for a very long time, but he was hospitalized due to a marked exacerbation of his complaints. On auscultation, rhonchi and wheezes are heard.His laboratory results are as follows:
pCO2 60 mm Hg(35-45 mm Hg)
pH 7.34( 7.35-7.45)
bicarbonate 31 mEq/L( 24 mEq/L)
Na+ 140 mEq/L( 135-145 mEq/L)
K+ 4.0 mEq/L( 3.5-5.5 mEq/L)
Cl-100 mEq/L(98-109 mEq/L)
What is the primary disorder?
a) metabolic acidosis with a normal anion gap
b) metabolic acidosis with an elevated anion gap
c) metabolic alkalosis
d) respiratory acidosis
e) respiratory alkalosis
D?
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| Tiff
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A 25-year-old hiker is traveling to the mountains to begin a several week hike. Over the course of several weeks his body will adjust to the high altitude by all of the following EXCEPT:
A. Decreasing 2,3 DPG
B. Increasing his minute ventilation
C. Increasing production of RBCs
D. Increasing renal excretion of bicarbonate
E. Increasing the number of mitochondria per cell
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| Tiff
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An infant born at 27 weeks develops respiratory distress syndrome. In the lungs, alveoli are maintained in their open, expanded state with the help of pulmonary surfactant which helps to reduce surface tension. Which of the following describes the composition of pulmonary surfactant after the 36th week of pregnancy?
A. Surfactant with a high proportion of sphingomyelin
B. A lecithin-to-sphingomyelin ratio less than 2:1
C. Surfactant containing less-surface-active alpha-palmitate, beta-myristate species
D. Surfactant containing phosphatidylglycerol
E. 75% lecithin and 10% sphingomyelin
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| dowjunk
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Tiff wrote:
A 25-year-old hiker is traveling to the mountains to begin a several week hike. Over the course of several weeks his body will adjust to the high altitude by all of the following EXCEPT:
A. Decreasing 2,3 DPG
B. Increasing his minute ventilation
C. Increasing production of RBCs
D. Increasing renal excretion of bicarbonate
E. Increasing the number of mitochondria per cell
A.............as 23DPG needs to increase ein the RBCs so that the affinity decreases!
I was confused with D here, but yes metabolic acidosis to compensate for the resp alkalosis!
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| dowjunk
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Tiff wrote:
An infant born at 27 weeks develops respiratory distress syndrome. In the lungs, alveoli are maintained in their open, expanded state with the help of pulmonary surfactant which helps to reduce surface tension. Which of the following describes the composition of pulmonary surfactant after the 36th week of pregnancy?
A. Surfactant with a high proportion of sphingomyelin
B. A lecithin-to-sphingomyelin ratio less than 2:1
C. Surfactant containing less-surface-active alpha-palmitate, beta-myristate species
D. Surfactant containing phosphatidylglycerol
E. 75% lecithin and 10% sphingomyelin
Ok, I'll first rule out A 'coz lecithin is our friend, not sphingo! B is incorrect 'coz we all know ideally it should be greater than 2:1. DPPC should be more in concentration to have a perfect breathe, I havent heard of ("alpha-palmitate, beta-myristate species") this word before! So Tiff can you please help us learn this term
Phosphatidylcholine, and not phosphatidylglycerol is the word (remember DPPC)
The last one is left for me to choose...... it should be a minimum of 66% and 33% (for 2:1) but a bigger former value and a smaller latter value will make the equation cool enuff!
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| dowjunk
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Tiff wrote:dowjunk wrote:
A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess
I would go 4 bronchiectasis......foul smelling......several weeks.....!!!
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| Tiff
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dowjunk wrote:Tiff wrote:dowjunk wrote:
A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess I would go 4 bronchiectasis ......foul smelling......several weeks.....!!!
As this may be true, pulmonary abscess also is known for foul smelling sputum. An aspiration of this sort can actually lead to both. Perhaps maybe one is more common than the other. Maybe someone could provide some more insight.
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| Tiff
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dowjunk wrote:Tiff wrote:
An infant born at 27 weeks develops respiratory distress syndrome. In the lungs, alveoli are maintained in their open, expanded state with the help of pulmonary surfactant which helps to reduce surface tension. Which of the following describes the composition of pulmonary surfactant after the 36th week of pregnancy?
A. Surfactant with a high proportion of sphingomyelin
B. A lecithin-to-sphingomyelin ratio less than 2:1
C. Surfactant containing less-surface-active alpha-palmitate, beta-myristate species
D. Surfactant containing phosphatidylglycerol
E. 75% lecithin and 10% sphingomyelin
Ok, I'll first rule out A 'coz lecithin is our friend, not sphingo! B is incorrect 'coz we all know ideally it should be greater than 2:1. DPPC should be more in concentration to have a perfect breathe, I havent heard of ("alpha-palmitate, beta-myristate species") this word before! So Tiff can you please help us learn this term Phosphatidyl choline, and not phosphatidylglycerol is the word (remember DP PC) The last one is left for me to choose...... it should be a minimum of 66% and 33% (for 2:1) but a bigger former value and a smaller latter value will make the equation cool enuff!
Actually the intended word was indeed phosphatidylglycerol which is an indicator for lung maturity. Phosphatidylcholine & Phosphatidylglycerol are both components of the mature lung. Choice E is incorrect because as you said the value for sphingomyelin should be higher. As for alpha-palmitate & beta-myristate, I haven't heard of it either. They're just distractors. Apparently they're some species of lecithin. So the answer is D.
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| new_n_lost
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Topics: 653
Posts: 6,086
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dowjunk wrote:Tiff wrote:dowjunk wrote:
A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess I would go 4 bronchiectasis ......foul smelling......several weeks.....!!!
Mate this is an abcess Since there was no pneumonia option then abcess is the next best choice if you are going for Bronchiectasis then you have to look at other signs and symptoms of Brochiectasis ( hemoptysis) Rusty foul smelling sputum is the classic sign of Strep Pneumonia which is rare in Brochiectasis. Other than that a smoker normally procduces extra amount of sputum which is less than the Bronchiectasis patient but more than the normal ones. So when it got to the point of rusty colored sputum and foul smelling which is like a hint for him to seek attention.
Also remember the sputum in a Bronchiectasis patient is usually in large amount but not foul smelling it becomes that when there is an exacerbations
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| new_n_lost
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Tiff wrote:dowjunk wrote:
A 65-year old male hospital in-patient has smoked cigarettes since he was 18 years old. He has a chronic cough and marked sputum production. When his doctor starts to give him the usual talk about losing weight, he explains that since he has about fifty pounds to lose, he has tried to exercise, but is unable to because of shortness of breath with any activity. Upon further questioning, he comments that his symptoms have been present for a very long time, but he was hospitalized due to a marked exacerbation of his complaints. On auscultation, rhonchi and wheezes are heard.His laboratory results are as follows:
pCO2 60 mm Hg(35-45 mm Hg)
pH 7.34( 7.35-7.45)
bicarbonate 31 mEq/L( 24 mEq/L)
Na+ 140 mEq/L( 135-145 mEq/L)
K+ 4.0 mEq/L( 3.5-5.5 mEq/L)
Cl-100 mEq/L(98-109 mEq/L)
What is the primary disorder?
a) metabolic acidosis with a normal anion gap
b) metabolic acidosis with an elevated anion gap
c) metabolic alkalosis
d) respiratory acidosis
e) respiratory alkalosis
D?
Hands down this is Chronic Respiratory Acidosis with some metabolic alkalosis as compensation.. (me thinks)
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| dowjunk
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Posts: 299
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new_n_lost wrote:dowjunk wrote:Tiff wrote:
[quote=dowjunk]A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess I would go 4 bronchiectasis ......foul smelling......several weeks.....!!!
Mate this is an abcess Since there was no pneumonia option then abcess is the next best choice if you are going for Bronchiectasis then you have to look at other signs and symptoms of Brochiectasis ( hemoptysis) Rusty foul smelling sputum is the classic sign of Strep Pneumonia which is rare in Brochiectasis. Other than that a smoker normally procduces extra amount of sputum which is less than the Bronchiectasis patient but more than the normal ones. So when it got to the point of rusty colored sputum and foul smelling which is like a hint for him to seek attention.
Also remember the sputum in a Bronchiectasis patient is usually in large amount but not foul smelling it becomes that when there is an exacerbations
[/quote]
I still think the other way: long Hx of productive cough, non-mentioning of fever (more common in abscess than bronchiectasis), bloody sputum is not its trademark, though it can occur! Favoring me is the prolong history of productive cough which later became rusty/foul smelling; while favoring you guys is the point that acute alcoholism is the #1 cause of lung abscess.
I'd say that in case of abscess the vignette wont mention the previous long sympomatology of productive cough, before things start worsening. I mean abscess will be more rapid in formation after an acute alcoholic's aspiration! But still cant force the abscess as a wrong choice. More appropraite for me is Bronchiectasis! Cheerz
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| dowjunk
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A 76-year-old man comes to your office in January with complaints
of abrupt onset of cough, with small amounts of green sputum, worse in
the morning, without any blood in it. He also has fever as high as 103
[font lang="JA" face="Symbol" color="#221f1f" size="2"]ｰ[/font]F,
a. Obtain a chest x-ray and schedule him to return tomorrow
b. Treat his symptoms with antipyretics and cough syrup
c. Prescribe an oral antibiotic and also antipyretics and cough syrup and schedule
him to return in 2 days
d. Admit him to the hospital in the intensive care unit for parenteral antibiotic
treatment
e. Administer a tuberculin skin test (PPD), treat his symptoms with antipyretics
and cough syrup, obtain a chest x-ray, and schedule him to return in 2 days for
interpretation of the skin test
very rapid respirations (32/min), and chest pain on his right side, worsened
with coughing. He exhibits some difficulty remembering the details of
his illness. On the basis of these clinical findings, you consider a diagnosis
of pneumonia. Which one choice would you make?
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| dowjunk
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ARDS is differentiated from acute lung injury (ALI) on the basis of
which one of the following?
a. Presence of bilateral interstitial infiltrates on chest x-ray
b. Severity of hypoxemia with Pa
O2/FiO2 ratio of less than 200 mmHg
c. Increased pulmonary capillary wedge pressure
d. Reduced compliance
e. Systemic inflammatory response
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| dowjunk
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A simple Q that still bothers me:
A 30-year-old male presents to the emergency room with shortness
of breath and right-sided pleuritic chest pain. His chest x-ray in the emergency
room is normal. An arterial blood gas is obtained while the patient is
breathing room air. The results show a pH of 7.48, Pa
CO2 of 35, PaO2 of 68,
a. 20
b. 30
c. 40
d. 50
e. 60
and an oxygen saturation of 92%. What is his A-a gradient?
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| dowjunk
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Ok you think that you are good e respiration:
In which one of the following diseases would the occurrence of
hemoptysis prompt a search for another disease as the cause of the hemoptysis?
a. Bronchogenic carcinoma
b. Acute bronchitis
c. Goodpasture
’s syndrome
d. Emphysema
e. Bronchiectasis
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| new_n_lost
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dowjunk wrote:
Ok you think that you are good e respiration:
In which one of the following diseases would the occurrence of hemoptysis prompt a search for another disease as the cause of the hemoptysis?
a. Bronchogenic carcinoma
b. Acute bronchitis
c. Goodpasture’s syndrome
d. Emphysema
e. Bronchiectasis
c. Goodpasture’s syndrome and Bronchiectasis
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| new_n_lost
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dowjunk wrote:new_n_lost wrote:dowjunk wrote:
[quote=Tiff][quote=dowjunk] A 35 year old Tennessee Titan fan aspirated peanuts while bemoaning their Superbowl loss, but was too drunk to seek immediate medical assistance. After several months of productive sputum, he began to cough up rusty foul smelling sputum. Before he could seek medical attention, he was hit by a car. His lung at autopsy shows:
A. Solitary pulmonary abscess
B. Bronchiectasis
C. Asbestosis
D. Bronchial carcinoid
E. Chronic bronchitis
A. Pulmonary Abscess I would go 4 bronchiectasis ......foul smelling......several weeks.....!!!
Mate this is an abcess Since there was no pneumonia option then abcess is the next best choice if you are going for Bronchiectasis then you have to look at other signs and symptoms of Brochiectasis ( hemoptysis) Rusty foul smelling sputum is the classic sign of Strep Pneumonia which is rare in Brochiectasis. Other than that a smoker normally procduces extra amount of sputum which is less than the Bronchiectasis patient but more than the normal ones. So when it got to the point of rusty colored sputum and foul smelling which is like a hint for him to seek attention.
Also remember the sputum in a Bronchiectasis patient is usually in large amount but not foul smelling it becomes that when there is an exacerbations
[/quote]
I still think the other way: long Hx of productive cough, non-mentioning of fever (more common in abscess than bronchiectasis), bloody sputum is not its trademark, though it can occur! Favoring me is the prolong history of productive cough which later became rusty/foul smelling; while favoring you guys is the point that acute alcoholism is the #1 cause of lung abscess.
I'd say that in case of abscess the vignette wont mention the previous long sympomatology of productive cough, before things start worsening. I mean abscess will be more rapid in formation after an acute alcoholic's aspiration! But still cant force the abscess as a wrong choice. More appropraite for me is Bronchiectasis! Cheerz
[/quote]
Do you have an answer to this question or is this one of those unanswered thingys. If it is then yup if you want to for Bronchiectasis then ok. but i would go for Abcess as the forementioned reasons.
Cheers Mate !!!
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| dowjunk
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Posts: 299
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new_n_lost wrote:dowjunk wrote:
Ok you think that you are good e respiration:
In which one of the following diseases would the occurrence of hemoptysis prompt a search for another disease as the cause of the hemoptysis?
a. Bronchogenic carcinoma
b. Acute bronchitis
c. Goodpasture’s syndrome
d. Emphysema
e. Bronchiectasis
c. Goodpasture ’s syndrome and Bronchiectasis
NnL: You read the question wrong ............
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| Tiff
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dowjunk wrote:
Ok you think that you are good e respiration:
In which one of the following diseases would the occurrence of
hemoptysis prompt a search for another disease as the cause of the hemoptysis?
a. Bronchogenic carcinoma
b. Acute bronchitis
c. Goodpasture
’s syndrome
d. Emphysema
e. Bronchiectasis
B. Acute Bronchitis
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