fungi stain black on silver stain->gm silver

little dots for yeast like forms or hyphi

on giemsa stain, the fungi are pink
pneumocystis jiroveci->subacute onset
dry cough, hypoxia, fever
attentuated symptoms if on prophylactic therapy
cd4<200
batwing perihilar bilateral fluffy infiltrate
immunofluorescence
helmet-shaped
spherules
silver stain
obstructive sleep apnea->young person with wasting illness, dry cough

aspergillus
immunosuppressed pts
segmented hyphae->branching in 45 angles
severe machophage dysfunction
histoplasma capsulatum
yeast phase organisms:ovoid,budding yeast-form,often in pmns
caseating granulomas
blasto
coccidioides immitis
cryptococcus neoformans->india ink->large prominent capsule
obstructive sleep apnea
decreases p02, profound sympathetic drive
tongue falls posteriorl, and pharyngeal sode tissue is redundant
nasopharynx collapses during inspiration
reflex is not sufficient
closes airway->esp when pressure in the lumen is low->inspiration->get inspirato
ry collapse
carcinoid tumor
solitary, round, dense mass, intraluminal
benign->associated with serotonin syndrome, secrete serotonin metabolite, 5-HIAA
theophylline
methylxanthines->smooth muscle relaxation: bronchodilation
act by inhibiting PDE to elevate cAMP=>also block adenosine receptors
narrow therapeutic window
cardiotoxicity(cardiac tachy-arrthymias)
neurotoxicity(restlessness,nervousness,anxiety)
nausea,stomach(GI) upset
alveolar size gradient
transpulmonary pressure->diff between the inside and outside pressure