Embryology, Anatomy, Physiology

Question 1

Bronchogenic cysts Caused by

► Diagnostic criteria

Answer 1

abnormal budding of the foregut and dilation of terminal or large bronchi
►Cartilage in wall

Question 2

Club cells
►Location
►Function

Answer 2

► Located in bronchioles.

►Degrade toxins b CYP 450; secrete component of surfactant; act as reserve cells.

Question 3

Law of laplace

Answer 3

Collapsing pressure (P) = 2 (surface tension) / radius

Question 4

Alveolar proteinases

Answer 4

1. Elastase
2. Matrix metalloproteinase
3. 0Cathepsin G

Question 5

Anti-proteinases

Answer 5

1. A1AT
2. TIMP (Tissue inhibitor of metalloproteinases)
3. Alpha-2 microglobulin

Question 6

Screening tests for fetal lung maturity:

Answer 6

1. lecithin sphingomyelin (L/S) ratio in amniotic fluid (≥2 is healthy; < 1.5 predictive of NRDS),
2. foam stability index,
3. surfactant-albumin ratio

Question 7

Albumin and total proteins in amniotic fluid normally _________from early gestation to term

Answer 7

decreases by 50%

Question 8

in lungs, _____ levels remain constant

Answer 8

sphingomyelin

Question 9

Therapeutic supplemental O2 can result in

Answer 9

(RIB).
Retinopathy of prematurity,
Intraventricular hemorrhage,
Bronchopulmonary dysplasia

Question 10

Neonatal respiratory distress syndrome

Risk factors:

Answer 10

1. prematurity,
2. maternal diabetes (due to fetal insulin),
3. C-section delivery

Question 11

Common iliac veins merge into IVC at ____ level

Answer 11

L5

Question 12

IVC is ____ to descending part of duodenum

Answer 12

medial

Question 13

IVC passes through the ____ of central tendon of diaphragm at ___ level

Answer 13

Right

T8

Question 14

Thoracocentesis for pleural effusion

Answer 14

area 1 or 2 intercostal spaces below the fluid level and 5-10 cm lateral to the spine or midscapular line.

Question 15

Needle positioning for tension pneumothorax

Answer 15

2nd intercostal space, midclavicular line

Question 16

Cartilage and goblet cells end at

Answer 16

bronchi

Question 17

Airway smooth muscle cells extend to

Answer 17

end of terminal bronchioles

Question 18

Pseudostratified ciliated columnar cells primarily make up epithelium of bronchus and extend to

Answer 18

beginning of terminal bronchioles

Question 19

Mostly cuboidal cells in ______, then simple squamous cells ________

Answer 19

respiratory bronchioles

up to alveoli

Question 20

Cilia terminate in

Answer 20

respiratory bronchioles

Question 21

________ cannot be measured by spirometry

Answer 21

RV and any lung capacity that includes RV

Question 22

Hysteresis: Lung inflation follows a different pressure volume curve than lung deflation due to

Answer 22

need to overcome surface tension forces in inflation

Question 23

At ____, airway and alveolar pressures equal atmospheric pressure (called zero), and intrapleural pressure is ______

Answer 23

FRC

Negative

Question 24

Hb exhibits ____ cooperativity and ______ allostery

Answer 24

positive

positive

Question 25

Myoglobin has ____ affinity for oxygen than Hb

Answer 25

higher

Question 26

Transpulmonary pressure:
positive
negative

Answer 26

Alveolar pressure - Intrapleural pressure

positive: holds airway open
negative: Airway collapse

Question 27

Equal pressure point in healthy lungs occurs in

Answer 27

cartilaginous airways

Question 28

Deoxygenated form of Hb has ___ affinity for oxygen

Answer 28

lower

Question 29

CO poisoning Classically associated with ______ lesions on MRI

Answer 29

bilateral globus pallidus

Question 30

CO poisoning OD curve

Answer 30

Left shift in curve →↑affinity for O2 →↓O2 unloading in tissues.

Question 31

In cyanide poisoning everything is normal except, ____ is increased and ____ is decreased

Answer 31

↑ venous O2 content

↓ arterial-venous O2 gradiant

Question 32

Cyanide binds iron in ____ form

Answer 32

Fe3+

Question 33

P50 for Hb and myoglobin is ____

Answer 33

Hb: 26mmHg
Myoglobin: 1mmHg

Question 34

If P50 is decreased, ODC will shift towards

Answer 34

left

Question 35

Hemoglomin M disease is a congenital cause of ______ due to mutation in ____

Answer 35

methemoglobinemia

heme-binding pocket

Question 36

At what point in ODC, compensatory erythropoeisis will occur?

Answer 36

left shift → ↓O2 unloading → renal hypoxia → ↑EPO production

Question 37

Alveolar gas equation

Answer 37

PAO2 = PIo2 - Paco2 / R

150 - Paco2/0.8

Question 38

R = respiratory quotient =

Answer 38

CO2 produced / O2 consumed

Question 39

In normal lung
ventilation is max at
perfusion is max at
V/Q ratio is max at

Answer 39

base
base
apex

Question 40

CO2 bound to Hb at

Answer 40

N-terminus of globin (not heme).

Question 41

Haldane effect

Answer 41

In lungs, oxygenation of Hb promotes dissociation of H+ from Hb. This shifts equilibrium toward CO2 formation; therefore, CO2 is released from RBCs

Question 42

Bohr effect

Answer 42

In peripheral tissue, H+ from tissue metabolism shifts curve to right, unloading O2

Question 43

High altitude sickness long tern complication

Answer 43

Chronic hypoxic pulmonary vasoconstriction results in pulmonary hypertension and RVH.

Question 44

H+ binds to Hb to

Answer 44

end of globin chain (not heme)

Question 45

Exercise: partial pressure of O2 and CO2 in blood

Answer 45

Arterial PaO2 and PaCO2 are normal

Venous O2↓ and CO2↑