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Dr. Mel - Respiratory > First Aid > Flashcards

First Aid Flashcards

1
Q

Pulmonary hypoplasia

A

Poorly dev bronchial tree
Abnl histo
Ass w/ congen diaphragmatic hernia, bilat renal agenesis

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2
Q

Bronchogenic cysts

A

Abnl budding of foregut
Dilation of terminal or large bronchi
Air-filled densities on CXR
Drain poorly + chronic infections

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3
Q

3 risk factors + 3 complications of Neonatal respiratory distress sd

A

RF: prematurity, maternal db, C-section
Compl: metabolic acidosis, PDA, necrotizing enterocolitis

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4
Q

Ttt + complications of O2 suppl in NRDS

A

Ttt: maternal steroids before birth, artificial surfactant for infant
Suppl O2: retinopathy of prematurity, intraventricular hge, bronchopulmonary dysplasia

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5
Q

3 symptoms/signs in Phrenic nerve palsy

A

Respiratory distress
Diminished breath sounds ipsilat
Elevation of hemidiaphragm

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6
Q

Ttt of cyanide poisoning

A 
Induced methemoglobinemia (metHg has high affinity for cyanide)
By nitrites then thiosulfate
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7
Q

Ttt of methemoglobinemia

A

Methylene blue and Vitamin C

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8
Q

Ttt of carboxyhemoglobinemia

A

100% O2 and hyperbaric O2

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9
Q

Response to high altitude

A

Respiratory alkalosis
Renal HCO3- excretion to compensate
Hypoxia: high EPO, Hb, 2,3-BPG
Chronic hypoxic pulmonary vasoconstriction: pulm HTN + RVH

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10
Q

Response to exercise

A

V/Q more uniform (apex to base)
Low pH in strenuous exercise (lactic acidosis)
No change in PaO2 and PaCO2
High venous CO2 and low venous O2 content

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11
Q

Microorganisms causing acute Rhinosinusitis

A

Viral +++

Superimposed bact: S pneumoniae, H influenzae, M catarrhalis

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12
Q

2 types of epistaxis

A

Ant: Kiesselbach plexus (ant ethmoidal, sphenopalatine, sup labial)
Post: sphenopalatine art (branch of maxillary art)

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13
Q

4 risk factors for Head and Neck cancer

A

Tobacco
Alcohol
HPV-16 (oropharyngeal)
EBV (nasopharyngeal)

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14
Q

Virchow triad predisposing DVT

A

Stasis
Hypercoagulability
Endothelial damage

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15
Q

Prophylaxis + ttt of DVT

A

Prophylaxis + acute ttt: unfractionated heparin or LMWH (enoxaparin)
Long-term prevention + ttt: oral anticoag (Warfarin, rivaroxaban)
Pregnancy: LMWH (best for mom+baby)

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16
Q

Ttt of PE

A

Immediate: heparin, rivaroxaban

Severe PE + unstable ptt: recombinent tPA

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17
Q

Centriacinar vs panacinar emphysema

A

CentriA: smoking, upper lobes; macroph+neutro release proteases
PanA: alpha1-antitrypdin def, lower lobes; excess neutro-elastase activity

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18
Q

Chronic bronchitis vs asthma

A

CB: hyperplasia of mucus-secreting glands in bronchi
Asthma: smooth muscle hypertrophy

19
Q

2 types of asthma

A

Extrinsic: atopic, high IgE, HS I
Intrinsic: non-immune mediated, normal IgE, precipitated by aspirin, cold air, inhaled irritants, stree, exercise, non-selective beta blockers, GERD, NSAIDs

20
Q

Definition + 5 findings in Bronchiectasis

A 
Chronic necrotizing inf of bronchi
Permanently dilated airways
Purulent sputum
Recurrent inf
Hemoptysis
Digital clubbing
21
Q

4 conditions ass w/ bronchiectasis

A

Bronchial obstruction
Poor ciliary motility (smoking, Kartagener)
Cystic fibrosis
Allergic bronchopulmonary aspergillosis

22
Q

Asbestosis

A

Ivory white, calcified, supradiaph, pleural plaques
Lower lobes
Asbestos in sputum (Prussian blue stain)
Bronchogenic carcinoma > mesothelioma

23
Q

Berryliosis

A

Granulomatous

Upper lobes

24
Q

Coal worker’s pneumoconiosis

A

Macrophages laden w/ carbon
Inflammation + fibrosis
Upper lobes
Anthracosis: asympt (urban)

25
Q

Silicosis

A

Macrophages release fibrogenic factors
Silica disrupt phagolysosomes + macroph: risk of TB
Upper lobes
Eggshell calcification of hilar lymph nodes

26
Q

Acute respiratory distress syndrome

A

Acute resp failure
Bilateral lung opacities: diffuse alv damage (protein-rich leakage)
No evidence of HF/fluid overload: normal PCWP
Sepsis, pancreatitis, pneumonia, aspiration, uremia, trauma, amniotic fluid embolism, shock

27
Q

Microscopy of ARDS

A

Intra-alv hyaline membranes
Toxic neutro substances
Activation of coag cascade
Oxygen-derived free radicals

28
Q

Small cell carcinoma of the lungs

A

Central; smoking; amplification of myc
Very aggressive
ACTH, SIADH, Lambert-Eaton sd, Ab against neurons
Neopl of neuroendocrine Kultchitsky cells
Chromogranin A+, Synaptophysin+, neuron-specific enolase+
Chemotherapy +/- radiation

29
Q

Adenocarcinoma of the lungs

A

Peripheral; most common in nonsmokers
Activating mutations: KRAS, EGFR, ALK
Glandular pattern (mucin+)
Bronchioloalveolar subtype: better px, along alveolar septa

30
Q

Squamous cell carcinoma of the lungs

A

Central; smoking
Cavitation, necrosis, hypercalcemia (PTHrP)
Keratin pearls, intercellular bridges

31
Q

Large cell carcinoma of the lungs

A 
Peripheral; highly anaplastic
Pleomorphic giant cells
Beta-hCG
Poor prognosis
Surgery
32
Q

Bronchial carcinoid tumor of the lungs

A

Excellent prognosis
Mass effect or carcinoid sd
Neuroendocrine cells
Chromogranin A+

33
Q

Indications + adv effects of 1st + 2nd gen of Antihistamines

A

1st: allergy, motion sickness, sleep aid
Adv eff: sedation, antimusc, anti alpha-adren

2nd: allergy
Adv eff: far less sedating

34
Q

Dextromethorphan

A 
Antitussive
Antagonizes NMDA glutamate recept
Synthetic codeine analog
Mild opioid if excess, mild abuse
Serotonin sd if combined w/ serotoninergic agents
If overdose: Naloxone
35
Q

Pseudoephedrine, phenylephrine

A

Alpha-adren agonists
Nasal decongestants
Adv eff: HTN, CNS stimulation/anxiety (pseudoephedrine)

36
Q

Pulmonary HTN drugs

A

Bosentan: antag endothelin-1 recept
Sildenafil: inhib cGMP PDE-5, prolongs eff of NO
Epoprostenol, iloprost: PGI2, vasodil pulm+system art, inh platelet aggreg

37
Q

Methacholine

A

M3 agonist

Bronchial challenge test: exclude dg of asthma

38
Q

6 asthma drugs

A 
Beta2-agonists
Inhaled corticosteroids
Muscarinic antagonists
Antileukotrienes
Anti-IgE monoclonal therapy
Methylxanthines
39
Q

3 beta2-agonists

A

Albuterol: short-acting, acute exacerb

Salmeterol, formeterol: long-acting, prophylaxis

40
Q

Inhaled corticosteroids

A

Fluticasone, budesonide
Inactivate NFkB
1st line ttt for chronic asthma

41
Q

Muscarinic antagonists

A

Ipratropium (short)
Prevents bronchoconstriction, blocks tracheobr glands, enhances eff of Beta2+
For COPD
Tiotropium (long-act)

42
Q

Antileukotrienes

A

Montelukast, Zafirlukast: block leukot recept

Zileuton: 5-lipoxygenase pathw inh, blocks conv of arach acid to leukot

43
Q

Anti-IgE monoclonal therapy

A

Omalizumab
Binds unbound IgE
For allergic asthma w/ high IgE resistant to inh cortico + long-act beta2

44
Q

Methylxanthines

A 
Theophylline
Inhib phosphodiesterase: bronchodilation
Narrow therapeutic index
Metab by CYP450
Blocks adenosine

Dr. Mel - Respiratory (2 decks)

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