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Pulmonary > High Yield > Flashcards

High Yield Flashcards

1
Q

What are the characteristics of IPF?

A

Usual interstitial pneumonia Heterogeneous Fibroblastic foci

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2
Q

What are the characteristics of COOP?

A

Masson bodies All uniform - space throughout the lungs Loose connective tissue

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3
Q

Characteristics of silicosis?

A

Sand blasting Increased risk of TB Macrophage dysfunction

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4
Q

What are the characteristics of hypersensitivity pneumonitis?

A

Type III hypersensitivity Loose granulomas Resolves after removing stimuli

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5
Q

What are the characteristics of pulmonary alveolar proteinosis?

A

A-cellular surfactant in the intraalveolar spaces Antibodies to GM-CSF

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6
Q

What are characteristics of Squamous Cell Carcinoma?

A

Intercellular bridges Keratin pearls Many syndromes - cushing, hypercalcemia, etc

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7
Q

What cardiac abnormality is associated with pectus excavatum?

A

Mitral valve prolapse

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8
Q

What is the role of the subcostal muscles?

A

Function to depress ribs during heavy exercise, assisting with forced expiration

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9
Q

What are the top and bottom muscles?

A

Serratus posterior superior - Top

Serratus posterior inferior - bottom

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10
Q

What is the target of Ipratropium?

A

Cholinergic receptors

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11
Q

What can cause a diaphragmatic herina?

A

Incorrect folding of the pleuroperitoneal fold

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12
Q

What is the lowest you would hear breathe sounds on in the back mid scapula?

A

10th rib

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13
Q

COPD causes dilation of what?

A

Alveolar ducts and respiratory bronchiole

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14
Q

Adrenergic receptors are a part of what system?

A

Sympathetic

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15
Q

What are the important muscles used for forced inspiration?

A

Serratus posterior superior

Sternocleidomastoid

Scalene

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16
Q

Can you have incomplete compensation?

A

YES!!!

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17
Q

What is pancoast syndrome?

A

Apical bronchogenic tumor can push on adjacent structures

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18
Q

This graph demonstrates a person with?

A

Decreased lung compliance needing more pressure to generate flow

The value of PTP or a given lung volume is greater than in the normal lung.

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19
Q

This graph demonstrates a person with?

A

Increased airway resistance

compliance is normal, PALV-PPL , i.e. the volume component is also normal for any volume.

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20
Q

What is the equation for alveolar ventilation?

A

(TV-VD)xRR

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21
Q

What determines the stretch of the lungs?

A

PALV-PPL and compliance

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22
Q

What determines the creation of airflow?

A

PB-PALV and Resistance

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23
Q

What is venous return on blood?

A

PO2 = 40

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24
Q

How does changing diffusion affect the concentrations of PaO2 and CO2?

A

If decreased by too much it will lose the PO2 will go down

If only slightly decreased, then it can be normal

25
Q

Unilateral chest expansion is significant for?

A

Pneumonia or Post intubation

26
Q

Clubbing is a sign of?

A

Respiratory disorder

CF

27
Q

If sternocleidomastoid and scalene muscles are being used for breathing, what can this be a sign of?

A

COPD

28
Q

Increased tactile fremitus that is unilateral is indicative of?

A

Pleural effusion

If it is symmetric it decreases the likelihood of it

29
Q

What does hyperresonance symbolize?

A

Pneumothorax

30
Q

Unilateral sounds after intubation predict what?

A

Right mainstem intubation

31
Q

Rales (Crackles) have what characteristics?

A

Inspiratory and are early

Indicative of CHF, pneumonia or pulmonary fibrosis

32
Q

What are the characteristics of rhonchi?

A

Snoring quality, low pitched

Think airway secretions

33
Q

What are the characteristics of stridor?

A

Loud upper airway obstruction

Epiglottitis

34
Q

What are the characteristics of wheezing?

A

High pitched, continuous musical sound

COPD or asthma

35
Q

Rales are the same as?

A

Crackles!

36
Q

Egophony is a sign for?

A

Pneumonia

EEEEE to AAA change

37
Q

Whispered pectoriloquy is a sign of what?

A

Consolidated lung

38
Q

What are the common gram negative pulmonary infections?

A

E. coli , Klebsiella, Proteus, Pseudomonas

Legionella

39
Q

When should a person worry about gram negative infection?

A

Aspiration leading to gram negative

At risk populations

40
Q

Bronchiectasis is a dilation of what?

A

Bronchiole

41
Q

What is the formula for carrying capacity of blood

A

(Hb x 1.34 x % sat) + (SaO2 x 0.003)

42
Q

What do V and A stand for?

A

Venous saturation and Arterial saturation

43
Q

Explain this graph

A

Changes in O2 affinity of Hb have important physiological relevance. Consider a person exercising vigorously: the Hb in the capillary blood flowing through the exercising muscles is exposed to a low pH, high PCO2, and high temperature. All these factors tend to lower Hb-O2 affinity; i.e. for a given PO2 value, Hb is less saturated. In other words, as the affinity of Hb for O2 decreases, Hb “lets go” of O2. This facilitates unloading of O2 in the exercising muscle without reducing the PO2 very much; accordingly, the PO2 gradient for O2 diffusion from the capillary to the muscle cell is maintained and allows O2 flow to continue. When the blood returns to the lungs, the Hb is exposed to a higher pH, lower PCO2 and lower temperature, all of which tend to increase Hb-O2 affinity. Now Hb likes the O2 a little more, so it picks up more O2.This facilitates loading of O2 in the lungs.

44
Q

Explain this graph

A
45
Q

Explain this graph

A

CO2 concentration is higher in venous blood

46
Q

Explain this graph?

A

The arterial and venous blood O2 and CO2 content, in ml/dl, are plotted as a function of the respective partial pressures. The units for CO2 concentration here are different from those of the curve in the previous slide. The objectve of this slide is to compare the differences in the shapes of the O2 and CO2 curves. In the next chapter we will see the implications of these differences on pulmonary gas exchange. Several differences are apparent:

  1. In the physiologic range, blood CO2 content is about twice the blood O2 content
  2. In the physiologic range, the curve for CO2 is fairly linear, which means that changes in

PCO2 are accompanied by roughly proportionate changes in blood CO2 content over a fairly wide range of PCO2. On the other hand, the non-linearity of the ODC means that the changes in O2 content produced by a given change in PO2 will depend on the initial PO2 level. As we will see in the next section, this has important implications for gas exchange.

  1. The CO2 curve is much steeper: the v-a PCO2 difference is ~ 6 mmHg and the v-a CO2 content difference is 4-5 ml/dl; on the other hand, the a-v O2 content difference is 5-6 ml/dl but the a-v PO2 difference is ~ 60 mmHg. This also has implications for gas exchange, as we will see later.
47
Q

What are the indications to used transesophageal echocardiography?

A
48
Q

Increased dead space also means?

A

Decreased efficiency of gas exchange

49
Q

What are the characteristics of increased dead space?

A

Increased total ventilation

Increased VD/VT ratio

Typically seen as low PaO2 with little CO2 retention

50
Q

What are the characteristics of an airway blockage (increased shunts)?

A

Large PaO2 drop due to mixing

PaO2 refractory to increases in PAO2

Small increase in PaCO2

51
Q

How can metabolic alkalosis shift the O2 curve?

A

An increase in blood pH shifts the oxygen-hemoglobin dissociation curve to the left. This creates a tighter bond between hemoglobin and oxygen, causing decreased oxygen delivery to tissues. Hypoxemia is worsened by a compensatory hypoventilation to elevate PCO2. Hypoventilation may be severe enough to cause apnea and respiratory arrest.

52
Q

How can you increase VO2?

A

Increasing cardiac output or increasing extraction

53
Q

How can you decrease diffusion?

A

Decreasing volume or increasing the extraction of O2 from the alveoli

54
Q

What is the equation for VA?

A

VCO2/PaCO2

55
Q

What is the difference between COPD and alpha-1 anti-trypsin in regards to where they effect?

A

alpha-1 antitrypsin - alveolar ducts and alveoli

Emphysema - respiratory bronchioles

56
Q

How can neutrophils affect the lungs?

A

Infiltration leads to destruction of bronchiolar and septal elastic

57
Q

In a BAL what would you see in a patient with HF?

A

Hemosiderin laden macrophages

58
Q

How would a patient with CF have Cl- on their skin but not in their airways?

A

The cells of the sweat fail to reabsorb NaCl while in the airway there is decreased Cl- secretion and increase H2O and Na+ reabsorption

59
Q

What is one role of Mast cells?

A

BALT and edema

Pulmonary (42 decks)

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