Kaplan Qbank Pulm Flashcards
Common causes for ARDS are? 4 things
trauma, sepsis, shock, and gastric aspiration
What type of lung cancer can cause SIADH?
SIADH can be caused by ectopic ADH secretion by small cell carcinomas of the lung, CNS disorders, chronic pulmonary dx, and certain drugs. Features include excessive water retention, hyponatremia, and serum hypo-osmolarity with urine osmolarity greater than serum osmolarity.
The histopathologic hallmark is formation of hyaline membranes consisting of proteinaceous material and epithelial necrotic debris.
ARDS
Release of cytokines, eicosanoids, and free radicals promotes alveolar damage.
Children with WHAT will be toxic in appearance, will refuse to eat, and may drool (distress, dysphagia, drooling)?
May also have acute onset of high fever, inspiratory stridor, and refusal to drink water.
Epiglottitis
hemosiderin-laden macrophage
Congestive heart failure
Could also be Goodpasture
Exudative effusions with high lipid content, and are most commonly related to trauma and malignancy.
Chylous effusions
Most common cause of lobar pneumonia? What is its gram stain? Type of hemolysis?
Streptococcus pneumoniae is the most common cause of lobar pneumonia in adults.
It is a gram-positive, catalase-negative diplococcus. It is alpha-hemolytic, bile-soluble, and inhibited by Optochin. Treat with penicillins if it is caused by a susceptible strain; antibiotic sensitivity testing is needed to guide drug choice.
What is a gram-positive, catalase-negative diplococcus that is alpha-hemolytic, bile-soluble, and inhibited by Optochin?
Strep pneumo
How do you treat strep pneumo?
Treat with penicillins if it is caused by a susceptible strain; antibiotic sensitivity testing is needed to guide drug choice.
Increased Reid index
Chronic bronchitis
Apical cavitary lesions
Secondary TB
Curschmann spirals
Asthma
Elevated sweat salt levels
CF
Enlarged hilar glands
Granulomatous diseases (sarcoidosis), lymphoma, or tumor
Result of stimulation of M3 in lungs and blood vessels
Bronchoconstriction and increased mucus secretion; decreased blood pressure and tachycardia
Result of stimulation of beta-2 receptors in the lungs and blood vessels
Bronchodilation; decreased BP and tachycardia
Alpha-1 stimulation
increased blood pressure and generates a reflex bradycardia
Radiolucency along CW on CXR
pneumothorax
History of asthma, sudden-onset SOB, altered breath sounds
pneumothorax
Lobar infiltrate
pneumonia
Wedge-shaped opacity
pulmonary embolism
Medial hypertrophy, arterial fibrosis, and marked narrowing of the arterial lumina
arterial thrombosis
Treatment of secondary pulmonary hypertension
Calcium channel blockers, endothelial receptor antagonists, phosphodiesterase type 5 inhibitors, prostacyclin analogues
early onset panacinar emphysema
alpha 1 antitrypsin deficiency
rapid-onset of respiratory insufficiency secondary to diffuse alveolar damage. lungs show alveoli filled with proteinaceous debris and desquamatated alveolar lining cells + alveolar septa lined by hyaline membranes
ARDS
Chronic airway inflammation and bronchial hyperresponsiveness
atopic asthma
Necrotizing and hemorrhagic pneumonitis accompanied by rapidly progressive glomerulonephritis; fresh hemorrhage and hemosiderin-laden macrophages in lungs
Goodpasture syndrome
Interstitial pneumonitis that produces noncaseating giant-cell granulomas + nodules in lungs and hilar lymph nodes
Sarcoidosis
Very ill patient develops hypoxia and bilateral lung infiltrates several days after being admitted to ICU
ARDS
Lung damage triggered by neutrophils that release cytokines that attract histiocytes and produce a variety of compounds that damage the alveolar epithelium
ARDS
What syndrome can develop in morbidly obese patients that results in hypoxemia and respiratory acidosis?
Pickwarian syndrome
Respiratory acidosis is characterized by:
low pH, high PaCO2, and high bicarb
Aspirin-induced asthma results from
inhibition of cyclooxygenase pathways –> relative decrease of prostaglandin bronchodilators to leukotriene bronchoconstrictors
