Lung 2a Flashcards
What is the pathway from antigen to mast cell leading to asthma?
allergen > collected by dendritic cell > presented to lymphocyte TH2 > increased IgE, attach to mast cells > primed mast cell explodes on next exposure.
What is air trapping?
Air gets in, but then gets trapped behind mucus and can’t get out.
What happens to the FEV1/FVC ratio in obstructive disease? Restrictive?
Obstructive: down
Restrictive: the same or up
In order to get CO2 out, what must go in?
O2.
A1AT deficiency leads to what type of alveolar damage?
Panacinar.
What happens to the DLCO2 with emphysema?
It decreases.
What two PFTs are the standard for indication of restrictive lung disease?
Low FEV1, but normal FEV1/FVC ratio.
What’s the difference between hypoxemia and hypoxia?
Hypoxemia = low O2 in blood
Hypoxia = low O2 in tissue
What is the relationship of PA, Pa, and Pv in the 3 zones of the lung?
Zone 1: PA > Pa > Pv
Zone 2: Pa > PA > Pv
Zone 3: Pa > Pv > PA
What are the 4 Starling forces?
- Hydrostatic of capillaries = filter out
- Oncotic of capillaries = filter in
- Hydrostatic of intersitium = filter in
- Oncotic of interstitium = filter out
What are the two stages of pulmonary edema?
- Interstitial: moves fluid out of capillaries, lymphatics have to over-work, but no affect on alveoli (except maybe during exertion)
- Alveolar: fluid in alveoli, hypoxemic, dyspneic cough up pink and frothy sputum
What are the 4 causes for disruption to normal lung fluid balance?
a. Increased capillary leakiness (ARDS)
b. Increased capillary hydrostatic pressure
c. Decreased lymph function
d. Decreased interstitial pressure (releasing penumothorax)
What are the systolic and diastolic pressures of the pulmonary artery?
Systole: 15-25mmHg
Diastole: 6-12mmHg
What is the mean pulmonary pressure?
< 25mmHg
What is the definition of pulmonary hypertension?
Mean pulmonary arterial pressure > 25mmHg at rest
What gene is most related to pulmonary hypertension?
BMPR2
What are two ways to classify pneumonia?
- community acquired (less virulent) vs. hospital acquired (more virulent)
- opportunistic vs. health care associated
What is the most common way of getting pneumonia?
Inhaling the bacteria from our own mouths.
How does Streptococcus Pyogenes look and stain?
Gram+ cocci in pairs.
What diseases does Streptococcus Pyogenes cause?
Strep throat (acute bacterial pharyngitis), skin infections, scarlet fever, acute glomerulonephritis
What are some important things to know about the virulence factor of Streptococcus Pyogenes?
a. M protein inhibits activation of compliment
b. can lead to TSS
How can you Dx Streptococcus Pyogenes?
Can do a rapid test with a throat swab, but must also do a culture to be sure.
What causes whooping cough, and how does it stain?
small, gram negative bacillus. Bordetella Pertussis.
What does Streptococcus Pneumoniae cause?
Lobar Pneumonia
How does Haemophilus Influenzae look and stain? What meds do we have to treat it?
Gram negative, coccobacillus. It is very resistant to penicillin, must use 3rd generation cephalosporin.
How does Legionella Pneumophila stain, and where does it reside after it infects a host?
Thin aerobic gram negative. It resides in the phagosome, infecting macrophages.
What type of antibiotics is Mycoplasma Pneumoniae resistant to? How is it diagnosed?
Resistant to beta lactam antibiotics.
Diagnose with PCR.
What connective tissue disease is most associated with PAH?
Scleroderma.
What drug is most associated with PAH?
Fen-fen.
What are the 5 known conditions associated with PAH?
- scleroderma (connective tissue disease)
- HIV infection
- Portal hypertension
- Congenital heart disease
- Schistosomiasis
