Monday wk2 Pulm 1 Flashcards
PMN secreted __ is endogenous proteolytic enzyme to hydrolyze elastin in alveolar walls
__ synthesizes A1AT to inhibit this breakdown
elastin is similar in synthesis to _ as it is 1st a large PP precursor
mostly __ AA. proline/lysine are not ___
__ fibers act as scaffold
lysyl oxidase deaminates lysine residues, forming desmosine ___ for the elastic properties
elastase
liver
collagen
nonpolar
hydroxylated
fibrillin
cross links
PAH defined as PA pressure greater than __ mmHg at rest
hereditary is due to inactivating mutation in __ gene transmitted AD w variable penetranc
predisposed to endothelial/smooth muscle __
w second __, dz upregulates endothelin, dec NO/prostacyclin
end result is vasc smooth muscle __, intimal __ and fibrosis, inc pulm vasc __
hypoxic __ seen w COPD/OSA/ILD
25
BMPR2
proliferation
insult
prollif, thickening, resistance
vc
Coccidioides is m_/h_ at low temps, and __ form at high temps
transmitted via __ inhalation
formed via fragmenting __
spherules form and __, releasing endospores to other tissues
5 presentations: acute __, chronc __, pulm /, extrapulm __ dz, and M__
lung dz mostly seen in __ host
__ yeast is present in pigeon droppings
pt w __ at risk for A fumigatas allergic rxn
aka allergic __
cough, dyspnea, migratory _ infiltrates
mold/hyphae, endospore
spherule
hyphae
rupture
PNA, PNA, nodules/cavities, nonmeningeal, meningitis
cyrpto
asthma
pulm
__ aka lecithin is component of surfactant
__ is membrane phospholipid
ratio used in 3rd trimester, which should show rise of __ by type 2 pneumocytes
__ remains unchanged
P__ is another component of surfactant, released at 36 w
chest tubes placed into 4/5th intercostal space at __/__ lines
can cross through S__ muscle, I__ muscles, and __ pleura
phosphatidylcholine
sphingomyelin
Lecithin
sphingo
phosphatidylglycerol
AA, MC
serratus anterior, intercostal, parietal
__ is total volume of air entering resp pathways per minute
TV * RR
__ is new volume entering areas of gas exchange per minute
total volume of dead space is __ dead space, which is anatomic + ___
TV-__ * RR
Each MHC class 1 molecule consists of a heavy chain and assc \_\_ microglobulin heavy chain is highly \_\_ allowing for a large variety of antigens to be presented
MV
alveolar ventilation
physio
alveolar
physio dead space
B2
polymorphic
MHC class 2 molecules consist of __/__ PP chains
respond to antigens digested /in __
activate __ cells for correct immune response
___ stimulates a4b2 nicotinic Ach receptor in the CNS
__ is partial agonist that competes w nicotine
can produce some __ but only mild release of __
used for __ to reduce wdrawal
pt w __ gets transient hyper__ and hypo__ in sleep
reflexive systemic/pulm __
endothelial dysfxn, ab venous return and __ stimulation
A/B
lysosomes
Th
nicotine
Varenicline
activation, DA
cessation
OSA
CO2, O2
VC, SNS
prolonged OSA can lead to __ and RHF
eventually, also get __ HTN due to chronic SNS stimulation and release of __
inc risk of __ comps
right ventricular __ leads to holosystolic murmur at the LLSB
left sided heart failure leads to PAH w pcwp greater than __
__ is VC and promotes smooth muscle prolif
endothelin receptor antags like B/A can be used for PAH to reverse this process
PAH
systemic
NE
cardiac
enlargement
12
endothelin
bosentan/ambrisentan
crytpo is acquired via __
pathogen cleared by __/__ cells in immunocompetent indiv
causes sx in IC indiv, usually M___
pulm form has minimal sx but can be dx as red yeast on __ stain
aspiration in supine indiv usually involves the __ segment of upper lobes or __ segment of lower lobes
upright pt aspirates into the __ segment of RLL
inhalation
Macros, t cells
meningoencephalitis
mucicarmine
posterior, superior
basilar
laplaces law states that smaller spheres will __ as pressure inc, while large spheres will __
surfactant counterracts this, by dec __, to minimize smaller collapse/larger expansion
sx of panic attack caused by dec __
this leads to hypoperfusion to the __ via VC
CO2 is a cerebral __
collapse, hyperexpand
surface tension
CO2
CNS
vasodilator
degree of lung __ affects PVR
inc lung volumes cause __ expansion and stretching of alveolar BV
this inc length and reduces __, leading to inc resistance
dec lung volumes during expiration causes vessels to be __, inc resistance
thus, PVR has __ curve and is lowest at __
__ tract first 10 gen accounts for most airway resistance
remainder of LR tract due to trachea, __ gen of bronchi due to highly turbulent flow
lowest in the __ due to large CSA
distension
alveolar
diameter
compressed
U shape
FRC
UResp (mouth)
2-5
bronchioles
___ synthesized by platelets for __ and platelet __
Leuk C4/D4/E4 cause broncho__ and inc bronchial __ secretion
use low dose \_\_ to prevent PE binds to \_\_\_ to prevent coag large DVT cause \_\_ in PA bifurcation smaller DVT lodge in \_\_ branches, producing \_\_ infarct as bronchial blood hemorrages \_\_ lobes more affected
aspirin blocks __ and platelet agg
used in preventing __ thrombosis and ischemic stroke
thromboxane A2
vasoconstriction, aggregation
spasm, mucus
warfarin AT3 saddle embolus peripheral, hemorrhagic lower
TA2
coronary artery
___ is most common type of lung cancer
arises from __ epithelium and is located peripherally
growth along intact alveolar __ w out invasion
well differentiated, dysplastic __ cells
can produce watery sputum B__
imaging shows __/__
__ is found incidentally on CXR as coin lesion
consists of hyaline __ w CT, SM and fat
Adenocarcinoma in situ alveolar septa bronchorrhea mass/consolidation
hamartoma
cartilage
__ is cx w low absent CD19/CD20 B cells
susceptible to __ bacteria, enterovirus and Girdia
__ is marker of RS for HL
major protease of elastin degredation in the lungs
XLA
encapsulated
CD15
ciliated __ epithelium lines pulmonary airways from trachea to respiratory bronchioles
goes from psuedostratified ciliated columnar to ciliated __ columnar
Ciliated cells present through __ but not alveoli
propels mucus toward __
__ keeps large airways open, but not found in bronchioles
bronchi have Ciliated PS colmnar epithelium w mucin sec __ cells and mucoserous gland
bronchioles lack __/__ and number of goblet cells dec
mucosal
simple
resp bronchioles
pharynx
cartilage
goblet
cartilage/glands
__ is musc agonist inducing bronchoconstriction and inc bronchial mucus prod
detects __ in pt w sx
I__ used for bc in asthma/emphysema
S__ is used for motion sickness
both are muscarinic __
L__ is B2 agonist used in pt w adverse rxn to albuterol
methacholine
asthma
ipratropium bromide
scopolamine
antags
levalvuterol
