Monday wk2 Pulm 2 Flashcards
probability of child of parents from 2 pops w different allele carrier freq inheriting an AR disease is __ multiplied by carrier freq
majority of alveolar surface is covered by flat __
remaining portion is covered by cuboidal __
T2 pneumos are source of __/__, and __ in response to injury
__ is primary cell clearing inhaled foreign particles from terminal resp units
L/S ratio measured in premature labor/PROM to determine timing of _ and if __ are needed
1/4
type 1 pneumocytes
type2 pneumos
surfactant, type 1 pneumos
alveolar macros
delivery, CS
Larger droplets of Tb contact tracheal/bronchial epithelium and are __ via cilia
smaller droplets are carried to __ and establish infection, usually in the ___ lobes
mycobacteria are __ by alveolar macros, and __ virulence factor allows for IC bacterial proliferation
this __ macro and allows for cell lysis, allowing subsequent phagocytosis/infection of macros
this Th1 response recruits __ and antigen carrying macros/DC go to lymph nodes (at a month)
become __ macros after losing motility
larger areas will __ and form a Gohn complex
Ab not effective bc Tb is __
removed alveoli, lower engulfed sulfatide kills
other macros
epithelioid
calcify
intracellular
lung apices extend above level of the __ through the superior thoracic aperture
puncture can lead to _/__ ptx, and H__
carotid body found at __ of common carotid artery
clavicle
PTX, tension, hemothorax
bifurcation
Train of four stimlation is used during anesthesia to assess degree of __ by NMJ blocking agent
w nondepolarizing agent like V/P/T used, competitize inhib of post syn AChR shows progressive __ in responses
less __ is released w each impulse due to addtl presynsaptic blockade
w depolarizing blocker like S__, it initially shows __ reduction during phase 1 blockade
presynaptic AchR allows release of __
w subsequent exposure, transition to phase __ blockde has Ach receptors depolarized and present similarly to nondepolarizng blockers
used for anesthesia bc of __
paralysis
vecuronium, pancuronium, tubocurarane, reduction
Ach
succinylcholine, equal
Ach vesicles
2
rapid onset
acute bronchial constriction during asthma begins w __ activation after interaction w IgE antibodies or other trigger
releases __ causes bronchail __/__, and inc __ prodxn
C/N inhibit mast cell degranulation by stopping release of mediators
P__ agent
anti IgE antibody O__ prevents IgE binding to mast cell
GC inhibit __ to stop release of meidatiors
Z is inhib of Leuk pathway
Z/M are LD4 inhibs
mast cell
mediators, constriction/edema, mucus
cromolyn, nedocromil
prohylactic
Omalizumab
Phsopholipase A2
Ziluteon
Zafirlukast, montelukast
adequate __ is necessary for maintaing O2 and CO2 excretion
to reduce work, TV and RR are optimized by __
work done against elastic resistance inc when __ is inc
work done against airflow resistance is inc w __ freq inc
pt w restrictive lung dz has minimal work of breathing w __ rr and __ TV
diseases w airflow resistance (OLD) pt have less work at __ rate
MV
control centers
RV
breathing
high, minimal
slow, deep
flagella/cilia have central __ w circular array of microtubule doublets and 2 central microtubules
anchored to cell by ___
doublet connected to __ arms containing an ATPase for energy to slide MT past each other
IL__ and __ fxn in IgE class switching
asthma may be caused by excess __ cell activity relative to Th1
IL1 released by CD4 t cells to stimulate T cell __ or secrete __
__ is involved in tissue regen and repair
axoneme
basal body
dynein
4, 13
Th2
prolif, lymphokines
TGFB
alveolar transmural pressure is always __
chest wall transmits expanding force, so __ transmural pressure
the forces opposed equally at __ where airway pressure is 0
at FRC, pressures oppose each other for a __ IP pressure to -5
w inspiration, pressure __ and air is brought into alveoli
thus is seen esp in __ as pleura communicates w atmosphere, and air __ pleural space
positive
negative
FRC
negative
drops
PTX, enters
__ lung cancer is more common in women/nonsmokers
tumor cells form __/__ structures peripherally
Assc w C/H
__/__ strong assc w smoking
__ carcinoma is extremely aggressive
__ carcinoma affects larger bronchi and arises from areas of __ bronchial metaplasia
SCLC arises from __ of bronchial epithelium
__ carcinoma may have features of adeno/SCC
large __ that form solid sheets/nests
usually located __
assc w G/G
adenocarcinoma
gland/papillary
clubbing, hypertrophic osteodystrophy
SCLC, SCC
SCLC
SCC, squamous
basal cells
large cell
polygonal cells
peripherally
galactorrhea, gynecomastia
___ PE in small arteries most likely to cause infarct due to watershed location
__ is primary mech for removing inhaled particles
mucus/fluid secreted onto epithelial surface to trap particles __ in air
clearance of particles that lodge distal to terminal bronchioles is dependent on phagocytic clearance by __
__ are found on alveolar wall for gas exchange
distal
mucociliary clearance
suspended
alveolar macros
T1 pneumocytes
Mycoplasma attaches to resp epithelium via __ surface antigens
these antigens also present on __ membranes
pt can develop cross reactive __ antibodies that attach to RBC, activate complement and cause __
called __ agglutinin bc it occurs at low temps
also seen in __/__
surfactant is deficient in __
results in __ due to inc surface tension
surfactant is stored/transported via __ bodies which cntain parallel lamella
released via __ into alveolar spaces
I antigen RBC IgM lysis cold
mono, hematologic malignancies
neonatal RDS
atalectasis
lamellar
exocytosis
partial pressure of O2 in alveoli is normally ___
blood pO2 in systemic circulaton is __ due to addition of deoxy blood
difference is termed __ gradient
normal value is less than __
greater numbers indicate __ w thickening of alveolar membranes
or __ mismatch w poor ventilation
If A-a gradient is normal but values are low, must be due to alveolar __ or inspiration of __ air
104
less
A-a
15
diffusion impairment
V/Q
hypoventilation, high altitude
patchy inflamm of a number of lobules is __ PNA
in __ PNA, infiltrate is confined to alveolar walls
when PNA involves entire lobe, it is __
Congestion: lobe is __ heavy and boggy
vascular __ and alveolar exudate contains __
Red hepatization: lobe is red and __
exudate contains __, PMN, fibrin
grey hepatization: lobe is __
RBC __, exudate mostly PMN/fibrin
resolution: looks __
__ digestion
Bronchopneumonia
interstitial
lobar
red
dilation, PMN
firm, RBC
pale
disintegrate
normal, enzymatic
aerobic exercise homeostatic mechanism maintain arterial / contents and arterial pH
more effects on __ circ
muscles extract excess __, so venous blood is __
venous blood CO2 is __, due to inc prodxn
venous pH is ___
CO2, O2
venous
O2, def
inc
low
__ is facultative gram neg bacillus
sx include high _ and cough, cofunsion, diarrhea
labs show low __ and inc __
pulm infiltrates/bronchiectasis in pt w asthma, high eosin, IgE, aspergillus ab is ___
Mycoplasma more likely to cause T__
xray looks __ than clinical sx
Legionella
fever
Na, LFTs
ABA
tracheobronchitis
worse
nasopharyngitis includes nasal __ and discharge, sore throt
caused by R/I/C
laryngotracheitis has URI sx followed by __ and stridor
virus is __ part of paramyxoviridae
stridor caused by __ tissue obstructing airway
URI followed by wheezing, cough is __ caused by RSV
congestion
rhinovirus, influenza, coronavirus
barky cough
parainfluenza virus
subglottic
bronchiolitis
paroxysmal breathing and wheezing in young pt w/out hx of aspirin, infect, inhalation, stress/exercise is __ allergic asthma
look for high __ w granule containing cells
and crystalloid bodies from __ crystals
dx is crhonic E___, due to high Eosin, IL5 released by __ cells
extrinsic
eosinophils, Charcot leyden
eosinophilic bronchitis
Th2 cells
__ is pattern of breathing w rising then falling tidal volume
usually seen in __/__ pts
pt has chronic __ w hypocapnia inducing apnea during sleep
OSA presents w reductions/cessation in airflow w minimal __ in TV
depth/rate of respirations determined by __ resp center w input from central/peripheral receptors
inc __ is major stimulator of central (medullar) chemoreceptors
__ chemoreceptors can respond to low O2
pulm strech receptors are myelinated/unmyelin _ fibers
regulate duration of __
cheyne stokes
CHF, CNS
hyperventilation
variation
medullary
CO2
peripheral
C
inspiration
__ is primary stimulator of resp
in COPD pt, tolerant to CO2 so they respond to __
only yeast that can survive inside macros and cause systemci dz is __
disseminated can cause __ due to preference for mononuclear phagocyte system
CXR will show \_\_, resembling Tb may present w painful \_\_ in IC pt aspirate shows round/oval \_\_ inside macros culture on agar shows \_\_ detect in blood/urine via \_\_
CO2
hypoxemia
Histo
HSM
hilar adenopathy
oral ulcers
yeast
hyphae
antibodies
Hb carries CO2 as __ and HCO3
CO2 produced via respiration enters RBC and is ___ to form H2CO3 via CA
bicarb ions usually leave RBC into plasma, and neutrality maintained via __ diffusing into RBC
process called __
carbamate
hydrated
Cl
chloride shift
arterial __ is main indicator of total alveolar ventilation
thus, if CO2 is low, alveolar __ is occurring
upper airway obs, reduced ventilation, resp muscle fatigue lead to __ and inc CO2
__ is yeast w thick wall
small ovoid, budding yeast is __
budding yeast w pseudohyphae is __
broad hypae w irregular branching and rare septations is __
CO2
hyperventilation
hypoventilation
blasto
histo
candida
mucor
_ forming bacteria survive boiling temps
think B/C
Emphysema causes __ of interalveolar walls and dec lung __
CB has airway __ and __ hypersecretion to limit airways
DLCO may be normal in __ but is dec in empysema
lung volumes are typically greater in __
spore
bacillus/clostridium
destruction, recoil
inflam, mucus
CB
emphysema
any adult w out boosters and acute tracheobronchitis think __
__ phase has URI sx
__ phase has severe spells and post tussive emesis
__ phase has improvements
B pertussis is gram _ and C__
Pertactin is point for __ and promotes __ to ciliated UR epi
tracheal __ results in damage/cough
pertussin toxin stimulates __ preventing phagocytosis and allows organism to survive
Lymphocytosis induced by _toxin
pertussis catarrhal paroxysmal convalescent neg, coccobaccilus vaccine, adherence
cytotoxin
AC
pertussis
_ may cause atypical PNA w ear pain
prominent intranuclear inclusions w clear halo is pathognomonic for pulm __
Secondhand smoke inc risk of S__, __ ear dz, A/resp tract infections
SIDS is death of healthy infant during __
Mycoplasma
CMV
SIDS, middle, asthma
sleep
Pulm __ occurs in lower lobes of alcoholics
gram __ anaerobic bacteria
dx w filamentous, __ pattern and ___ granules staining purple formed by mycelial frags
tx w __
lung __ can present w pulm consolidation and air bronchograms
cells are Cuboidal to low __
pleomorphic, hyper__ w prominent n__
actinomyces positive branching sulfur penicillin
adenocarcinoma
columnar
chromatic, nucleoli
central collection of clustered epitheliod macros surrounded by rim of mononuclear cells is __ granuloma
__ response
___ stimulates Th1, __ activates macros
Sarcoid due to accumulation of __ and oligoclonal expansion
pleural thickening, calcified pleural plaques in the 6-9 ribs indicates ___ exposure
may progress asbesotis, w chronic lower lobe __
noncaseating
Th1
Il2, IFNG
CD4 t cells
asbestos
fibrosis
__ pleura covers lungs but does not have pain fibers
__ pleura covers thoracic wall
__ pleura covers mediastinum
__ pleura reflects on diaphragm
__ pleura extends into neck
PNA can cause shoulder pain due to __ damage if located in _/__ pleura
sensory innervation of rest of pleura felt via __ nerves, pain felt closer to location
visceral
costal
mediastinal
diaphragmatic
cervical
phrenic nerve, mediastinal/diaphragmatic
intercostal
#1 diagnostic test for PE is \_\_ avoid in pt w \_\_ failure due to risk of contrast neohropathy instead, perform \_\_
tx for neonatal RDS is supplemental __, nasal __ and MV w __
hypoxia n the retina can upregulate __, leading to neovasc and retinal detachment upon return to room air
called retinopathy or prematuriy of __ fibroplasia
CT angiography
renal
VQ perfusion scan
O2, CPAP, surfactant
VEGF
retrolental
T__ is B agonist used to delay labor/delivery by stopping uterine contractions
SE include neonatal __, hypo__/__ and I
terbutaline
IVH, gly/Ca, ileus
