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Step 1 > PP Pulmonary > Flashcards

PP Pulmonary Flashcards

0
Q

What color is air on an x-Ray?

A

Black “radiolucent”

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1
Q

What is the difference between a carotid body and a carotid sinus?

A

Body: chemoreceptors
Sinus: baroreceptors

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2
Q

What color is fluid/solid on x-Ray?

A

White “radiopaque”

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3
Q

What disease has a steeple sign on neck film?

A

Croup

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4
Q

What disease has a thumb sign on neck film?

A

Epiglottitis

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5
Q

What is a “blue bloater”?

A

Bronchitis

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6
Q

What is a “pink puffer”?

A

Emphysema

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7
Q

What disease have pulmonary eosinophilia?

A

Aspergillosis

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8
Q

What drugs cause pulmonary eosinophilia?

A

Nitrofurantoin

Sulfonamide a

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9
Q

What are the risk factors for lung cancer?

A

Smoking
Radon
2nd hand smoker
Pneumoconiosis (except anthracosis)

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10
Q

What disease have hemoptysis?

A 
Bronchiectasis 
Bronchitis
Pneumonia
TB
Lung cancer
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11
Q

Where is a Bokdalek hernia?

A

Back of diafragma

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12
Q

Where is a Morgagni hernia?

A

Middle of diafragm

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13
Q

What disease have respiratory alkalosis?

A

Restrictive lung Dz ( anxiety, pregnancy, Gram - sepsis, PE)

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14
Q

What disease have respiratory acidosis?

A

Obstructive lung Dz

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15
Q

What disease have metabolic alkalosis?

A

Low volume state ( vomiting, diuretics, GI blood loss)

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16
Q

What disease have metabolic acidosis?

A

Acid production ( MUDPULES, RTA II, Diarrhea)

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17
Q

What does stridor tell you?

A

Extrathoracic narrowing => narrows when breath in => neck x-Ray

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18
Q

What does wheezing tell you?

A

Intrathoracic narrowing => narrows when breath out => chest x-Ray

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19
Q

What does rhonchi tell you?

A

Mucus in airway => OLD

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20
Q

What does grunting tell you?

A

Blows collapsed alveoli open => RLD

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21
Q

What does dull percussion tell you?

A

Something b/w airspace and chest wall absorbing sound ( fluid or solid)

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22
Q

What does hyperresonance tell you?

A

Air in lung

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23
Q

What does tracheal deviation tell you?

A

Away from pneumothorax OR toward atelectasis “ air phobic”

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24
Q

What does fremitus, egophony and bronchophony tell you?

A

Consolidation “pathognomonic for pneumonia”

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25
Q

What is RLD?

A

Small stiff lungs

Trouble breathing in

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26
Q

What is OLD?

A

Big mucus-filled lungs

Trouble breathing out

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27
Q

What is Epiglotitis?

A

X-Ray thumb sign

Drooling

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28
Q

What is Croup?

A

X-Ray steeple sign

Barking cough

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29
Q

What is tracheitis?

A

Look toxic
Grey pseudomembrane
Leukocytosis

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30
Q

What is Asthma?

A

Wheeze on expiration
IgE
Eosinophils

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31
Q

What is bronchiolitis?

A

Asthma in kids < 2y/o

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32
Q

What is Sinusitis?

A

Teeth pain worse with bending forward

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33
Q

What is Bronchiectasis?

A

Bad breath
Purulent sputum
Hemoptysis

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34
Q

What is Bronchitis?

A

Lots of sputum
“Blue bloater”
Cough for >3 month per year for >2 years

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35
Q

What is Emphysema?

A

Restrictive to Obstructive pattern
“Pink puffer” barrel-shaped chest
Decrease recoil

36
Q

What is Laryngomalacia?

A

Epiglottis roll in from side to side
The bulky arytenoid cartilage prolapse anteromedially on inspiration resulting in stridor ( 6 pharyngeal arch is responsible for the formation of these structure)

37
Q

What is Pneumonia?

A

Consolidation of airway

38
Q

What in Pneumothorax?

A

Decreased breath sound on one side

39
Q

How do you detect a Pulmonary Embolus?

A

Tachypnea
Increased V/Q scan
EKG: S1Q3T3

40
Q

What is Tamponade?

A

Decreased breath sound/ BP

Increased JVD

41
Q

What is Tracheomalacia?

A

Soft cartilage

Stridor since birth

42
Q

What is Cystic Fibrosis?

A

Meconium ileus
Steatorrhea
Bronchiectasis

43
Q

What is Aspergillosis?

A

Allergy to: mold, dead plants, compost piles

44
Q

What is Silicosis?

A

Sandblasters
Glassblowers
Icrease susceptibility to TB

45
Q

What is Byssinosis?

A

Cotton workers

Chest tightness

46
Q

What is berylliosis?

A

Radio

TV welders

47
Q

What is Anthracosis?

A

Coal workers
Massive fibrosis
Black lung

48
Q

What is Sarcoidosis?

A

Non-caseating granulomas

Eggshell calcification of lymph node

49
Q

What is Carcinoid syndrome?

A

Flushing
Wheezing
Diarrhea

50
Q

What is Small cell CA?

A 
At carina 
Malignant
Cushing's 
SIADH
SVC syndrome
51
Q

What is Large cell CA?

A

Periferal
Large stuff
Poor prognosis

52
Q

What is Squamous cell CA?

A 
Central
Smoker
High PTH
High Ca
Cavitation
Kerating pearls
53
Q

What is Broncheoalveolar CA?

A

Looks like pneumonia; due to pneumoconiosis

54
Q

Embryologic structure that form the diafragm

A

Septum transversum
Pleuroperitoneal mm
Dorsal mesentery of the esophagus
Abdominal wall

55
Q

Who innervates the diaphragm?

A

The phrenic nerve by C3,C4 and C5

56
Q

What structures perforated the Diaphragm?

A

T8 - IVC
T10 - esophagus and vagus nerve
T12 - aorta, thoracic duct and azygos vein

57
Q

Muscles of respiration in Quiet breathing?

A

Inspiration: Diaphragm
Expiration: passive

58
Q

Muscles of respiration in Exercise?

A

Inspiration: external intercostals, scalene, sternocleidomastoids
Expiration: rectus abdominis, internal and external obliques,
transversus abdominis, internal intercostals

59
Q

Hypoxemia?

A

Decrease PaO2

  • normal A-a gradient { high altitude, hypoventilation}
  • increase A-a gradient { V/Q mismatch, diffusion limitation, R to L shunt, pulmonary fibrosis}
60
Q

Hypoxia?

A

Decrease O2 delivery to tissue

  • Decrease CO
  • Hypoxemia
  • Anemia
  • CO poisoning
61
Q

Ischemia?

A

Los of blood flow

  • impeded arterial flow
  • reduce venous drainage
62
Q

How the body compensate hypoxia at high altitude?

A

Increase of

  • ventilation
  • ematopoyesis
  • renal excretion of HCO3
  • mitochondrial tissue
  • 2,3-DPG
63
Q

What enzyme converts CO2 in to HCO3?

A

Carbonic anhydrase

64
Q

Virchow’s triad?

A

Stasis
Hypercoagulability
Endothelial damage

65
Q

Which are the OLD?

A

Chronic bronchitis
Emphysema
Asthma
Bronchiectasis

66
Q

Two type of emphysema?

A

Centriacinar - smoking

Panacinar - alfa1-anti trypsin defi

67
Q

Asbestosis?

A

Pluming
“Ivory white” calcified pleura
Associated with Carcinoma y Mesothelioma
Iron containing nodules in alveoli

68
Q

Adenocarcinoma?

A

Periferal
MC lung cancer
K-Ras mutation

69
Q

Mesothelioma?

A

Malignancy of the pleura associated with Asbestosis

Histology: Psammoma bodies

70
Q

Pancoast tumor?

A

Carcinoma that occur in the apex of the lung

Affect cervical sympathetic plexus, causing Horner’s syndrome ( Ptosis, miosis, anhidrosis)

71
Q

Which are the 1st generation H1blocker?

A

Diphenhydramine
Dimenhydrinate
Chlorpheniramine
*LIPOPHILIC SEDATION

72
Q

Which are the 2nd generation H1blocker?

A 
Loratadine
Fexofenadine
Desloratadine
Cetrizine 
*LIPOPHOBIC LESS SEDATING
73
Q

Which are the Asthma drugs Beta-agonists?

A 
Short acting agonist :
- albuterol
- methaproterenol
- terbutaline 
Long acting agonist :
- salmterol ( combined with corticosteroids as prophylactic)
- formoterol
74
Q

Function of the Asthma drugs Theophylline ?

A

Bronchodilator by inhibit PDE to increase cAMP

Blocking Adenosine receptors

75
Q

Which are the Asthma drugs Muscarinic antagonists?

A

Ipratropium

76
Q

Ipratropium?

A

Preventing bronchoconstriction
For COPD
Long acting Muscarinic antagonist

77
Q

Corticosteroids for Asthma?

A

Beclomethasone
Fluticasone
* 1st line therapy for Chronic Asthma

78
Q

Mechanism of corticosteroids?

A

Inhibits synthesis of cytokines

  • by inhibiting phospholipase A2
  • inactivation of transcription factor NF-kB -> decrease TNF gama
79
Q

Antileukotrienes?

A

Montelikast, Zafirlukast
- block leukotriene (LTD4) receptor
Zileuton
- inhibidor of 5-lipoxygenase pathway( blocks the convention of arachidonic acid to leukotriene)

80
Q

Omalizumab?

A

Monoclonal anti-IgE antibody

81
Q

Which are the expectorant?

A

Guaifenesin ( expectorant- thins respiratory secretions, do NOT suppress cough reflex)
N-acetylcysteine ( mucolytic)

82
Q

Bosentan?

A

Treat Pulmonary Artery Hypertension ( antagonizes endothelin-1 receptor)

83
Q

Dextromethorphan?

A

Antitussive

Synthetic codeine analog

84
Q

Which are the nasal decongestant?

A

Pseudoephedrine

Phenylephrine

85
Q

Which are the types of pneumonia?

A

Lobar
Bronchopneumonia
Interstitial

86
Q

Organism causing Lobar pneumonia?

A

S. pneumoniae

Klebsiella

87
Q

Organism causing Bronchopneumonia?

A

S. pneumoniae
S. Aureus
H. Influenza
Klebsiella

88
Q

Organism causing Interstitial pneumonia?

A

Virus ( influenza, RSV, adenovirus)
Mycoplasma
Legionella
Chlamydia

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