Pulm 1 Flashcards
Rubber like qualities of elastin due to…?
Extensive cross linking between elastin monomers
Facilitated by lysyl oxidase
Legionnaire’s disease clinical findings
Affects smokers
- Very high fever
- Diarrhea
- HA, confusion (CNS findings)
- Lab studies = hyponatremia
G(-) rod – not detected on gram stain
Most common form of CF
- Mutation in CFTR gene
- Causes defective post-translational folding and glycosylation
- Result => degradation of membrane protein before it reaches cell surface
∆F508 mutation
Kartagener syndrome triad
- Situs inversus
- Chronic sinusitis
- Bronchiectasis
Pathophysiology of Kartagener syndrome
Primary ciliary dyskinesia
Mutations => failure to form dynein arms in cilia => immotility
Recurrent resp infections, infertility (sperm in men, fallopian tubes in women)
PE is associated with what on an ABG?
Respiratory alkalosis
Centriacinar emphysema inflammatory infiltrate…?
PMNs
Alveolar macros
Release proteinases!
Why does pus/sputum turn green because of a bacterial infections?
Presence of myeloperoxidase
- blue/green heme-based enzyme
- released from PMN azurophilic granules
- Forms hypochlorous acid
Most common non-small cell lung cancer
- Adenocarcinoma
- Found in women and non-smokers
Which lungs cancers are associated with smoking?
Squamous cell carcinoma
Small cell carcinoma
Adenocarcinoma
- Women/non-smokes
- Located peripherally
- Consists of tumor cells that form glandular or papillary structures
Mycobacterium avium complex
MAC
- Common opportunistic infection
- Causes disseminated disease in HIV+ pts
- CD4+
Cromolyn & nedocromil MOA
- Inhibit mast cell degraulation (prevents release of histamine)
Prevent acute attacks
Less effective than inhaled steroids
Considered 2nd-line for tx of allergic rhinitis and bronchial asthma
Pleuritic chest pain
- Sharp, localized, often severe
- Can be due to PNA
- Exacerbated by coughing, breathing, or changing position
- Worse on inspiration
- Results from any inflammation of the pleura
Referred pain from pleuritic chest pain
C3-C5 distribution (based of neck and over the shoulder)
Phrenic nerve irritation
Diaphragmatic and mediastinal pleura pain fibers
Cancer associated with asbestos exposure?
MOST COMMON:
Bronchogenic carcinoma
Less common:
malignant mesothelioma
Epiglottitis presentation (sx)
- Acute fever
- Inspiratory stridor
- Drooling
- Odynophagia
- (+) “thumb sign” on lateral cervical x-ray (b/c of edema)
H Flu vx develops Abs to what?
- Polyribosyl-ribitol-phosphate (PRP
- Response to capsular material
Facilitates complement-dependent phagocytosis and killing through opsonization
Methacholine
- Cholinergic muscarinic agonist
- Commonly used as an inhaled test substance for pts thought to have asthma
What is diffusing capacity?
- How much oxygen travels from alveoli to blood stream
- Decreased diffusing capacity = destruction of alveoli and adjoining cap beds
How do you measure fetal lung maturity via amniotic fluid?
Lecithin (phosphatidylcholine) : Sphingomyelin (L/S ratio)
Via amniotic fluid, how do you know when fetal lungs are mature?
L/S ratio is 2:1 or higher
Lecithin sharply increases after 30 weeks gestation
Two types of CD4+ T-helper cells
Th1
Th2
What does Th1 secrete?
- gamma-interferon
- IL-2
- others
What does Th1 activate?
- Macros
- CD8+ cytotoxic T-cells
Think type 4 delayed hypersensitivity
What does Th2 secrete?
- IL-4
- IL-13
- IL-5
What does Th2 activate?
- B-cell Abs
IL-4 and IL-13 do what?
Class switching to IgE
IL-5 does what?
Activates eosinophils
IgA synthesis
