Pulm 2.0

Question 1

Lung CA

most common

Answer 1

Adenocarcinoma

Question 2

Lung CA

Central, Necrosis and cavitation

Answer 2

Squamous cell carcinoma

Question 3

Lung CA
Peripheral
Gynecomastia

Answer 3

Large Cell

Question 4

Coin Lesion

hyaline cartilage, connective tissue, smooth muscle, fat

Answer 4

Hamartoma

Question 5

What must you have to ddx sarcoidosis

Answer 5

lung biopsy w/ non-caseating granuloma

Question 6

Baby is born with no surfactant and given o2 as rx. Complications?

Answer 6

o2 therapy in baby–> retinal damage–> blindness

likely mediated by VEGF

*Major cause of blindness in developed world

Question 7

In V/Q what does v and q mean

Answer 7

v= ventilation

q= blood flow

Question 8

Describe lung zone 1 pressures

Answer 8

apex

alveolar> arterial> venous

Question 9

Describe zone 3 pressures

Answer 9

arterial> venous> alveolar

Question 10

Describe lung zone 2 pressure

Answer 10

arterial> alveolar> venous

Question 11

when airway pressure is 0 you are in a resting state. What is the intrapleural pressure

Answer 11

-5 cm H20

Question 12

How can pleura pull air into the lung

Answer 12

resting pleural presure= -5

inspiration= -7.5

-7.5 creates a negative alveolar pressure that draws air into the lung

Question 13

A lot of stuff causes allergic asthma, but rx vs receptor only works for these two things

Answer 13

LTC4, LTD4, LTE4

AcH

Question 14

Do histamine antags help in asthma

Answer 14

No

Question 15

Describe the irritation and changes smoking does to lungs

Answer 15

Normal: pseudostratified ciliated columnar cells

Smoking: columnar is replaced by squamous

Question 16

What does osmium tetroxide do

Answer 16

Stains fat black

Question 17

What stains hemosiderin macs

Answer 17

prussian blue shows iron

Question 18

What strains platelets purple

Answer 18

write stain

Question 19

Who has increased FEV1/FVC

Answer 19

restrictive disease

Question 20

Who has decreased FEV1/FVC

Answer 20

obstructive disease

Question 21

Why is systemic partial pressure o2 less than alveolar partial pressure

Answer 21

because bronchial deoxygenated blood drains into the oxygenated pulm vein

Question 22

Where is there always a left shift in oxy curve

Answer 22

Lungs shift left

↓ H, 2,3 DPG, and Temp

Question 23

What causes a right shift oxy heme curve

Answer 23

↑ H, 2,3- DPG, and temp

Question 24

What can attract PMNs

Answer 24

Leukotriene B4 (and some precursor)
C5a
Il-8

Question 25

What 3 cytokines cause systemic inflammation

Answer 25

Il-1, IL-6, TNF-a

Question 26

What does bradykinin do

Answer 26

Vasodilation Contracts smooth muscle mediates pain ↑ Permeability

Question 27

Where is epo made

Answer 27

peritubular cells of kidneys

Question 28

What does platelet- activating factor do

Answer 28

It does a lot... ``` vasoconstriction bronchoconstriction platelet stimulation enhanced leukocyte adhesion chemotaxis phagocytosis degranulation ```

Question 29

What makes ESR happen

Answer 29

high levels of freely circulating fibrinogen

Question 30

What is SVC syndrome

Answer 30

a mass compresses the SVC and causes facial swelling and upper extremity issues

Question 31

What does second hand smoke do to babies

Answer 31

low birth weight asthma middle ear syndrome SIDS

Question 32

What is characteristic of Primary TB

Answer 32

Ghon complex and ipsilateral hilar adenopathy

Question 33

What causes tracheal deviation TOWARD the lesion

Answer 33

Lung Collapse - atelectasis ex: bronchus obstruction--> obstructive atelectasis--> trachea PULLED in

Question 34

What causes tracheal deviation away from lesion

Answer 34

``` Tension pneumothorax (air cannot exit) excess air/fluid PUSHES trachea ```

Question 35

What is a pleural effusion

Answer 35

excess fluid in pleural layers

Question 36

What is a pneumothorax

Answer 36

Air in pleural space

Question 37

Meconium plug obstructing the intestine preventing the passage of stool

Answer 37

meconium ileus Seen in CF

Question 38

What part of the type 2 pneumocyte makes surfactant

Answer 38

lamellar bodies

Question 39

what are the most common malignancy from asbestos

Answer 39

#1- most common: bronchogenic carcinoma 2- mesothelioma

Question 40

How do you measure the severity of bronchitis

Answer 40

reid index-measurement of mucus enlargement ratio = mucus glands / (epithelial + mucus + ct) normal is 40% does not include thickness of cartilage

Question 41

What causes TB caseous necrosis

Answer 41

macs, giant cells, and CD4 t lymph aggregate--> granulomatous caseous necrosis WBC activation--> collateral tissue damage--> cavitary

Question 42

Why does pancreatitis --> ARDS

Answer 42

pancreatitis has large amount of inflammatory cytokines and panc enzymes in circulation PMNs invade lungs--> leaky alveoli and injury pancreatitis is MAJOR risk factor for ARDS

Question 43

what will small cell lung CA stain for

Answer 43

SCC has neuroendocrine differentiation stains: Chromogranin, synaptophysin, enolase

Question 44

What is hypersensitivity pneumonitis

Answer 44

inhalation of organic material diffuse nodular infiltrates

Question 45

What is responsible for the green color of puss

Answer 45

myeloperoxidase of PMNs

Question 46

what does RA typically do to the lungs

Answer 46

tends to cause a idiopathic interstitial pneumonia like interstitial lung disease- restrictive

Question 47

What is anergy

Answer 47

failure to generate a response with t cells

Question 48

Why does it matter that ACTH and opioids are derived from the same thing

Answer 48

supports theory that stress and opioid axis are related