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pulm Flashcards

1
Q

mechanism of action of cromolyn

A

inhibits mast cell degranulation

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2
Q

most common bacteria causing PNA

A

strep pneumo

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3
Q

rifampin monotherapy

A

N meningitis prophylaxis for those know to be exposed

used with other meds in pulm infxn because high occurrence of resistance

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4
Q

tx for idopathic pulmonary arterial hypertension while awaiting transplant

A

Bosentan
competitive antagonist of endothelin receptors

endothelin= vasconstrictor that stim endothelial proliferation
tx decreases pulmonary arterial pressure and lessens progression of vascular and R ventricular hypertrophy

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5
Q

rifampin mechanism of action

A

inhibits DNA dependent RNA synthesis–> no transcription

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6
Q

What does the acid fast stain bind

A

mycolic acid

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7
Q

effect of COPD on cerebral vasculature

A

COPD–> increased CO2 and decreased O2
brain needs more O2 so it decreases cerebral vascular resistance.
Cannot increase O2 by increasing flow because brain will swell–> bad

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8
Q

Where on the lung capacity curve is the Pulm Vasc Resistance the lowest

A

at the Function residual capacity

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9
Q

stim of vagus nerve to the lung

A

parasympathetic stim with ACh acting on M3 receptors–> bronchoconstriction and increased mucous secretion–> increases work of breathing

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10
Q

what things can cause decreased pulmonary compliance

A

lung cannot stretch well

pulmonary fibrosis
pulmonary edema (like from heart failure)
insufficient surfactant

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11
Q

mucicarmine stain

A

Cryptococcus neoformans

detects polysaccaride capsule (stains red)

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12
Q

what enzyme is functioning in the nuclelous?

A

RNA polymerase I making rRNA

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13
Q

treatment for RSV Viral bronchiolitis

A

use ribavarin for this with immunodeficiency, prematurity, or cardiopulm disease

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14
Q

cystic fibrosis is what kind of transmembrane receptor?

A

ATP gated chloride channel

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15
Q

Why is clindamycin a good Abx for drunk with aspiration PNA?

A

covers anaerobic oral flora and aerobic bacteria

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16
Q

Varenicline mechanism of action

A

aka chantix

partial agonist of nicotinic ACh receptors
decreases withdrawal cravings and rewarding effects of nicotine

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17
Q

pleasure and addiction center of the brain

A

nucleus accumbens

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18
Q

obstructive sleep apnea likely to develop?

A

pulmonary HTN

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19
Q

where is the pulmonary lesion in secondary TB?

A

apical lesion

20
Q

lower lobe lung lesion with calcified lymphnode on the same side

A

primary TB

21
Q

vitamin deficiency cause of squamous metaplasia of epithelium to keratinizing epithelia

A

Vit A deficiency

Vit A required for normal differentiation of epithelial cells

22
Q

cause of the color in green sputum or pus

A

myeloperoxidase is released from neutrophil granules

it contains heme pigmentation and is blue green

23
Q

stabbed in the L fifth intercostal space, mid clavicular line

A

will hit L lung and possibly L ventricle if deep enough

24
Q

mechanism of action of N-acetylcysteine in CF

A

breaks disufide bonds within mucous–> loosens mucous

25
Q

mechanism of tissue damage in M tuburculosis

A

type 4 hypersensitivity

26
Q

what is the molecular abnormality of CF?

A

abnormal post translational processing of CFTR–> sents protein to proteosome instead of membrane

27
Q

mechanism of action of streptomycin

A

inhibits initiation of protein synthesis by bind and distorting prokaryotic ribsome 30s

28
Q

What factors involved in asthma have symptoms relieved when treated with antagonists

A

leukotrienes C4, D4, E4, and Ach

29
Q

acid fast bacteria in HIV pos with CD4 count of 40

A

MAC

30
Q

treatment and prophylaxis of MAC

A

prophylaxis: Azithromycin
treatment: clarythromycin or azithromycin with rifabutin or ethambutol

31
Q

What is the measure of pathological index for chronic bronchitis?

A

Reid Index:
thickness of mucus gland layer / total bronchial wall thickness

normal is 0.4

32
Q

mechanism of action of ethambutol

A

inhibits carbohydrate polymerization of peptidyglycan cell wall

33
Q

major causes of hypoxemia (low PaO2)

A

alveolar hypoventilation
ventilation/perfusion mismatch
diffusion impairment
R to L shunting

34
Q

hypoxemia with normal A-a gradient

A

alveolar hypoventilation

35
Q

what nerve is located in the piriform recess?

A

internal laryngeal nerve, branch of vagus

cough reflex

36
Q

selective beta blockers

A

metoprolol, atenolol, esmolol, acebutolol

37
Q 
at high elevation
pH
PaO2
PaCO2
HCO3
A 
pH elevated (blowing off most CO2)
PaO2 decreases (approx 60)--> increased drive for ventilation
PaCO2 decrease (blowing off CO2 because of increased resp drive)
HCO3 decreased (losing HCO3 to compensate for resp alk)
38
Q

What is the mechanism of Amphotericin B toxicity?

A

binds to cholesterol

prefers fungal ergosterol, but still binds cholesterol to some degree

39
Q 
what are the PFTs in COPD
FVC
FEV1
Residual vol
TLC
residual vol/TLC increased
A 
FVC decreased
FEV1 decreased
residual vol increases (lots of air trapped in there)
TLC idncreased
Residual vol/TLC increase
40
Q

cytokines that mediate systemic inflammatory response

A

TNF alpha
IL 1
IL 6

41
Q

mechanism behind increased ESR in inflammatory response

A

TNF alpha, IL 1, IL6 stimulate release of acute phase proteins (fibrinogen).

increased fibrinogen–> increased ESR

42
Q

what is the last trait of bronchiole epithelium that disappears as the airways branch

A

cilia

43
Q

what is the mechanism of pulmonary abscess?

A

lysosomal enzymes released from neutrophils and macrophages

44
Q

Mechanism of action of Ipratroprium

A

ACh blocker

inhibits vagus mediate bronchoconstriction

45
Q

s/p lung transplant
fibrotic obstruction of the terminal bronchioles
necrosis lymphcytic inflammation

A

chronic rejection

remember (16 decks)

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