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A_First Aid Random Memorizing > Pulm > Flashcards

Pulm Flashcards

1
Q

when and from where does lung development come from

A

distal end of respiratory diverticulum during week 4

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2
Q

errors in which stage of development can lead to tracheoesophageal fistula

A 
embryonic stage (week 4-7)
this is because trachea, mainstem bronchi, and lobar/segmental bronchi develop
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3
Q

when do terminal bronchioles develop

A

pseudoglandular (week 5-17)

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4
Q

when is respiration capable

A

25 weeks

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5
Q

when do alveolar ducts and prominent capillary network develop

A

cannalicular (week 16-25)

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6
Q

What stage do pneumocytes and SURFACTANT start

A

saccular (week 26-birth)…mature levels of surfactant not there until 36 weeks

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7
Q

how long does it take for all adult alveoli to develop

A

8 years (300-400 million alveoli)

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8
Q

congenital diaphragmatic hernia and bilateral renal agenesis assocaited with…

A

pulmonary hypoplasia

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9
Q

recurent respiratory infections, airway compression, discrete round sharply defined fluid filled densities on CXR

A

bronchogenic cysts (abnormal budding of foregut and dilation of terminal/large bronchi

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10
Q

purpose of club cells

A

secrete component of surfactantm degrade toxins, act as reserve cells

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11
Q

what type of pneumocytes make up 97% of alveolar surface

A

type I, thin and optimal for gas diffusion

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12
Q

components of surfactant

A

mix of lecithins (most important one is dipalmitoylphsphatidylcholine - DPPC)

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13
Q

formula for collapsing pressure

A

(2 x surface tension)/radius
so decrease collapsing pressureby decreasing surface tension
alveoli more likely to collapse during EXPIRATION

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14
Q

these cells secrete surfactant from lamellar bodies, are cuboidal and clustered and are precursors to type I and type II cells

A

type II pneumocytes

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15
Q

how does surfactant affect lung recoil and compliance

A

decrease recoil, increase compliance

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16
Q

which cells proliferate during lung damage

A

type II pneumocytes

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17
Q

prenatal screening has decreased Lecithin/sphingomyelin ratio in amniotic fluid (<1.5)…risk for….

A

neontal respiratory distress syndrome (NRDS) (surfactant deficiency leading to increasd surface tension and alveolar collapse)

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18
Q

what cardiac complication is NRDS prone to

A

PDA (due to persistantly low O2 tension)

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19
Q

gi complication of NRDS

A

NEC

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20
Q

risk of giving O2 in NRDS

A

RIB

retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary displasia

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21
Q

components of large airways

A

nose, pharynx, larynx, trachea, bronchi

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22
Q

components of small airways

A

bronchioles and terminal bronchioles (least airway resistance here due to largely parallel orientaiton)

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23
Q

large and small airways are called “anatomic dead space” why?

A

do not participate in gas exchange

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24
Q

cellular make up of conducting zone

A

cartilage and goblet cells extend to end of bronchi

psuedostratified clilated columnar in bronchus which transition to cuboidal as you leave terminal bronchioles

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25
Q

where to airway smooth muscle cells extend

A

until the end of terminal bronchioles

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26
Q

What makes up the respiratory zone

A

respiratory bronchioles, alveolar ducts, alveoli (all participate in gas exchange)

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27
Q

Cellular make up of respiratory zone

A

mostly cuboidal in respiratory bronchioles then transition into simple squamous cells in alveoli

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28
Q

where to cilia terminate

A

repistoary bronchioles

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29
Q

where to cartilage and goblet cells extend to

A

end of bronchi

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30
Q

what cell type is found in brochioles, terminal bronchioles, and respitaory bronchioles

A

club cells! “clara cells”

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31
Q

which lung has the lingula

A

left lobe

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32
Q

What is the relation of carina to ascending and descending aorta

A

carina (split of right and left bronchus) is posterior to ascending aorta and anteromedial to descending aorta

33
Q

Which side does aspirations tend to occur more and why

A

right side because mainstem bronchus is more wide,shorter, and more vertical than the left

34
Q

where do things aspirate when you’re supine vs standing

A

supine - upper right lobe, posterior

standing - basal segment of right lower lobe (preferentially)

35
Q

What does RALS mean

A

refers to relation of pulmonary artery to bronchus
in right lung, pulmonary artery is right of bronchus
in left lung, pulmary artery is superior to bronchus

36
Q

What penetrates diaphragm at T8

A

IVC, right phrenic nerve

37
Q

What penetrates diaphragm at T10

A

esophagus, vagus nerve (CN 10, 2 trunks)

38
Q

What penetrates diaphragm at T12

A

aorta (red), thoracic duct (white), azygos vein (blue)

39
Q

whre does the common carotid bifurcate

A

C4

40
Q

where does the abdominal aorta bifurcate

A

L4

41
Q

where does the trachea bifurcate

A

T4

42
Q

where can pain from diaphragm radiate

A

shoulder (C5) and trapezius ridge (C 3,4)

43
Q

lung volume that can’t be measured by spirometry

A

any measurement that includes RESIDUAL VOLUME

44
Q

air that can be inhaled after normal exhalation

A

inspiratory capacity

45
Q

air that can still be breathed in after normal inspiration

A

inspiratory reserve volume

46
Q

air that can be breathed out after normal expieration

A

expiratory reserve volume

47
Q

how to calculate inspiratory capacity

A

IRV + TV

48
Q

how to calculate vital capacity

A

TV + IRV + ERV….volume of air that can be exhaled after MAXIMAL respiration

49
Q

how to calculate volume of physiologic dead space

A 
(Taco) x (Peco - Paco)/Paco
Vt X ([Peco-Paco)/Paco)
50
Q

How to calculate FRC (functional residual capacity(

A

volume of air left in lungs after normal expiration

51
Q

chest tube placement at 5th intercostal space at mid axilarry line pierces what muscle

A

serratus anterior

52
Q

how do high altitudes affect blood pH, PaO2, PaCO2, and plasma HCO3 when you’re there for more than 2 days

A

high altitude = less PaO2 = trigger hyperventilation = less PaCO2 (respiratory alkalosis) = 2 days later compensation for respiratory alk by lowering HCO3

53
Q

normal pO2 room air/trachea
normal pO2 expiratory in alveoli
normal pCO2 expiratory in alveoli

A

breathed in air has pO2 160 which will decrease to arteries during expiration will increase PVR due to less radial 150 mmhg in trachea…as it gets to alveoli it will equilibrate to about 104 mmhg…meanwhile blood being brought into alveoli for gas exchange will bring about pCO2 of 40 mmhg

if there is a perfusion defect, PE for example, tracheal pO2 and alveolar pO2 would equilibrate at 145 and pCO2 would be low

54
Q

when is PVR the lowest

A

fucntional residual capacity (volume after normal expiration)
at max inspiration and max expiration, high lung volumes will stretch due to expanding alveoli and extra alveolar

55
Q

how does interstitial lung disease affect lung volume, elastic recoil, and radial traction on airways

A

decreases lung volume due to fibrosis
fibrotic tissue will increase elastic recoil because fibrotic tissue will have INCREASED radial traction on airways
this will decrease FVC which will increase FEV1/FVC ratio

56
Q

patient prior hx of TB that was treated in the past develops hemoptysis with no fevers night sweats or weight loss…imaging shows old cavities filled with new round mass

A

aspergillus colonization

57
Q

what nerve to stimulate in OSA with loud snoring/gasping rspirations

A

hypoglossal….this will move tongue forards and increase anteroposterior diameter of airway reducing number of apneic events by holding airway open

58
Q

SOB with normal PaO2, nml Sa02, lowered O2 conent

A

anemia

59
Q

nml PaO2, nml Sa02 and increased O2 content

A

polycythemiaa

60
Q

decreased PaO2, decreased Sao2, decreased O2 content

A

high altitiude

61
Q

SOB with nml PaO2, SaO2, and oxygen content

A

cyanide poising

62
Q

major virulence factor causing epiglottitis in Hflu

A 
polysaccaride capsule (PRP, polyribosylribitol phosphate)
Hib vaccine is composed of PRP conjugated to tetanus toxoid)
63
Q

piriform recess in larynx houses what nerve

A 
internal laryngeal nerve (branch of superior laryngeal nerve CNX)....carries only sensory fibers
if damged (i.e. foreign body)...lose cough reflex
64
Q

which cardiac anomaly is associated with increased risk of circle of willis abnormalities, intracerebral hemorrhage, and AVMs?

A

coarctation of aorta

65
Q

what pattern of breathing is favored (decreased work o fbreathing) for diseases with increased elastic resistance vs obstructive disease

A

elastic resistance - quick shallow breaths, work o fbreathing goes down as RR goes up
obstructive - deep long breaths…work of breath goes up the faster you breathe

66
Q

how long do you have to be vegetarian to become vitb12 deficiency and get anemia

A

years!!!!!!!!!!!!

if you get a lil hoe who’s only been vegetarian for a few months, she mostly likely got IDA from her period yo

67
Q

most common predisposing condition to native valve endocarditis in developing and non developing nations

A

MVP - developed

rheumatic heart dx - nondeveloped

68
Q

malignant cells often show decreased binding of integrin with….

A

fibronectin, colagen, and laminin

all components of normal extracellular matrix

69
Q

composition of benign lung hamartomas

A

native tissue to lung but disorganized
cartilage, fibrous and adipose tissue

NOT ALVEOLAR TISSUE (bronchioalveolar carcinoma)

70
Q

How far to epithelial cilia reach

A

terminal bronchioles

goblet cells, glands, cartilage only go up to respitary bronchioles

71
Q

what does left heart failure do to lung compliance

A

backed up fluid accumulation into lungs WILL INCREASE lung compliance

72
Q

MOA of vareniciline

A

partial agonist to nicotine (a4B2 nicotininc) receptor so will reduce withdrawal cravings while slightly inducing some weak reward effects of normal nicotine

73
Q

MOA of succinylcholine

A

deploarizing block
prevents repolarizing of motor end plate….has two phases
first decreases but maintains constant stimulation in phase I
in phase II there is a fading of response across multiple stimulations

74
Q

MOA of vecuronium

A

NONdepolarizing nmj block….depolarizes ….progressive reduction of train of four stimulation immediately by competitively inhibiting post synaptic

75
Q

pancytopenia, bone marrow biopsy empty fat cells, no LAD or splenomegaly

A

mcc idiopathic aplastic anemia

76
Q

what changes are seen 0-4 hours after post MI in myocardium

A

NONE BITCH

takes 4 hours to see changes

77
Q

asian male smoker with painful foot ulcers and exertional calf pain demonstrates hypersensitivity to intradermal injected tobacco extract

A

buerger’s disease
segmental thrombosing vasculitis that extends into contiguous veins and nerves
affects medium sized vessles
priniipally tibila and radial arteries

78
Q

BRCA1BRCA2 responsbile for

A

tumor suppressor genes involved in DNA repair

A_First Aid Random Memorizing (17 decks)

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