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Step 1 > Pulm > Flashcards

Pulm Flashcards

1
Q

Recall the mnemonic for the Q-coupled receptors.

A

“KISS and KICK till you’re SICK of SEX” (QISS and QIQ till you’re SIQ of SQS):

alpha1=Q
alpha2=I
beta1=S
beta3=S

M1=Q
M2=I
M3=Q

D1=S
D2=I
H1=Q
H2=S
V1=Q
V2=S
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2
Q

How does surfactant affect lung recoil and compliance?

A

Decreases recoil, increases compliance

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3
Q

What do club/clara cells do?

A

Secrete components of surfactant
Degrade toxins
Act as reserve cells

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4
Q

Persistently low O2 in fetal lung –> risk of __________.

A

PDA

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5
Q

How do each of the following affect surfactant production:

  • Insulin
  • Glucocorticoids
A

Insulin decreases production
Glucocorticoids (eg maternal stress) increases production
- Decreased in C-section

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6
Q

Consequences of supplemental O2 to infant?

A

RIB
Retinopathy of prematurity (blindness)
Intraventricular hemorrhage
Bronchopulmonary dysplasia

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7
Q

When does lung epithelium transition from pseudostratitifed ciliated columnar epithelium to cuboidal cells?

When do cilia terminate?

When do cartilage/goblet cells terminate?

A

Beginning of terminal bronchioles

Respiratory bronchioles

Bronchi (prior to bronchioles)

[so first you lose cartilage/goblet cells after bronchi, then you lose pseudostratification at terminal bronchioles, then you lose cilia last at the respiratory bronchioles]

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8
Q

What bi-four-cates at C4?
What bi-four-cates at T4?
What bi-four-cates at L4?

A 
C4 = Common carotid
T4 = Trachea
L4 = Abdominal aorta
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9
Q

What is the physiological dead space formula?

A

“Taco Paco Peco Paco”

Vd = Vt x (PaCO2 - PeCO2)/(PaCO2)

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10
Q

What does methemoglobinemia p/w?

A

Cyanosis and chocolate-colored blood

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11
Q

Why is CO poisoning a problem?

A

Causes left shift -> decrease O2 release in tissues

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12
Q

Give an eg of a diffusion limited substance.

A

CO

O2 (in emphysema or fibrosis, for eg)

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13
Q

How do flow, pressure, and resistance relate?

A

Q = P / R

P = Q x R

R = P / Q

(deltaP, really. Q = flow)

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14
Q

What is the alveolar gas equation?

PAO2 = (estimated)

A

PAO2 = 150mmHg - PaCO2 / 0.8

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15
Q

What is the imaging test of choice for DVT?

What about for PE?

A

Compression US

CT pulmonary angiogram

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16
Q

Classic triad of fat embolus?

A
  • Hypoxemia
  • Neuro abnormalities
  • Petechial rash
17
Q

What is Homan sign?

A

Calf pain on foot dorsiflexion => DVT

18
Q

Conditions a/w bronchiectasis?

A

Smoking
Kartagener’s
CF
ABPA

[bronchiectasis: necrotizing infection of bronchi -> permanently dilated airways, purulent sputum, recurrent infections, hemoptysis, clubbing]

19
Q

What is Caplan syndrome?

A

RA & pneumoconiosis w/intrapulmonary nodules

20
Q

Which of the pneumoconioses affect the lower lobes?

A

Asbestosis (all others affect upper lobes)

Asbestosis is from the roof but affects the base, silica and coal are from the base but affect the roof.

21
Q

Causes of ARDS?

A 
SPARTAS
Sepsis
Pancreatitis/PNA
Aspiration
uRemia
Trauma
Amniotic fluid embolism
Shock
22
Q

What is the major consequence of obesity hypoventilation syndrome?

A

Increased PaCO2 at night continues during the day (retention)

23
Q

What happens to the pulmonary arteries in pulmonary HTN?

A

Arteriosclerosis
Medial hypertrophy
Intimal fibrosis

24
Q

Hereditary pulmonary arterial HTN often due to a mutation in what gene?

A

BMPR2 (normally inhibits vascular smooth muscle)d

25
Q

What drugs can cause pulmonary HTN?

A

Coke, speed

26
Q

Which lung abnormality has increased fremitus?

A

Consolidation: lobar PNA, pulmonary edema

27
Q

What is chylothorax?

A

A lymphatic pleural effusion

due to thoracic duct injury from trauma/malignancy; increased triglycerides

28
Q

What’s #1 and #2 most common bugs to cause lobar PNA?

A

1) Strep pneumo

2) Legionella

29
Q

What is bronchopneumonia?

What bugs cause it?

A

Patchy distribution involving >/= 1 lobe

Strep pneumo, S aureus, H flu, klebsiella

30
Q

Besides mycoplasma, Chlamydia, and legionella, what else causes atypical (interstitial) PNA?

A

RSV, CMV, influenza virus, adenovirus

31
Q

Stains positive in mesothelioma?

A

Cytokeratin+
Calretinin+

(smoking is not a r/f)
(+psammoma bodies)

32
Q

How is the mgmt of small cell lung cancer different from the others?

A

Not removed- use chemo/radiation

[chromogranin+, enolase+]

33
Q

Mutations of adenocarcinoma of the lung?

A

EAK:

EGFR
ALK
KRAS (smokers)

Step 1 (15 decks)

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