Pulm Flashcards
Recall the mnemonic for the Q-coupled receptors.
“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
How does surfactant affect lung recoil and compliance?
Decreases recoil, increases compliance
What do club/clara cells do?
Secrete components of surfactant
Degrade toxins
Act as reserve cells
Persistently low O2 in fetal lung –> risk of __________.
PDA
How do each of the following affect surfactant production:
- Insulin
- Glucocorticoids
Insulin decreases production
Glucocorticoids (eg maternal stress) increases production
- Decreased in C-section
Consequences of supplemental O2 to infant?
RIB
Retinopathy of prematurity (blindness)
Intraventricular hemorrhage
Bronchopulmonary dysplasia
When does lung epithelium transition from pseudostratitifed ciliated columnar epithelium to cuboidal cells?
When do cilia terminate?
When do cartilage/goblet cells terminate?
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]
What bi-four-cates at C4?
What bi-four-cates at T4?
What bi-four-cates at L4?
C4 = Common carotid T4 = Trachea L4 = Abdominal aorta
What is the physiological dead space formula?
“Taco Paco Peco Paco”
Vd = Vt x (PaCO2 - PeCO2)/(PaCO2)
What does methemoglobinemia p/w?
Cyanosis and chocolate-colored blood
Why is CO poisoning a problem?
Causes left shift -> decrease O2 release in tissues
Give an eg of a diffusion limited substance.
CO
O2 (in emphysema or fibrosis, for eg)
How do flow, pressure, and resistance relate?
Q = P / R
P = Q x R
R = P / Q
(deltaP, really. Q = flow)
What is the alveolar gas equation?
PAO2 = (estimated)
PAO2 = 150mmHg - PaCO2 / 0.8
What is the imaging test of choice for DVT?
What about for PE?
Compression US
CT pulmonary angiogram
Classic triad of fat embolus?
- Hypoxemia
- Neuro abnormalities
- Petechial rash
What is Homan sign?
Calf pain on foot dorsiflexion => DVT
Conditions a/w bronchiectasis?
Smoking
Kartagener’s
CF
ABPA
[bronchiectasis: necrotizing infection of bronchi -> permanently dilated airways, purulent sputum, recurrent infections, hemoptysis, clubbing]
What is Caplan syndrome?
RA & pneumoconiosis w/intrapulmonary nodules
Which of the pneumoconioses affect the lower lobes?
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.
Causes of ARDS?
SPARTAS Sepsis Pancreatitis/PNA Aspiration uRemia Trauma Amniotic fluid embolism Shock
What is the major consequence of obesity hypoventilation syndrome?
Increased PaCO2 at night continues during the day (retention)
What happens to the pulmonary arteries in pulmonary HTN?
Arteriosclerosis
Medial hypertrophy
Intimal fibrosis
Hereditary pulmonary arterial HTN often due to a mutation in what gene?
BMPR2 (normally inhibits vascular smooth muscle)d
