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Pulm & Heme > Pulm Extras > Flashcards

Pulm Extras Flashcards

0
Q

alveolar oxygen equation

A

PAO2=150-PCO2/.8

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1
Q

exhaled CO2 equation

A

Vt(PaCO2-PeCO2)=Vd(PaCO2)

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2
Q

complex alveolar oxygen equation

A

PAO2=FiO2(Patm-Ph20)-PCO2/R

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3
Q

Aa gradient equation

A

A/a=(150-PCO2/.8)-PaO2

A/a= PAO2-PaO2

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4
Q

> 10mm Aa gradient suggests

A

gas exchange problem

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5
Q

gas flow equation

A

Vgas=A/T*Dk(PA-Pc)

flow increases with area, decreased thickness, better diffusion and more pressure from alveolus to capillary

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6
Q

5 causes of hypoxia

A 
decreased cardiac output
hypoxemia
anemia
carbon monoxide
cyanide
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7
Q

mec of hypoxia via hypoxemia

A

decreased PaO2, O2 sat of hemoglobin, O2 in blood

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8
Q

mec of hypoxia via anemia

A

decreased hemoglobin concentration, O2 in blood

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9
Q

mec of hypoxia via carbon monoxide poisoning

A

less O2 in blood, left-shift of hemoglobin curve

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10
Q

mec of hypoxia via cyanide

A

less O2 utilization by tissue

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11
Q

no cartilage or goblet cells

A

terminal and respiratory bronchioles, alveoli

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12
Q

no cilia or smooth muscle

A

respiratory bronchioles and alveolus

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13
Q

5 causes of hypoxemia

A 
increased altitude
hypoventilation
diffusion defect
v/q defect
RL shunt
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14
Q

3 cause of hypoxemia with increased Aa gradient

A

diffusion defect, V/Q defect, RL shunt

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15
Q

cause of hypoxemia not helped by supplemental O2

A

RL shunt

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16
Q

squamous and thin

A

type 1 pneumocytes

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17
Q

cuboidal, secrete surfactant, precursor to I and II pneumocytes

A

type II pneumocytes

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18
Q

nonciliated, columnar, secrete component of surfactant

A

clara cells

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19
Q

muscles in exercise inspiration

A

external intercostals, scalenes, SCM

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20
Q

muscles in exercise expiration

A

abs, internal intercostals

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21
Q

shift curve right (less affinity) 5

A

increased PCO2, temp, 2,3PG
decreased pH,
exercise

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22
Q

shift curve left (more affinity) 5

A

decreased PCO2, temp, 2,3DPG
increased pH
fetal hemoglobin

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23
Q

High HR in modified wells

A

100 BPM (1.5)

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24
Q

wells points for DVT, PE

A

> 2, >4

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25
Q

PaO2, PaCO2 in exercise

A

stay the same

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26
Q

arterial pH in exercise

A

decrease (strenuous)

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27
Q

V/Q ratio in exercise

A

more evenly distributed

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28
Q

dead space in exercise

A

decreases

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29
Q

PAO2, PaO2 at high altitude

A

decreases

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30
Q

RR, pH, Hgb, 2,3DPG, PVR, PAP at high altitude

A

go up

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31
Q

top of lung

A

vent is lower, v/q high

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32
Q

bottom of lung

A

vent is higher, v/q is lower

33
Q

decreased O2 delivery to tissues

A

hypoxia

34
Q

PEEP benefits 4

A

prevent alveolar collapse, lower shunt fraction, improve LV function, decrease autoPEEP (usually 3-5)

35
Q

PEEP harm 2

A

increase airway pressure, decrease cerebral perfusion

36
Q

incomplete exhalation, leads to air trapping

A

autoPEEP

37
Q

treat autoPEEP 4

A

lower TV/RR
increase inspiratory flow rate (makes exhale longer than inhale)
treat airflow obstruction
temporarily disconnect the vent

38
Q

70% of CF mutations

A

deltaF508 (block in gene processing)

39
Q

reabsorbs Cl from sweat

A

CFTR

40
Q

positive sweat test

A

> 60 mEq/L

41
Q

airflow obstruction definition

A

FEV1/FVC < .7

42
Q

chronic bronchitis criteria

A

persistent cough/sputum for at least 3 months

for 2 consecutive years

43
Q

may also cause liver disease?

A

AAT deficiency (basilar emphysema)

44
Q

shunt or diffusion defects contribute to hypoxemia in COPD

A

no

45
Q

pulmonary edema *always due to

A

osmosis of fluid from pulmonary capillaries

46
Q

ARDS gas exchange criterion

A

PaO2/FiO2 <300

47
Q

FiO2 in room air

A

.21

48
Q

ARDS risk factors 5

A

fat, old, ill-fed, EtOH & cirrhosis

49
Q

refractory hypoxemia, shunt, decreased compliance, hyaline membranes

A

exudative ARDS (2-3 days)

50
Q

increased dead space and Ve, pulmonary HTN, type II pneumoncyte hyperplasia

A

ARDS proliferative stage

51
Q

mostly likely thrombus to embolize

A

popliteal and proximal veins

52
Q

inherited risk factors for VTE 5

A

V leiden, prothrombin mutation, S, C, antithrombin deficiency

53
Q

d-dimers are elevated in nearly all cases of

A

DVT. sensitive, not specific

54
Q

anatomic disposition to DVT

A

May-Thurner: squashed left iliac vein

55
Q

untreated DVTs leading to PEs

A

50%

56
Q

untreated PEs leading to death

A

30%

57
Q

hypoxemia and respiratory alkalosis

A

PE?!

58
Q

mec of hypoxemia in PE

A

VQ mismatch and shunt

59
Q

do anticoagulants accelerate thrombus lysis?

A

no

60
Q

recurrent PE frequency, mortality

A

3%, 79%

61
Q

over 40, limited mobility for 3 or more days, or other risk factor

A

consider PE prophylaxis

62
Q

empyema

A

pus in the pleural space

63
Q

denser, infection inflammation malignancy

A

exudate

64
Q

less dense, (<.5 protein, .6 LDH), heart failure, cirrhosis

A

transudate

65
Q

rare, milky, lipid rich, exudative

A

chylothorax (50% trauma)

66
Q

rare, unilateral, usually neoplasm or obstruction

A

urinothorax

67
Q

very rare, pleural effusion with ascites and benign ovarian tumor

A

meig’s syndrome

68
Q

rare fatal spontaneous pneumothorax/pleural effusion in young female

A

lymphangioleiomyomatosis

69
Q

centrilobar nodules that aren’t TB or bacterial infection

A

hypersensitivity pneumonitis

70
Q

opiods, trauma, stroke, increased ICP, bihemispheric infarc

A

cluster breathing

71
Q

mean PAP over 25

A

PH

72
Q

mean PAP over 25, PCPW less than 15

A

PAH

73
Q

most frequent PAH symptom

A

exertion dyspnea

74
Q

PAH risk factors 7

A

FHx, premature, CTD, congenital heart disease, portal HTN, environment/drugs, HIV

75
Q

9-15% of adult asthma

A

occupational

76
Q

requires desensitization period

A

immunological occupational asthma

77
Q

alveolar filling (acute) & nodular opacities (chronic)

A

silicosis

78
Q

parenchymal & pleural disease, malignancy, ferruginous bodies, plaques, BAPE and atelectasis (PE and collapsed lung)

A

asbestosis

79
Q

noncaseating granulomas, looks like sarcoid, treat with steroids

A

berylliosis (T cell rxn to beryllium)

Pulm & Heme (6 decks)

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