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uworld > PULM1 > Flashcards

PULM1 Flashcards

1
Q

RESTtrictive or obstructive in ARDS

A

restrictive\ca

cause pul edema

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2
Q

atelectasis restrictive or obsturcitve

A

restrictive

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3
Q

why does asthma have an increase DLCo

A

due to increased pulmonary capillary blood volume

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4
Q

Rheumatoid arhtitis obstructive or restrictive

A

restritctive

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5
Q

which T cell increased in COPD

A

cd8 T cells

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6
Q

bronchiolitis obliterans affects the

A

small aireways

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7
Q

hypoxic vasconstriciton improves VQ mismath by

A

decreaseing phys shunting in poorly ventialted alveoli leading to overall more efficient gas exchagne

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8
Q

PUL HTN complication of

A

CREST syndrome

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9
Q

no normal PFT in hypoxic vasoconstriction

A

TRUE

seen in chronic lung disease or hypoventilation syndromes

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10
Q

destruction of vascular beds

A

emphysema: raisess vasculare resistance; contributing to PAH

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11
Q

cavitary lung lesions caused by

A

aggregations of activated leuklocytes

( release of proteases, NO, ROS) cause cavitary ; damage

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12
Q

stimulation of hypoglossal nerve does what

A

cause tongue to move forward slighlty; increasing AP dimater of airway

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13
Q

reid index is the ratio of

A

thickness of submucosal bronchial glands to thickness of bronchial wall bw epithelial basement membrane and bronchial cartialges

mucous glands/submucos + lp

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14
Q

larger diamter, shroter, and more vertically oreinted

A

right main bronchus

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15
Q

where should thoracentesist be performed

A

above 8th rib in midclavicular line, the 10th rib along midaxillary line, and 12th rib along posterior scapualr or paravertebral line

lower than these poitns: increase risk of penetrating abdominal structures

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16
Q

lung is located about 8th in mid axillary

A

true

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17
Q 
staph aureus
burkholderia cepacia
serratia marcescens
nocardia
aspergillus
A

CGD

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18
Q

2 major mechanisms of hypoxemia in advanced COPD

A
  1. emphsyemaptous destructio nof alveolar capillary membrane results in impaired diffusion of O2
  2. airway obstruction (due to bronchial inflammation and mucus secretion) and air-trapping (due to both bronchial inflammation and emphseymeatous airway collapse ) cause vq mismatching
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19
Q

air trapping leads to an increase in

A

FRC in pt’s w copd

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20
Q

perpetual collapsin force on lugns caused by

A

alvoelar transmural pressure always being positive

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21
Q

ARDS assoc intersitial edema and hyaline membrane formation along w fluid filled alveoli collapse and atelectasis result in decreased lung compliance and increased work of breathing. the fluid filled, collapsed alveoli are unable to deliver oxygen despite continuing to receive adequate blood flow, resulting in Vq mismatch and hypxoia

A

true

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22
Q

ARDS incraese or decrease lung complaicen

A

decrease

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23
Q

inspissated mass green

A

meconium ileus

dehdyrated meceoniem

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24
Q

most common cause of ddeeath in hirschprung

A

enterocolitis

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25
Q

impaired fodling and glycoyslation of CFTR

A

Cystic fibrosis

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26
Q

eosinohils recruited by

A

IL5

27
Q

decrease ERV is most focmmon dinicator of

A

obestiy related disease

28
Q

classic triad in fat embolism syndrome

A

neurologic abnormality
hypoxemia
petechiae

29
Q

astham has no effect on

A

lung compliacnce

30
Q

VTE prohylaixixs

A

lmwh

31
Q

high vq regions have large capacity to

A

exhale additional co2

32
Q

why does hyperventialtion not significantly improve arterial oxygenation

A

hemoglobin is nearly fully satured w o2 in areas of normal vq ratio, there is little capacity for high vq regions to increase blood o2 content much furtehr

33
Q

pulm edema affecss where in lung

A

lung bases

34
Q

untreated OSA causes

A

pulmonary Hypertension

35
Q

cancers located in apex of lung

A

superior sulcus

36
Q

anterior mediastinum mass

A

thymoma, teratoma, thyroid cancer, terrible lymphoma

37
Q

VTE vs tricuspid valve endocarditis

A

tricuspid valve: high grade fever, recent IV drug use; multiple infarcts

38
Q

primary site of lactate clearance

A

liver

39
Q

lactic acidosis in septic schok results from tissue hypoxia which

A

impairs ox phosphorylation and causes shunting of pyruvate to lactate following glycosis. tehre is a buildup of nadh

40
Q

initial treatment of choice for sacrocidois

A

oral glucocorticoids 9prednisone)

41
Q

syphillis

A

caseating granulomas

rash on maculopapulor involved palms and soles

42
Q

OSA

resp effort

A

resp effort adquate THROUGHOUT

43
Q

cheyne-stokes breathing seen in

A

advanced CHF

44
Q

cyclic breathing patternr in which apnea is followed by gradually increasing then decreasing tidalvolumes until next apneic period

A

cheyne stokes breathing

45
Q

chesst tube for drainigae of pleural effusion into 4th or 5th ics in anterior axillary or midaxillary lin traverses

A

serratus anterior muscle
intercostal muscles
parietal plerua

46
Q

heart failure cells seen in

A

CHRONIC left heart failure

if acute; more likely transudate cardiogenic pulm edema

47
Q

neutrophils in alveolar fluid

A

exduate

48
Q

restoring CFTR proteins to emmbrane

A

lumacaftor

49
Q

enhance protein function

A

ivacaftor (chloride transport)

50
Q

whorled collagen fibers and dust laden macs

A

silicosis

51
Q

sound vibrations travel faster and more efficeintly thorugh liquids than gases thus

A

increased breath sound, increased tactile fremiuts
lobar consolidiaton
pulm edema

52
Q

peripheral chemoreceptors located in the

A

carotid and aortic bodies

53
Q

in copd: what decreses

A

peripheral chemoreceptors.
remember not senstiive to paco2; so peripheral becomes major drive (hypoxemia)
peripiheral chemoreceptors are primarily responsbile for sensingpao2; and can be suppressed with oxygen administraiton

54
Q

lung apices extend above

A

clavicle and first rib

55
Q

ansa cervacilis

A

arise from c1, c2, c3 nerve roots and innervates sternohyoid, sternothyroid, omohyoid
penetrating trauma to neck above cricoid cartialage can injure this nerve

56
Q

leakage of protein-rich fluid in alveolar airspaces

A

lobar pneumonia; happens in congestion
neutrophils respond to bacterial components by releasing cytokines that increase permeability of pulmonary capillary endothelium

57
Q

excesssive fibroblast proliferation and ecm matrix depsotion

A

idopathic pulmonary fibrosis

58
Q

absolute vs relative

erythrocytosis

A

absolute has a true increase in RBC mass

Relative Has a normal rBC mass

59
Q

relative erytrhocytosis due to dehydration or

A

excessive diruessis

normal RBC mass

60
Q

causes lung abscess formation driven by

A

neutrophil recuritment and activation leading to release of cytotoxic granules that kill bacteria but also cause liquefying necorsis of surrounding tissue

61
Q

decrease chest wall compliance

A

increases work of breathing

62
Q

UTI: sepsis leads to what pulm

A

ARDS

63
Q

wedge shaped areas of hemorraghic necrosis caused

A

by pulmonary embolism

64
Q

SVC sydnroem caused by

A

anterior mediastinal mass

uworld (14 decks)

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